Journal of Clinical Hypertension · Nov 11, 2026

Effect of Inspiratory Muscle Training on Blood Pressure and Heart Rate in Normotensive Adults: A Systematic Review

By Barbosa RM, Santos ACND, Sacramento MDSD et al.

Systemic arterial hypertension is a predominant risk factor for cardiovascular diseases, thus small reductions in blood pressure (BP) can slow progression and cardiovascular risk. Inspiratory muscle training (IMT) is a portable and low‐cost intervention with effects that reduce BP in hypertensive patients, but there was no synthesis of its effectiveness in normotensive patients. This systematic review, registered in PROSPERO (CRD420251112144) and conducted according to PRISMA, searched for randomized clinical trials/intervention studies up to June 2026 in PubMed, PEDro, Virtual Health Library, Web of Science, Scopus, and gray literature. Normotensive adults undergoing isolated IMT were included, with outcomes of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), or heart rate (HR); two reviewers selected studies, extracted data, and assessed risk of bias (RoB 2 and ROBINS‐I). Among 2,564 records, six studies (134 participants) were eligible; volunteers were mostly young men (20–27 years) with baseline BP ∼115/75 mmHg. Six‐week protocols with 75% of maximum inspiratory pressure (MIP) and 30 breaths per day reduced SBP by 4.3–9.6 mmHg and DBP by 3.9–6.1 mmHg without altering cardiac output; loads ≤ 40% MIP did not modify BP. Acute sessions demonstrated transient increases in BP and HR during exercise followed by sympathetic suppression during recovery. It is concluded that high‐intensity IMT can reduce BP in normotensive individuals and be a non‐pharmacological strategy for primary prevention, but current evidence is limited and heterogeneous. Larger randomized trials with standardized protocols and ambulatory monitoring are needed to confirm the benefits.

doi.org/10.1111/jch.70359Open accessPubMed 43015130Interventions