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Take a breather

Simple breathing techniques may help you to better manage heart-related issues.

Published: November, 2019

Maybe you’re already in the habit of taking a deep breath to calm down when you’re feeling fed up or frustrated.
But a regular practice of focused breathing might offer even bigger rewards.

“Stress directly affects blood flow to the heart muscle, and any technique people can use to lower stress will benefit the heart,” says Dr. Kimberly Parks, a cardiologist at Harvard-affiliated Massachusetts General Hospital.
Some people turn to yoga, tai chi, or meditation for stress relief.

But others aren’t interested in trying those techniques.

For them, a simple breathing practice may be more appealing, in part because it’s easy, it’s free, it takes just a few minutes, and it can be done anywhere at any time.

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Calming the stress response

Focused, deep breathing stimulates the vagus nerve, which extends from the brain to the belly.


This activates the “rest and digest” response of your nervous system, which slows down the heart and lowers blood pressure.

Threatening or stressful situations activate the “fight or flight” response, which has the opposite effect on your cardiovascular system.

Dr. Parks advises her patients to try alternate-nostril breathing or belly breathing to help manage stress (see “Two breathing techniques to try”).

Both techniques, when practiced regularly, have been shown to decrease blood pressure and increase heart rate variability.

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Heart rate variability is simply a measure of the variation in time between heartbeats, but it reflects the health of your cardiovascular system.

Your heart rate isn’t meant to stay at the same speed all the time; it changes depending on your activity and emotions.

A highly variable heart rate suggests flexibility and resilience and is linked to a healthier, longer life.

Lower heart rate variability is associated with a greater risk of heart disease.

Alternate-nostril breathing requires a bit more concentration than belly breathing, but that could be one reason it’s helpful, says Dr. Parks. “Having to switch between pressing down your thumb or index finger gives you something to focus on,” she notes, which helps draw your attention away from distracting thoughts.

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Deep, focused breathing helps engage the diaphragm, a strong sheet of muscle that separates your chest from your abdomen.

As you breathe in, the diaphragm drops downward as your lungs expand full of air, delivering oxygen to the many small blood vessels in the lowest portion of the lungs.

As you breathe out, the diaphragm presses back upward against your lungs, helping to expel carbon dioxide.

Two breathing techniques to try

Alternate-nostril breathing

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  • Sit in a comfortable position.
  • Place your left hand on your left knee.
  • Lift your right hand up and place your right thumb on your right nostril to close your right nostril.
  • Inhale through your left nostril.
  • Use your right index finger to close the left nostril, briefly closing both nostrils at once.
  • Open the right nostril and exhale through the right side.
  • Inhale through the right nostril and then close this nostril using your thumb.
  • Open the left nostril and exhale through the left side.
  • Continue these cycles for up to five minutes.

Diaphragmatic (belly) breathing

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  • Sit in a comfortable position or lie on your back, if you prefer.
  • Place one hand on your upper chest and the other on your belly, just below your rib cage.
  • Breathe in slowly through your nose, letting the air in deeply, toward your lower belly. The hand on your chest should remain still, while the one on your belly should rise.
  • Tighten your abdominal muscles and let them fall inward as you exhale through pursed lips. The hand on your belly should move down to its original position.
  • Continue for five to 10 minutes.

When medications don’t make sense

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Breathing practices can be especially helpful for people whose blood pressure is normal most of the time but skyrockets during times of stress.

Some people can even sense when their blood pressure is rising. Rather than reaching for the blood pressure cuff (because a high reading often makes people feel even more anxious), a few minutes of deep breathing is a better option.

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One of her patients sets a reminder on his phone to do alternate-nostril breathing for five minutes right before a stressful daily staff meeting. Try it for yourself the next time you feel anxious or are having trouble falling asleep.

A daily breathing practice may help you feel calmer and improve your heart health.

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Dr. Benjamin Díaz Curiel

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