5-min breathing workout lowers blood pressure as much as exercise, drugs (2021)

I got a pulse oximeter a couple years ago too, and it was eye opening (before COVID, and I didn't get COVID).

The realtime feedback is useful and actionable. Breathing more slowly, exhaling more than inhaling (counterintuitive), pausing, and breathing through the nose definitely make a difference for me.

But everyone is a little different so you have to experiment. Breathing is very multidimensional and hard to explain. The Nestor book is a good intro, and I've mentioned it on HN a few times before.

I'm a big believer now. It is almost laughably simple, and I have to cite the fact the fact that no company profits if you breathe better, sleep better, etc. It's a trite saying but true ...

You say “their technique” and “this new tool”. For someone who hasn’t read Hof and Nestor, could you point to any resources explaining the specific techniques you are referring to? If I go down the Google/YT rabbit hole, I fear I’ll be confronted with hundreds of such techniques and just get utterly confused. Thank you.

wim-hof is a life saver. I used during my covid battle as well. I had this video https://www.youtube.com/watch?v=tybOi4hjZFQ on loop when I was suffering with covid

Wim Hof is really good, the calmness you feel after the breathing is unmatched.

There all these small techniques for managing emotions that are just not well known. If you need to calm down in the moment for example, doing a simple inhale for 4 seconds, hold for 2, exhale for 8 can make your stress melt away. Or in really stressful situations, try grabbing an icepack and holding it for a minute.

The article is about IMST, which is strictly about muscle strengthening. This is maybe a side effect of the Wim Hoff Method, but the WHM also has other purposes because the main mechanism is hyper ventilation and breath holding. Here is good medical explanation of what happens when practicing the WMH (by a medical professional): https://www.youtube.com/watch?v=D6EPuUdIC1E (summary at 33:46).

When I worked on Mt Erebus we used to play pulseox bingo: see who could match their O2 saturation to their pulse at the lowest or highest value.

I also watched Wim Hof on youtube during the pandemic, he even made a video regarding Covid at that time

Well, I never really got Covid myself, I feel good knowing your recovery experience with that method

Now, I should start using Wim Hof or similar method already

Do you have a cheat sheet or video we can watch to get the gist? Thanks!

https://www.youtube.com/watch?v=tybOi4hjZFQ It's amazing.

do you mean it increased your running time?

Where can you buy one? Which one did you buy? Does it require a prescription?

>their techniques

can you link to the exact regimen? tia

The only beef i have with Wim Hof is he says one's attitude matter in following his method. He says a person should be open minded and accept without ego, something along those lines. The problem is its not quantifiable and kind of cop-out, so I don't take it too seriously.

When recovering after exercise, the body does something called overcompensating. It doesn't just repair the damage done but actually strengthens the area. Muscles undergo hypertrophy and bone becomes more dense. So when you challenge the body physically a moderate amount, something called functional overreaching, your body responds by actually strengthening itself. Obviously inanimate objects don't have this system so they simply wear out over time

There are a lot of low level mechanisms that improve health with exercise. The basic breakdown is some things like digestion where optimized by evolution around the fact our ancestors moved. For similar reasons UV light in childhood are a requirement for normal vision exercise was simply universal for a very long time.

A lower level example is feedback mechanisms. Mechanical stress from motion are used to maintain bone strength. The cells involved in bone breakdown and repair can detect damage and reinforce where needed, but they also remove bone where it’s not needed. Without that kind of feedback our bones would either be weak or heavy.

The same thing happens with your circulatory system, you grow new capillaries in response to demand. Or for a “negative” example fat cells reproduce when you can store more energy.

An extension to that question: Why do people say elevating your heart rate is good in relation to exercise, and bad in relation to cocaine? People frequently say things like "stimulants stress your circulatory system", but so does exercise.

Simple machines don't have internal processes that rebuild themselves to be stronger after wear and tear.

Bodies heal unlike machines. Maintaining capacity of tissues has energy costs. The body does not want to waste energy maintaining capacity that it does not need. Therefore if your day to day existence does not demand a high level of fitness to function, you will decondition . You must provide stressful stimulus to the body to let it know the level of condition it needs to maintain to be properly adapted.

Rubber band can't dynamically detect and repair weared off molecule clusters.

Mammals are highly adoptive by the design, a living organism consists of trillions programmed and partially controllable nanomachines.

Body has autonomous and centralised systems, which checks and sends hormonal signals and redistribute resources from other parts and could directly command specific cell groups to grow or change behavior in a chance to increase organism survivability.

The human body doesn’t shut down so much as idle. There are mechanical systems that don’t like to idle, like air cooled engines. Anything that maintains itself as part of vigorous operation (flushing out pipes, circulating lubricants or coolants) can get into trouble if not operated vigorously enough for too long. You need to “exercise” your car every few weeks or the battery dies.

Not exactly what you were asking for, but Nassim Taleb's "Antifragile" might be of interest to you. It's about how many human made things e.g. machines, the economy, etc. are fragile and get weaker/collapse under stress. In contrast many organic things (e.g. muscles) are antifragile, i.e., they gain from (small) stressors. Definitely an interesting read.

Your body has a hypertrophy response to exercise stress.

The low-level mechanism could be the endocrine system and its production of anabolic hormones, depending on how 'low-level' you are looking for.

Exercise is bad for your body. Recovery from exercise is very good.

If you have a simple machine that wears out then someone will be along to fix it, if it's of any use to do so and you have the budget. The body uses the same idea.

It is hard to give a short answer to your question but you will find the following books helpful (check reviews on Amazon and elsewhere on the Web);

1) Body by Science: A Research Based Program for Strength Training, Body building, and Complete Fitness in 12 Minutes a Week by John Little and Doug McGuff.

2) The Energy of Life: The Science of What Makes Our Minds and Bodies Work by Guy Brown.

Both human and simple machine wear out of exercise.

Human cells (controlled by DNA algorithm) repair the wear out parts via reinforcement learning.

My basic understanding is when we are strength training we are putting tiny tears in our muscle fibers. The body then uses protein to heal those tears and make the muscle fiber bigger as part of that process, allowing us to train even harder in the future.

Elastic bands are relatively just static objects.

In human body, new cells are created every day which is not case with elastic band. Best anology could be economy. If you keep creating wealth and not spending one day you reach your limitations. Continously churning and creating gives boost to economy.

Why is a machine an appropriate analogy to a living body?

life eg. cellular growth

Oxygen Advantage is a great book. I'd recommend James Nestor's - 'Breath' [0] as a first read, however. I feel like the book has more real world application and I picked up a number of things outside of what I learned studying Hof breathwork. I also studied, prior to both books, with Wim Hof in Poland in 2017 on one of his week long expeditions. The in person experience of group breath work is something to experience if you've never. It's so much different than working on it solo - especially if you're new to any of these methods.

Breath work and cold exposure have been a large part of my life after reading 'What Doesn't Kill Us' by Scott Carney [1]. That was the book that drove me want to experience it first hand.

[0] https://www.goodreads.com/en/book/show/48890486-breath [1] https://www.goodreads.com/book/show/30039048-what-doesn-t-ki...

Amazing book! My nasal breathing definitely improved from few simple tips from the book, and I wasn't even particularly diligent with following the program very far. I'm sure I could get even more benefits if I adhered to the exercises more consistently.

Please don't take this the wrong way, but is there a tl;dr? Often these "self-help" books are the same concept repeated for 200 pages that can be summed up in a paragraph.

How should I breathe?

Would this be helpful for someone who has chronic allergies and can’t breathe out of one nostril about 95% of the time?

Safety note for folks with uncontrolled hypertension: before squatting even just your body weight, read up on the Valsalva maneuver.

when I'm completely relaxed after a breathing workout, I sometimes dont "feel" the need of breathing, for long periods, is that normal?

Casual vs ambulatory blood pressure readings seem to account for the difference between what is reported in Table S2 and what is shown in the main paper. I don't know which kind of reading is more clinically significant or reliable. A little worrying that its not seen in the ambulatory too.

Comparing group means might not be quite so informative in any case, because of baseline effects (e.g. you'd want to do paired tests I think to compare the diffs)

Hmm this is a great catch. The figures quoted in their Methods and Results ("from 135±2 mm Hg to 126±3 mm Hg") don't seem to match any in Table 2.

If you are going to study effects on blood pressure in your own physiology, I very much recommend getting a home device so you can take a lot of measurements. Blood pressure changes constantly for any reason or (as far as I can tell) no reason.

When I take my own measurements, I take five measurements back to back without moving and see bigger swings that you did. I've seen that using three different home devices. I've seen it in clinical settings being measured by many, many professionals. I remember once seeing a thirty point swing between two measurements taken immediately back to back by a nurse. The sheer amount of downright superstitious behavior I've seen in nurses surrounding blood pressure measurements is pretty incredible, too: lots of retaking measurements until the number is what they expect, repositioning, or trying something random like you did. I find it all very reminiscent of the 2 4 6 Puzzle -- a lot more confirmation and explanation than investigation.

I'm not trying to say this sort of thing is statistically invalid at a population level. On the contrary. I'm pretty convinced in my own case that breathing exercises are worth about ten points. But I strongly recommend developing a healthy respect for the sheer variability of the number before drawing strong conclusions from a low number of measurements.

I agree, this is a great trick. I've been using it for almost 20 years and it's kinda funny to use around friends too, if you are playing around with home blood pressure equipment for any reason. Also take off any hats, wear loose-fitting clothing, wear sandals instead of shoes if possible, and uncross your feet if they are crossed.

Also if they are weighing you clothes-on, it's worth some care as well. A lot of doctors offices will happily register that you gained a significant amount of weight without taking into account that you are wearing work boots, jeans, a vest holding your phone, etc. vs. your last appointment in the summer when you were wearing shorts, a T-shirt, and sandals. Your doctor won't see any of this of course, so it's your word vs the EMR.

And finally, a friend tells me that you should always feel out the doctor first before showing them your full noot stack or other health experiments. ;-)

IIRC standard protocol is (don't know how closely adhered to) to give the patient a 5 minute resting period before doing a BP reading anyway.

My BP is always high while I'm talking

It might just be the sitting there for 5 minutes, and not so much the protocol. I get my BP checked regularly by my PCP's nurse. Usually they have me sit for a few mins and then come in to check. It's not uncommon that the first reading is higher than they'd like, and then they tell me to wait there for 5-10 mins and voila when they come back it's much lower.

> For anyone searching on youtube, he and other gurus make lot of tall claims and say irrational things, sell snake oil and are in general against western medicines, you'll have to ignore it.

That's the insidious thing about those gurus: they often couple genuinely healthful practices like mindful breathing and exercise and healthy diet with horrible things like snake oil remedies and religious intolerance - essentially using the former to try to legitimize the latter, and many who follow them are not equipped to distinguish one from each other.

How does it help?

Paper is linked in the article: https://www.ahajournals.org/doi/10.1161/JAHA.121.020980

Intervention section mentions that study participants used a device called 'POWERbreathe K3 inspiratory muscle training device'.

Googling the device provides these videos: https://www.youtube.com/watch?v=nd5U7mDhFi4 & https://www.youtube.com/watch?v=ZvtZW5Q1ox8

When I was working out in the gym in the summer in pandemic season with masks on, I noticed my breathlessness, the movement of the mask amplifies the visual and it was easy to draw a comparison in this way with my surrounding gym peers, and indeed I realized my lungs were in much worse shape than I'd expected, so I'm going to give this thing a try.

Edit: model featured in YouTube is not the same one the study used but close ‘nuff to get the idea.

Don't know for sure but from skimming the paper it looks like it's inhalation only. "Inspiratory muscle strength training (IMST) is an alternative form of physical training that uses the diaphragm and accessory respiratory muscles to repeatedly inhale against resistance." The words "exhale," "expire," and their various inflected forms don't appear anywhere in the paper.

I'm not sure I understand the question.

The point is to breathe in and out as strongly/deeply and slowly as possible. You don't "do" anything aside from breathing and increasing the difficulty mode as your strength improves (over e.g. weeks).

If you breathe out quickly you're losing a large amount of the benefit of the exercise.

PS - I own a POWERBREATHE Sport, no relation to the company or this study.

In the video on the webpage at 0:14 the patient is using the device only for inhaling, not for exhaling. I tried breathing through my fist and it worked really well. Since I am not interested in another device that I have to clean and carry with me on travels I will try the fist method in the next weeks.

While breathing during swimming is definitely “less easy” than normally, I would point out that when swimming you are not experiencing resistive airflow. But some trainer snorkels do include pieces to increase airflow resistance and it might have similar effects to IMST. I’m not sure if these are used by serious athletes though.

There are inhalation resistance trainers on Amazon for as little as $20. I'm doubtful the more expensive devices offer any benefits. In fact the simpler less expensive models look much easier to take apart and clean. As long as you are breathing against resistance, you're getting a benefit.

What grip exercises?

Just lift weights.

The follow up clinical trial.

This is especially true for pregnancy. The provider you choose has an extreme amount of power over you towards the end.

For my first we were basically threatened and coerced for near zero medical reason to get "interventions". Before we got to the hospital we were promised one thing, but when we got there it was break her water or find a new provider and potentially have our baby die.

We trusted the doctors even though we both felt coerced and lied to. It all culminated in an unnecessary C-section 12 hours later because the doctor was already woken up for someone else. She said our baby was going to have a much worse outcome. That we would just have a c-section anyway so we might as well just do it.

I think we both deal with the team from that still.

Just remember to interview your doctor's and find local patient outcomes. We wish we had the first time.

The second went with minimal intervention and, fingers crossed, the third will go the same.

Also it's not that we are against needed intervention or chosen intervention. We simple want the best outcome for everyone. Intervention imo should be a last resort or as needed for patients like my wife.

I had a similar situation a few years ago.

I knew I had strep, went to urgent care to get tested so I could get antibiotics. They said there was no way I had strep, and told me the white spots all over my throat were "stress cankers". I was really sick and ended up going back 2 hours later because I wasn't breathing well. They just blew it off again and wouldn't do anything for me.

5 hours later I was in the ER because I couldn't breathe and ended up having strep and pneumonia. ER doctor said I would have died if I had waited longer since I was had sepsis. He also told me that the strep test is only 50% effective so there is no way they should have been that dismissive of me.

Good that she could self-advocate!

https://en.wikipedia.org/wiki/White_coat_hypertension describes the condition.

You are completely correct with your TLDR. I saw the same when a close family member had to battle their way through the medical system to live through (and eventually overcome) advanced cancer.

I’ve started to see doctors more like advanced chatbots than anything else.

They are good if you know what you need and how to formulate your questions. They are good at searching UpToDate (a database of DDx flows). They are good at treating specific problems.

But it is a very rare doctor who takes considerate time to understand a patient and treat them holistically. I believe this is why alternative medicine providers are able to peddle their voodoo so effectively. Many people who don’t feel understood by allopathic medicine turn to cranks, because at least the cranks listen to them and make them feel heard.

That TLDR should be on every so-called physician's office, especially in America. Actual healthcare is your own duty. Most physicians are there for medicine/testing, which are both for-profit, and they are not incentivized to keep you in optimal health. In fact, they make a little bit more money if all of their clients are not too healthy... which is why so many doctors are moral injured from hospitals putting profits ahead of health when they realize they act as prescription and diagnosis drones for so many of their patients. It's better to call US "healthcare system" the "disease maintenance industry", as once you combine the "health" lobby with the "food" lobby, you see they work synergistically to keep consumers at sub-optimal health, and maximum profitability for all the leeches involved. Disgusting.

> TL;DR - doctors will kill you.

Personal opinion only but I think that in 100 years we will look back on the standard prescription drugs of the current era with the same mixture of horror and fascination that we feel today when we look back on the medicine of the 19th century.

I have a blood pressure monitor at home and my values can go from 140/100 to 110/80 within pretty short time. It's completely insane to make a medication recommendation after only one blood pressure measurement.

I wonder if they will come down in price. The internal mechanism doesn't seem to warrant a starting price of 400€.

>This is called Pranayam.

Does Pranayam involve high-resistance inspiratory breathing?

Anyway, this is about scientific investigation, not received wisdom and cultural or religious practice. Conceivably they could have found no effect; would you have "congratulated" them then?

What else do you believe the west is missing?

mainne englo shikshakon ke saath adhyayan kiya, lekin seedhe Sri BKS Iyengar ke vansh ke tahat. mere shikshak bahut satark the. main bahut achchhe svaasthy mein hoon aur tees saal baad ab meree achchhee aadaten hain. Light on Pranayama kee adhikaansh takaneeken ek shaharavaasee ke lie, yahaan tak ki mere lie bhee, bahut unnat hain.

edit: apologies for the terrible Hindi, but since YNews was so rude to a guest with a downvote, I wanted to show some respect to the South Asian knowledge. Yogas citta vritti naroda'ha -- namaste

Another commenter made this observation, but his comment was deleted by HN moderators.

I sure hope Elon Musk takes over Twitter so we will not need HN to have an open conversation.

> Walking isn't very aerobic.

Depends how much weight is in your pack

I bought this one for this purpose and it seems to work. ($25) https://www.amazon.com/Expand-A-Lung-BD12512-Breathing-Fitne...

You could try this instead. It has similar benefits.

https://highbloodpressurebegone.com/how-to-do-hand-grip-exer...

Seems to be available on the amazons: https://www.amazon.com/s?k=POWERbreathe

I haven't read the paper yet, so not going to impule-buy a $70 device yet, but the cheaper models seem interesting (assuming they operate on the same principle).

Interestingly enough, I entered a friend’s clinical research study last year where they’re looking to replace the standard cardiac stress test by proving their hypothesis.

Essentially, they believe that by purposefully engaging in a combination of deep/long/shallow/etc. ("Wim Hoff style breathing techniques" - my friend’s words not mine), and get a patient to hyperventilate basically (in a controlled environment and developed protocol/framework), they could produce similar results and draw similar clinical conclusions as one would after a traditional stress test. They had me do two hours of various breathing techniques while simultaneously imaging my heart and then my brain using fMRI imaging.

* NAD but I managed to get the DICOM files and found some open source software (Horos) and loaded up the slices and it was super cool seeing what was going on during the different breathing *

I recently caught up with the individual and was told the study is in its final stages and so far looks very promising (which I’m sure all researchers say right but I’ll give them the benefit of the doubt).

If you read the article you'll see this is an adjustment of a technique used since the 80s.

Considering it's an exercise protocol from the 1980s, probably not.

They mention power breathe device

https://www.powerbreathe.com/

And weight loss. See:

https://www.nhlbi.nih.gov/files/docs/public/heart/hbp_low.pd...

and

https://www.tn.gov/content/dam/tn/wfhtn/documents/wfhtn_aha_...

My brother, who is probably about 70 pounds overweight, takes blood pressure medication. Won't even try losing weight. He claims that "everyone he knows" takes it and just resigned to having to use it.

It's called Inspiratory Muscle Strength Training (IMST) and they are on the market: https://www.powerbreathe.com/ (and other manufacturers).

I believe this study used the POWERbreathe K-Series: https://www.powerbreathe.com/product-category/breathing-trai...

Amazon. PowerBreathe. Around $70.

Rather than post this completely useless comment, why don't you actually contribute by posting why you think this study should be ignored? I think many people in this comment section know from personal experience that breathing is a powerful tool for stress management so this result is intuitive to them.

BP tends to go up with age even being able bodied and active, so research into how to control it without medications (which have to be tuned to the individual and can have some unpleasant side effects) is worthwhile.

Why are you punishing yourself with unnecessary work if the easy way gets most of the benefit? Literally just breathe.

"But I like exercise" OK that's great for you, I have other things to do and not enough time to do them.