What if that 30 minutes could be cut down to just five minutes a day? A new study out of the University of Colorado at Boulder is proposing just that through a breathing exercise called inspiratory muscle strength training (IMST). The study found that doing IMST for five minutes a day could be even more effective at lowering blood pressure than aerobic exercise or even medication. What exactly is IMST and could it truly be as beneficial as the study suggests? A renowned cardiologist unaffiliated with the study gives his honest thoughts.
What Is Inspiratory Muscle Strength Training (IMST)?
For the study, 18 participants between the ages of 50 and 79 with high blood pressure (but who were otherwise healthy) did the IMST training for six weeks. Another group of 18 people (also between the ages of 50 and 79 with high blood pressure but no other health conditions) did a placebo exercise. At the end of the six weeks, the researchers found that the participants who did IMST experienced a blood pressure drop of an average of nine points, which is about the same as what someone who exercises for 30 minutes a day or takes blood pressure medication would experience. So, what is IMST? Dr. Howard Weintraub, MD, the clinical director of the Center for the Prevention of Cardiovascular Disease at NYU Langone Health, explains that IMST is done by breathing through a scaled tube that uses resistance to strengthen the muscles used to breathe. Think of it as strength training for your diaphragm. Similar to how lifting weights in the gym can make your arms stronger, IMST uses resistance to make the diaphragm stronger. Dr. Weintraub, who is unaffiliated with the University of Colorado study but is knowledgeable about IMST, says that IMST is vastly different from aerobic activity. What they have in common is that both IMST and aerobic exercise make it more difficult to breathe. The major difference between them is that IMST focuses on the diaphragm and unlike aerobic exercise, it does not increase heart rate. He explains that the way IMST was used in the study is that participants took five breaths and then rested for a minute, which they repeated for five minutes. “The whole idea of aerobic exercise is that you have a sustained heart rate,” he says. “This would be like telling someone to walk for 15 seconds and then take a minute to recover.” In other words, it prevents heart rate from elevating, something that has repeatedly been shown to effectively lower blood pressure. Also, unlike aerobic exercise, Dr. Weintraub says that IMST will not lead to weight loss—an important point given that obesity is a risk factor for high blood pressure. While we know through scientific studies that aerobic exercise helps lower blood pressure because it makes the heart stronger, which allows it to pump more blood with less effort and decrease the force put on the arteries, the researchers of the study were not able to explain why IMST effectively lowered blood pressure; they just observed that it did.
Can IMST Really Replace Aerobic Exercise and Medication?
While Dr. Weintraub thinks this new study about IMST and blood pressure is interesting, he doesn’t advocate ditching exercise or prescription meds for a five-minute daily breathing exercise. First, he points out that the study is very small; there were only 36 people, which is not comparable to the millions of people taken into account in the many, many studies on aerobic exercise and blood pressure. Second, he reiterates that the researchers can’t explain the results. With this in mind, certainly more scientific evidence is needed to establish a firm connection between IMST and lowering blood pressure. Instead, he says that where IMST could come in handy is in addition to other healthy habits including regular exercise, eating heart-healthy foods and taking prescription medication (if necessary). He says that it won’t hurt and could benefit cardiovascular health in a complementary way. There are other ways that aerobic activity makes for a better choice, in the exercise versus IMST debate. Briskly walking for 30 minutes is free while IMST requires a special tube and training. Aerobic activity is also linked to benefitting mental health, as well as helping lower depression and anxiety. IMST is an interesting idea, but it’s likely not the shortcut some may have been hoping for. So don’t throw away your sneakers just yet; regular exercise will still do your body a whole lot of good. And that’s advice worth taking to heart. Next up, find out why blood pressure went up during the pandemic.
Sources
Dr. Howard Weintraub, MD, clinical director of the Center for the Prevention of Cardiovascular Disease at NYU Langone HealthExercise: A drug-free approach to lowering high-blood pressure. Mayo Clinic. Accessed 10/10/22.Craighead D, Heinbockel T, et al. Time-Efficient Inspiratory Muscle Strength Training Lowers Blood Pressure and Improves Endothelial Function, No Bioavailability, and Oxidative Stress in Midlife/Older Adults With Above-Normal Blood Pressure. Journal of the American Heart Association. 2021;10(13). Cao L, Li X, et al. The effectiveness of aerobic exercise for hypertensive population: A systematic review and meta-analysis. American Journal of Hypertension. 2019;21(7):868-876.Jiang SZ, Lu W, et al. Obesity and hypertension. Experimental and Therapeutic Medicine. 2016;12(4):2395-2399.Smith P, Merwin R. The Role of Exercise in Management of Mental Health Disorders: An Integrative Review. Annual Review of Medicine. 2021;(72):45-62.
