Prolong Your Life With This 5 Minute Exercise 

Prolong Your Life With This 5 Minute Exercise 

As most of you know, the leading cause of death in “developed” societies is cardiovascular disease (CVD). Obviously, the risk of heart disease increases as we age, and a big factor in this risk is high blood pressure: particularly systolic blood pressure (SBP).  Figures from the U.S. indicate that over 65% of adults, aged 50 and older, have above-normal SBP, however the good news is that this CVD risk factor is modifiable. And we are now going to examine a unique way of modifying this risk factor.

As well as high blood pressure, two other health issues serve as primary causes of CVD: endothelial dysfunction; and increased arterial stiffness (atherosclerosis), which is also associated with endothelial dysfunction.  All three of these risk factors are, in part, a result of decreased nitric oxide (NO) levels.

Nitric Oxide

“The cardioprotective roles of NO include regulation of blood pressure and vascular tone, inhibition of platelet aggregation and leukocyte adhesion, and prevention of smooth muscle cell proliferation. Reduced bioavailability of NO is thought to be one of the central factors common to cardiovascular disease, although it is unclear whether this is a cause of, or result of, endothelial dysfunction.”   (Source)

Unfortunately, once the reduction in NO bioavailability occurs, one also sees an increase in oxidative stress (free radical damage), and an increase in chronic low level inflammation (also a mechanism that speeds up cardiovascular weakness).


One of the most efficient ways to keep the heart healthy, and the blood pressure regulated, is aerobic exercise. A level of aerobic exercise proven to protect us, involves 150 min/wk of moderate‐intensity aerobic exercise, or 75 min/wk of vigorous aerobic exercise.  However, many people cannot attain this level of regular exercise, with statistics indicating that less than 40% of older adults meet these guidelines. Studies have found that for many people, “this low rate of adherence is because of barriers such as lack of time, facility access, transportation, mobility issues, and financial costs of membership to exercise facilities”.

What if the scientific community found a solution for those who find it hard to attain the required level of exercise to prevent CVD? A solution that was as effective as the above mentioned amount of aerobic exercise at reducing SBP, improving vascular health in older people, and also improved NO levels.


Well, step right up folks, and view the amazing “Inspiratory Muscle Strength Training” (IMST), “an alternative form of physical training that uses the diaphragm and accessory respiratory muscles to repeatedly inhale against resistance”. This breathing exercise (involving a device) has been around for a while, but sessions lasted around 30 minutes, and one required multiple sessions per week, which added up to an amount of time similar to moderate intensity aerobic exercise guidelines.

Inspiratory Muscle Strength Training was developed in the 1980s as a technique to help critically ill patients with respiratory disease. By inhaling vigorously through an IMST hand-held device (which provides resistance) these patients could strengthen their diaphragm, as well as other muscles required for breathing. So, the initial approach to IMST was a 30 minutes per day regimen, having the device set to low resistance (you are sucking air through a tube that is sucking back; how much it sucks back is the level of “resistance”).

Recently, a group of researchers started testing another approach to see if they could develop a more efficient protocol that required less time from the patients. Their approach was to have the device used at 30 inhalations per day, at high resistance, for 6 days a week.

The Study

The result of their work was published in June of this year (2021), in the Journal of the American Heart Association.  For their study they followed 36 otherwise healthy adults (aged 50 to 79), who all had above normal systolic blood pressure. Half of their subjects did High-Resistance IMST, and half did a placebo version, in which the resistance of the device was set much lower.

After the six week trial period, the HRIMST group had their systolic blood pressure (the top number in a blood pressure reading) drop, on average, by nine points. This decline is better than the average drop in SBP to be attained by walking briskly for 30 minutes, five days a week, and equal to the effects of some of the blood-pressure lowering drugs.

While the authors of this study are not exactly sure how strengthening the breathing muscles results in lowering blood pressure, they suspect it is due to the exercise inducing the cells which line the blood vessels to produce more nitric oxide. The nitric oxide in turn relaxes and dilates the blood vessels, allowing the blood pressure to drop back to normal.  Six weeks following the end of the study, after the successful group had quit doing High-Resistance IMST, they still maintained most of the improvement in their SBP status.

But Wait: There’s More!

The group practising HRIMST also showed a 45% improvement in their vascular endothelial function, and a major increase in their nitric oxide levels.  Since our NO levels decline with age, and this molecule is necessary for dilating the arteries, and preventing the buildup of plaque, this is no small benefit.  As for the aforementioned other CVD risk factors, oxidative stress and chronic inflammation, well those levels were also found to be significantly lower in the subjects who did the HRIMST.

Another interesting factor in this study relates to postmenopausal women. Previous research has found that, when it comes to vascular endothelial function, women who do not take estrogen do not get the same protective benefit from aerobic exercise as men.

In this study, the women achieved the same benefits as the men, regardless if they were using estrogen supplements or not.  Furthermore, results from this study implied that HRIMST improved brain function, and sports performance.

According to lead author, Daniel Craighead: “If you’re running a marathon, your respiratory muscles get tired and begin to steal blood from your skeletal muscles. The idea is that if you build up endurance of those respiratory muscles, that won’t happen and your legs won’t get as fatigued.”

Study Conclusion

One obvious attribute of this approach to CVD is compliance, which in this case was much higher (95%) than aerobic exercise.

“We have identified a novel form of therapy that lowers blood pressure without giving people pharmacological compounds and with much higher adherence than aerobic exercise,” said senior author Doug Seals, a Distinguished Professor of Integrative Physiology.

(Study: 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)


So, we have an exercise that “can be done in five minutes in your own home while you watch TV”. That is a kind of exercise that I can get behind, so I did a quick search to see if these devices are available to the public. And they are.  They range from simple and very affordable (THE BREATHER® Respiratory Muscle Trainer   $43 US), to more expensive and better designed (Breather Fit – Inspiratory/Expiratory Respiratory Muscle Trainer  $150 CAN). (Many other options can be found on Amazon and online.)

And, while the research group who did this study are developing a smartphone app to work with the device, it appears such a version already exists in Europe (Airofit PRO  €379).

Related Aside

Most readers are familiar with the fact that drinking beet juice will increase NO levels (as will a supplement called Neo40), but there is another most interesting way to increase your NO levels.

“The paranasal sinuses are major producers of nitric oxide (NO). We hypothesized that oscillating airflow produced by humming would enhance sinus ventilation and thereby increase nasal NO levels. Ten healthy subjects took part in the study. Nasal NO was measured with a chemiluminescence technique during humming and quiet single-breath exhalations at a fixed flow rate. NO increased 15-fold during humming compared with quiet exhalation.”

(Study: Weitzberg E, Lundberg JO. Humming greatly increases nasal nitric oxide. American Journal of Respiratory Critical Care Medicine. 2002; 166(2):144-5)


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