The effects of progressive muscular relaxation and breathing control technique on blood pressure during pregnancy

Mahboobeh Aalami, Farzaneh Jafarnejad, Morteza ModarresGharavi

Abstract


Background: Hypertensive disorders in pregnancy are the main cause of maternal and fetal mortality; however, they have no definite effective treatment. The researchers aimed to study the effects of progressive muscular relaxation and breathing control technique on blood pressure (BP) during pregnancy.

Materials and Methods: This three‑group clinical trial was conducted in Mashhad health centers and governmental hospitals. Sixty pregnant (after 20 weeks of gestational age) women with systolic BP ≥ 135 mmHg or diastolic BP ≥ 85 mmHg were assigned to three groups. Progressive muscular relaxation and breathing control exercises were administered to the two experimental groups once a week in person and in the rest of the days by instructions given on a CD for 4 weeks. BP was checked before and after the interventions. BP was measured before and after 15 min subjects’ waiting without any especial intervention in the control group.

Results: After 4 weeks of intervention, the systolic (by a mean of 131.3 to 117.2, P = 0.001 and by a mean of 131.05 to 120.5, P = 0.004, respectively) and diastolic (by a mean of 79.2 to 72.3, P = 0.001 and by a mean of 80.1 to 76.5, P = 0.047, respectively) BPs were significantly decreased in progressive muscular relaxation and breathing control groups, but they were not statistically significant in the control group.

Conclusions: The interventions were effective on decreasing systolic and diastolic BP to normal range after 4 weeks in both the groups. The effects of both the interventions were more obvious on systolic BP compared to diastolic BP.

 


Keywords


Blood pressure; breathing exercises; hypertensive disorders; muscle relaxation; pregnancy complications; pregnancy‑induced hypertension

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References


James PR, Nelson‑Piercy C. Management of hypertension before, during, and after pregnancy. Heart 2004;90:1499‑504.

Cunningham FG, Leveno JJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics. 23rd ed. United States: McGraw‑Hill Companies; 2010. p. 706‑56.

Mugo M, Govindardjan G, Kurukulasuria R, Sowers JR, McFaralane SI. Hypertension in Pregnancy. Curr Hypertens

Roberts JM, Pearson G, Cutler J, Lindheimer M; NHLBI Working Group on Research on Hypertension During Pregnancy. Summary of the NHLBI Working Group on Research on Hypertension During Pregnancy. Hypertension 2003;41:437‑45.

Amira OC, Okubadejo NU. Frequency of complementary and alternative medicine utilization in hypertensive patients attending an urban tertiary care centre in Nigeria. BMC Complement Altern Med 2007;7:30.

Gabbe SG. Obstetrics: Normal and Problem Pregnancies. Elsevier Health Sciences; 2007. p. 779-26.

Chen XK, Wen SW, Smith G, Yang Q, Walkera M. Pregnancy‑induced hypertension is associated with lower infant mortality in preterm singletons. BJOG 2006;113:544‑51.

Ananth CV, Basso O. Impact of Pregnancy‑Induced Hypertension on Stillbirth and Neonatal Mortality. Epidemiology 2010;21:118‑23.

Madadzadeh M, Feizi Z, Hagikazemi E, Haghani H. Mothers’ hypertension and neonatal birth weight. Iranian J Neonatal 2005;18:17‑26.

Miranda ML, Swamy GK, Edwards S, Maxson P, Gelfand A, James S. Disparities in maternal hypertension and pregnancy outcomes: Evidence from North Carolina, 1994‑2003. Public Health Rep 2010;125:579‑87.

Chen XK, Wen SW, Smith GN, Yang Q, Walker MC. New‑onset hypertension in late pregnancy and fetal growth: Different associations between singletons and twins. Hypertens Pregnancy 2007;26:259‑72.

Yücesoy G, Ozkan S, Bodur H, Tan T, Calişkan E, Vural B, et al. Maternal and perinatal outcome in pregnancies complicated with hypertensive disorder of pregnancy: A seven year experience of a tertiary care center. Arch Gynecol Obstet 2005;273:43‑9.

Everly GS Jr, Lating JM. The concept of stress. In: Everly GS Jr, Lating JM, editors. A Clinical Guide to the Treatment of the Human Stress Response. 2nd ed. New York: Springer; 2002. p. 3‑14.

Hernández‑Díaz S, Werler MM, Mitchell AA. Gestational hypertension in pregnancies supported by infertility treatments. Role of infertility, treatments, and multipl gestations. Fertil Steril 2007;88:438‑45.

Mikolajczyk RT, Zhang J, Ford J, Grewal J. Effects of interpregnancy interval on blood pressure in consecutive pregnancies. Am J Epidemiol 2008;168:422‑6.

Poon LC, Nicolaides KH. First‑trimester maternal factors and biomarker screening for Preeclampsia. Prenat Diagn 2014;34:618‑27.

Vahidroodsari F, Ayati S, Ebrahimi M, Esmaily H, Shahabian M. The effect of prepregnancy body mass index on the development of gestational hypertension and preeclampsia. J Babol Univ Med Sci 2009;11:49‑53.

Bhattacharya S, Campbell DM, Liston WA, Bhattacharya S. Effect of body mass index on pregnancy outcomes in nulliparous women delivering singleton babies. BMC Public Health 2007;7:168.

Turzanski Fortner SR. Modifiable Risk Factors for Hypertensive Disorders of Pregnancy among Latina Women: A Dissertation for the Degree of Doctor of Philosophy. Massachusetts, USA: University of Massachusetts; 2009. p. 1-96.

Tanaka M, Jaamaa G, Kaiser M, Hills E, Soim A, Zhu M, et al. Racial disparity in hypertensive disorders of pregnancy in New York state: A 10‑year longitudinal population‑based study. Am J Public Health 2007;97:163‑70.

Mastrogiannis DS, Spiliopoulos M, Mulla W, Homko CJ. Insulin resistance: The possible link between gestational diabetes mellitus and hypertensive disorders of pregnancy. Curr Diab Rep 2009;9:296‑302.

Meher S, Abalos E, Carroli G. Bed rest with or without hospitalisation for hypertension during pregnancy (Review). Cochrane Database Syst Rev 2005;CD003514.

Todros T, Verdiglione P, Oggè G, Paladini D, Vergani P, Cardaropoli S. Low incidence of hypertensive disorders of pregnancy in women treated with spiramycin for toxoplasma infection. Br J Clin Pharmacol 2005;61:336‑40.

Takiuti NH, Kahhale S, Zugaib M. Stress‑related preeclampsia: An evolutionary aladaptation in exaggerated stress during pregnancy? Med Hypotheses 2003;60:328‑31.

Leeners B, Neumaier‑Wagner P, Kuse S, Stiller R, Rath W. Emotional stress and the risk to develop hypertensive diseases in pregnancy. Hypertens Pregnancy 2007;26:211‑26.

Tarkhan M, Safarinia M, Khosh Sima P. Effectiveness of group stress inoculation training on the systolic and diastolic blood pressure and life quality of hypertension in women. Quarterly Journal of Health Psychology 2012;1:46‑58.

Igosheva N, Taylor PD, Poston L, Glover V. Prenatal stress in the rat results in increased blood pressure responsiveness to stress and enhanced arterial reactivity to neuropeptideY in adulthood. J Physiol 2007;582:665‑74.

Roy‑Matton N, Moutquin JM, Brown C, Carrier N, Bell L. The impact of perceived maternal stress and other psychosocial risk factors on pregnancy complications. J Obstet Gynaecol Can 2011;33:344‑52.

Vollebregt KC, van der Wal MF, Wolf H, Vrijkotte TG, Boer K, Bonsel GJ. Is psychosocial stress in first ongoing pregnancies

associated with pre‑eclampsia and gestational hypertension? BJOG 2008;115:607‑15.

Smith CA, Levett KM, Collins CT, Crowther CA. Relaxation techniques for pain management in labour. Cochrane Database Syst Rev 2011;CD009514.

Wolsko PM, Eisenberg DM, Davis RB, Phillips RS. Use of mind‑body medical therapies. J Gen Intern Med 2004;19:43‑50.

Shinde N, Shinde KJ, Khatri SM, Hande D, Bhushan V. Immediate effect of Jacobson’s progressive muscular relaxation in hypertension. Sch J App Med Sci 2013;1:80‑5.

Anthony B, Boudreaux L, Dobbs I, Jamal S, Guerra P, Williamson JW. Can relaxation lower metaboreflex‑mediated blood pressure elevations? Med Sci Sports Exerc 2003;35:394‑9.

Bertisch SM, Wee CC, Phillips RS, McCarthy EP. Alternative mind‑body therapies used by adults with medical conditions. J Psychosom Res 2009;66:511‑9.

Astin JA, Shapiro SL, Eisenberg DM, Forys KL. Mind‑body medicine: State of the science, implications for practice. J Am Board Fam Pract 2003;16:131‑47.

Goldstein CM, Josephson R, Xie S, Hughes JW. Current perspectives on the use of meditation to reduce blood pressure. Int J Hypertens 2012;2012:578397.

Dickinson HO, Campbell F, Beyer FR, Nicolson DJ, Cook JV, Ford GA, et al. Relaxation therapies for the management of primary hypertension in adults. Cochrane Database Syst Rev 2008;CD004935.

Grossman E, Grossman A, Schein MH, Zimlichman R, Gavish B. Breathing‑control lowers blood pressure. J Hum Hypertens 2001;15:263‑9.

Joseph CN, Porta C, Casucci G, Casiraghi N, Maffeis M, Rossi M, et al. Slow breathing improves arterial baroreflex sensitivity and decreases blood pressure in essential hypertension. Hypertension 2005;46:714‑8.

Beddoe AE, Lee KA. Mind‑body interventions during pregnancy. J Obstet Gynecol Neonatal Nurs 2008;37:165‑75.

Nickel C, Lahmann C, Muehlbacher M, Pedrosa Gil F, Kaplan P, Buschmann W, et al. Pregnant women with bronchial asthma benefit from progressive muscle relaxation: A randomized, prospective, controlled triall. Psychother Psychosom 2006;75:237‑43.

Little BC, Hayworth J, Benson P, Hall F, Beard RW, Dewhurst J, et al. Treatment of hypertension in pregnancy by relaxation and biofeedback. Lancet 1984;1:865‑7.

Kaushik RM, Kaushik R, Mahajan SK, Rajesh V. Effects of mental relaxation and slow breathing in essential hypertension. Complement Ther Med 2006;14:120‑6.

Urech C, Fink NS, Hoesli I, Wilhelm FH, Bitzer J, Alder J. Effects of relaxation on psychobiological wellbeing during pregnancy: A randomized controlled trial. Psychoneuroendocrinology 2010;35:1348‑55.


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