6 Science-Backed Breathing Exercises That May Lower Blood Pressure

5.     Alternate nostril breathing

• Exhale completely.
• Use your index finger to pinch closed your left nostril and inhale all the way with the right nostril.
• Pinch both nostrils closed, pause two seconds, and then release the left nostril.
• Breathe out through the left nostril
• Inhale through the left nostril, pinch both nostrils closed and hold for two seconds.
• Release the right nostril and exhale out of that nostril.

Word of caution: This exercise may be difficult for those with congested sinuses, allergies or other difficulties breathing through their nose. It’s also important to wash your hands thoroughly before touching your nasal area to reduce the risk of spreading germs into your nasal passage.

6.     Inspiratory muscle strength training (IMST)

This breathing exercise requires a device that makes it more difficult to inhale by providing sequentially more and more levels of resistance. This makes you breathe in against resistance and is essentially like weightlifting for your breathing muscles, specifically, the inspiratory muscles of breathing.

Research has shown that this exercise can have a significant impact on blood pressure. A 2021 study on midlife/older men and postmenopausal women with above‐normal systolic blood pressure published in the Journal of the American Heart Association measured the effect of IMST. In a six-week program, participants saw a nine-point drop in their systolic blood pressure. A control group that was given sham training with low breathing resistance saw no improvement, according to the researchers.

Instructions for using IMST vary by device. Your doctor may be able to provide more guidance on the best device and method for you.

The impact of the sympathetic and parasympathetic nervous systems

In addition to decreasing stress, deep breathing can have an impact on our physiology. Our breathing and heart rate are both controlled by the same areas in our brains, and they communicate with one another to stay in the same rhythm. When we inhale, our lungs expand outward and the pressure on the heart and blood vessels changes. This process stimulates your sensory nerves, which impacts how hard you breathe. For example, when we feel threatened or stressed, our heart rate rises, and we breathe faster. This is the sympathetic nervous system process.

When we are relaxed, we breathe more slowly and our heart rate decreases. This rest period is managed by the parasympathetic nervous system. By purposefully slowing and controlling our breathing through deep breathing exercises, we can stimulate the vagus nerve that controls our heart rate, among other involuntary functions, according to the American Heart Association.

“Deep breathing exercises are ones that ultimately lower the respiratory rate per minute. And that’s a key component, kind of the magic ingredient if you will, of breathing exercises and lowering blood pressure,” Liang says. Having done that, “we’re better able to drop into that more restorative healing state, and then as a result our blood pressure has more of a likelihood to decrease.”

A 2023 review of research published in Frontiers in Physiology found declines in both systolic (the top number) and diastolic (the bottom number) blood pressures in 17 out of 20 studies on people participating in deep breathing exercises, Harvard Health Publishing reports.

Why should you try breathing exercises?

Deep breathing exercises like these can help you manage your emotions and, in turn, your physical body, says Tania T. Von Visger, an assistant professor at the State University of New York at Buffalo School of Nursing.

Von Visger uses breathing techniques herself as a critical care nurse. When a stressful situation arises, such as a computer going down during a medical emergency, she takes a deep breath to calm herself. This is often what our bodies do naturally when we gasp in surprise or alarm.

“Isn’t it interesting, when we come into a scenario of shock, we automatically take a deep breath. You take in a volume of air, you hold it. With the holding, you keep lungs expanded for an extended period of time,” Von Visger says. This can help clear your mind so you can address whatever urgent situation is at hand. “It’s about leveraging what we have.... And our breath is always with us.”

Breathing exercises are an opportunity for people who are looking to “use the body’s miraculous ability to influence a lot of different organ systems by just controlling their breathing,” Liang says.

How should you approach doing breathing exercises?

As noted above, the exercises should be done sitting down until you are more accustomed to your body’s reaction. Diaphragmatic breathing can be done sitting or lying down. You should also be aware of your posture. In our technology- and screen-filled days, many of us have a propensity to lean forward and hunch, Liang says. This is not the best position for breathing exercises.

To optimize lung capacity and safety when doing the breathing exercises, Liang and Von Visger recommend:

• Sit up straight so the head is positioned over your neck and your shoulders are over your hips.
• If you have arthritis or other conditions that may prevent you from sitting up fully, do the best you can to sit in a comfortable position. Diaphragmatic breathing can be done lying down.
• Avoid doing the exercises in the heat of the sun or other hot areas, Von Visger warns, as that could contribute to dizziness.
• Deep breathing apps can help provide a visual guide through cycled breath, particularly apps with which you can set timers, Von Visger says. Voice-guided breathing videos are helpful as well, Liang says.  

How often should you do breathing exercises?

The average person may be able to do five minutes a day of breathing strength exercises, whereas someone with COPD or asthma may be able to tolerate only three to five breath cycles, Liang says. “For many of these breathing practices, I wouldn't recommend more than three to five breath cycles initially,” she says.

Von Visger recommends starting small with a variety of the breathing techniques every day and then increasing the practice to two or three times a day: “It’s like going to the gym to increase muscle mass. You don’t go for five hours the first time, you go there for a short time and then increase the number of cycles and frequency.”

It can help to make an appointment with yourself to do the exercises, Von Visger says. “We make appointments with a lot of people, but do you make an appointment with yourself? You have to check in with yourself, love yourself, and check in with your breath.”

And if one of the exercises isn’t feeling right that day, it’s OK to skip it and try something else. You can also incorporate a social element to the exercises by doing them with family and friends.

How long does it take for a breathing exercise to lower blood pressure?

As you make the exercises part of your daily routine, you should start to see differences in your blood pressure, Liang says.

Some studies have shown anywhere from up to six to 12 weeks for consistent results, but Liang has even seen immediate results in her practice. A calmer mental state can oftentimes help with lowering blood pressure even within the same doctor’s visit.

Which breathing exercise is right for you?

You can harness nature’s medicine by simply being curious about breathing exercises and figuring out which one feels most comfortable for you, Liang says: “I would say the best breathing exercise for someone is the one that they’re actually going to remember to do.”

If you find a breathing exercise uncomfortable or anxiety-provoking, it’s going to cause you stress and you’re not going to want to do it again, which defeats the whole purpose of the practice, she says. You can work with your doctor or therapist to find the best breathing exercises for you.

Can breathing exercises replace blood pressure medication?

“Breathing exercises do not replace medications for high blood pressure necessarily, but we hope that they can be used more like an adjunct to medication,” Liang says. “If their blood pressure is mild enough and they do practice it for weeks and weeks and weeks, it’s possible that they might be able to go off of medications. [However], it is meant to be integrated with your current medication regimen.”

For those looking into complementary approaches to blood pressure management, an integrative health care professional, someone who explores the relationship of the mind, body and spirit, can help, Liang says. These health care professionals focus on non-medicinal approaches to blood pressure control and reductions in stress like mindfulness. The National Center for Complementary and Integrative Health offers more information about complementary health practices. Your doctor may be able to provide a referral as well.

How safe are breathing exercises for lowering blood pressure?

As noted above, breathing exercises could be uncomfortable for patients with COPD and other lung or breathing issues, or those who feel anxiety around focusing on their breathing. You should consult your doctor if you have any concerns prior to starting a breathing exercise regimen, particularly if you have:

• Uncontrolled hypertension (meaning you currently have elevated blood pressure (see Ranges of Blood Pressure chart above) but are not taking medication to treat the condition or your treatments have not been effective in lowering your blood pressure. Liang recommends consulting with your doctor about the appropriateness of breathing exercises before beginning.)
• Recent abdominal surgery
• Osteoporosis
• Rib fractures
• Spontaneous pneumothorax (often called collapsed lung)
• Perforated tympanic member (part of your ear that separates the outer ear from the middle and inner parts)

For many, though, deep breathing exercises can be a natural and convenient way to harness the power of your own breath to lower blood pressure and improve your overall health and mental well-being.

“Think about this practice as one that you can do anytime, anywhere, at your convenience,” Von Visger says. “You are in charge of your body; you have the choice.”