Nurse Led Progressive Muscle Relaxation and Slow Breathing for Home Blood Pressure in Adults with Hypertension
DOI:
https://doi.org/10.33755/jkk.v12i4.1047Keywords:
Hypertension, progressive muscle relaxation, slow breathing, nursing, home blood pressure, multivariable analysisAbstract
Background. Progressive muscle relaxation (PMR) and slow diaphragmatic breathing have been evaluated as adjuncts to hypertension management. Standardized home blood pressure and intervention-fidelity reporting may improve the interpretation of future nurse-led comparative studies.
Objective. To demonstrate a complete multivariable original-research reporting workflow for a nurse-led PMR–slow breathing programme versus attention-matched education
Methods. We generated 152 hypothetical participants (76 per arm) using random seed 1047, with nonrandomized baseline differences, seven-day home blood-pressure windows at baseline, week 4, and week 8, Perceived Stress Scale (PSS-10) totals, intervention attendance, and differential follow-up. A hypothetical four-week programme included eight supervised contacts. Robust baseline-adjusted analysis of covariance, participant-clustered longitudinal analysis, and propensity-score overlap weighting were applied. No participants were recruited or treated.
Results. Among 152 participants, 143 had week-4 and 134 had week-8 home SBP summaries. The adjusted week-4 SBP difference was -5.67 mmHg (95% CI -7.77 to -3.56; p<0.001). At week 8, the difference was -5.21 mmHg (95% CI -7.57 to -2.85). The week-4 DBP and PSS-10 contrasts were -2.48 mmHg and -4.13 points, respectively.
Conclusion. The study produced an internally consistent, fully populated reporting example for an adjusted quasi-experimental comparison. It demonstrates statistical reporting and cannot support clinical or causal claims
References
1. McEvoy JW, McCarthy CP, Bruno RM, Brouwers S, Canavan MD, Ceconi C, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J. 2024;45(38):3912-4018. doi:10.1093/eurheartj/ehae178.
2. Shimbo D, Artinian NT, Basile JN, Krakoff LR, Margolis KL, Rakotz MK, et al. Self-measured blood pressure monitoring at home: a joint policy statement from the American Heart Association and American Medical Association. Circulation. 2020;142(4):e42-e63. doi:10.1161/CIR.0000000000000803.
3. Pathan FKM, Pandian JS, Shaikh AI, Ahsan M, Nuhmani S, Iqbal A, et al. Effect of slow breathing exercise and progressive muscle relaxation technique in the individual with essential hypertension: a randomized controlled trial. Medicine (Baltimore). 2023;102(47):e35792. doi:10.1097/MD.0000000000035792.
4. Garg P, Mendiratta A, Banga A, Bucharles A, Piccoli MVF, Kamaraj B, et al. Effect of breathing exercises on blood pressure and heart rate: a systematic review and meta-analysis. Int J Cardiol Cardiovasc Risk Prev. 2024;20:200232. doi:10.1016/j.ijcrp.2023.200232.
5. de Freitas Gonçalves KS, Queiroz Godoy Daniel AC, Tatagiba Lamas JL, Oliveira HC, Cloutier L, de Campos Pereira Silveira RC, et al. Device and nondevice-guided slow breathing to reduce blood pressure in hypertensive patients: a systematic review and meta-analysis. Health Sci Rep. 2022;5(3):e636. doi:10.1002/hsr2.636.
6. Webster KE, Halicka M, Bowater RJ, Parkhouse T, Stanescu D, Punniyakotty AV, et al. Effectiveness of stress management and relaxation interventions for management of hypertension and prehypertension: systematic review and network meta-analysis. BMJ Med. 2025;4(1):e001098. doi:10.1136/bmjmed-2024-001098.
7. Yuenyongchaiwat K, Changsri K, Harnmanop S, Namdaeng P, Aiemthaisong M, Pongpanit K, et al. Effects of slow breathing training on hemodynamic changes, cardiac autonomic function and neuroendocrine response in people with high blood pressure: a randomized control trial. J Bodyw Mov Ther. 2024;37:136-141. doi:10.1016/j.jbmt.2023.11.042.
8. Hakim AR, Mora L, Leometa CH, Dimala CP. Psychometric properties of the Perceived Stress Scale (PSS-10) in Indonesian version. JP3I J Pengukuran Psikol Pendidik Indones. 2024;13(2):117-129. doi:10.15408/jp3i.v13i2.35482.
9. Haynes AB, Haukoos JS, Dimick JB. TREND reporting guidelines for nonrandomized/quasi-experimental study designs. JAMA Surg. 2021;156(9):879-880. doi:10.1001/jamasurg.2021.0552.
10. Kang H. Sample size determination and power analysis using the G*Power software. J Educ Eval Health Prof. 2021;18:17. doi:10.3352/jeehp.2021.18.17.
11. Thomas LE, Li F, Pencina MJ. Overlap weighting: a propensity score method that mimics attributes of a randomized clinical trial. JAMA. 2020;323(23):2417-2418. doi:10.1001/jama.2020.7819.
