5 Best Inspiratory Muscle Training (IMST) Devices & Apps to Lower Blood Pressure in 2026
Updated: Sep 29
Updated: September 2026 | By Dmitri Konash, PhD — Founder of BreathNow
Inspiratory muscle training — usually shortened to IMST — has become one of the more interesting breathing techniques studied for lowering blood pressure.
But do you actually need an IMST device?
The short answer is: it depends on your goal. If you want to reproduce the exact high-resistance IMST protocols used in the strongest clinical studies, a physical resistance device is the closest match.
If you are happy with trying this type of breathing and following a high resistance inhale by squeezing your nostrils, an app such as BreathNow offers a much lower-cost and more flexible way to follow guided breathing, build a routine and — importantly — track whether your blood pressure changes over time. BreathNow app helps to perform an IMST breathing without a device.
For this 2026 review, we compared one app-only approach with four established respiratory muscle training devices.
📊 5 Best IMST Devices & Apps Compared
Solution | Type | Physical Resistance | Measures / Controls Resistance | BP Tracking | AI BP Coach | Other Breathing Exercises | Best For |
📱 App-only | ⚠️ No calibrated device resistance | ❌ | ✅ | ✅ Dedicated AI BP Coach | ✅ Slow breathing, 4-7-8, box breathing & more | Low-cost device-free training + BP tracking | |
POWERbreathe Plus + ActiBreathe | 🫁 IMST device + optional app | ✅ | ✅ Adjustable; Smart Adaptor adds testing & feedback | ❌ | ❌ | Limited | Closest match to high-resistance BP research |
Airofit | 🫁 Smart breathing device + app | ✅ | ✅ Lung testing + app-guided training | ❌ | ❌ | ✅ Multiple breathing programs | Smart feedback & progress tracking |
BREATHER FIT + Breather Coach | 🫁 Manual RMT device + app | ✅ Inspiratory + expiratory | ✅ Manual resistance levels | ❌ | ❌ | ✅ Guided RMT programs | Affordable hardware training |
PrO2 Fit | 🫁 Smart IMT device + app | ✅ | ✅ Real-time inspiratory-pressure feedback | ❌ | ❌ | Limited | Advanced measurement & performance training |
Important: This is an editorial comparison of usability, evidence alignment, accessibility, app functionality and user feedback — not a ranking of clinical efficacy.
How We Selected the 5 IMST Solutions
We looked at factors particularly relevant to people interested in IMST for cardiovascular wellness:
🫁 Ability to train inspiratory muscles
⚙️ Resistance control
📊 Training feedback and progress tracking
📱 Quality of the companion app
🩺 Ability to track blood pressure
💰 Cost and need for additional hardware
🔄 Flexibility for other breathing exercises
🔬 Relationship to published IMST research
⭐ Current App Store and Google Play feedback
👍 Public user feedback
We reviewed current scientific literature, manufacturer documentation, U.S. App Store and Google Play listings and publicly available user feedback in September 2026.
Disclosure: BreathNow is published by Cardio Calm Ltd., the company behind this website. It is included because it offers an app-only approach to guided IMST-style breathing and BP tracking; competing products are assessed using the same criteria.
🥇 1. BreathNow — Best for IMST Training Without a Device + BP Tracking
Best for: People who want a low-cost, convenient introduction to IMST-style breathing while also tracking blood pressure and using other breathing exercises.
Unlike the other four solutions in this comparison, BreathNow does not require the purchase of a dedicated respiratory trainer.
The app guides breathing sessions on a phone (when a user squeezes their nostrils to create resistance duirng an inhale)
or Apple Watch and lets users combine them with BP tracking, slow breathing, meditation, exercise and stress-management activities.
What stands out
📱 No dedicated IMST device required
💰 Lower upfront cost than buying specialist hardware
🩺 Built-in blood-pressure tracking
📈 Lets users compare BP trends over time
🫁 IMST-style guided breathing
🌬️ Slow breathing exercises
4️⃣ 4-7-8 breathing
🧘 Box breathing and relaxation
⌚ Apple Watch support
🍎 Apple Health integration
🤖 Android Health Connect integration
🤖 AI BP Coach
Why BP tracking matters
A dedicated IMST device normally tells you how well your breathing muscles are performing.
BreathNow addresses a different question:
“Is my blood pressure actually changing?”
You can log BP before beginning a training program and then monitor weekly trends to see whether your readings are moving.
The flexibility advantage
An app also lets you switch between techniques.
On one day you might use an IMST-style session. On another, you may prefer slow breathing, 4-7-8 breathing, meditation or another calming exercise.
That flexibility is valuable because IMST and slow breathing are different interventions and may work through different mechanisms.
What to consider
The major limitation is equally important:
BreathNow cannot physically impose or accurately measure the 55–75% maximal inspiratory pressure used in high-resistance clinical IMST.
What users say
Users report meaningful improvements in their BP after using breathing exercises.
U.S. Apple App Store: ⭐ 4.7/5, Google Play: ⭐ 4.3/5
Our verdict
BreathNow is the most flexible option in this comparison for somebody specifically searching for IMST training without a device.
🥈 2. POWERbreathe Plus + ActiBreathe — Best Match to High-Resistance IMST Research
Best for: People who want physical inspiratory resistance and a setup closer to protocols used in BP research.
POWERbreathe has a long history in inspiratory muscle training and offers several manual and electronic products.
The POWERbreathe Plus uses adjustable resistance, while the optional Smart Adaptor and ActiBreathe app add breathing-strength testing, personalized guidance, real-time feedback and progress analysis.
What stands out
✅ Genuine physical inspiratory resistance
⚙️ Multiple adjustable resistance levels
🫁 Designed specifically for IMT
📊 Optional strength testing
📱 ActiBreathe companion app
📈 Training history and progress
🎯 Personalized training plans with Smart Adaptor
🔬 Strong relationship to the IMST research ecosystem
Why it matters for BP research
The high-resistance studies that generated much of the excitement around IMST used specialized resistance devices and prescribed training relative to maximal inspiratory pressure.
That makes a resistance trainer conceptually much closer to the studied intervention than an app-only breathing timer.
What to consider
The hardware costs more than an app-only solution, and the digital experience requires additional hardware if you want Smart Adaptor feedback.
There is also no integrated blood-pressure diary comparable with BreathNow, so users interested in BP outcomes will generally need a separate BP-monitoring system.
What users say
POWERbreathe's own product page contains generally favorable hardware feedback, particularly around ease of use and perceived improvements in breathing strength.
U.S. Apple App Store: ⭐ 3.0/5, Google Play: no rating yet
Our verdict
If your priority is doing loaded IMST in a way that more closely resembles the clinical research, POWERbreathe is one of the most relevant choices in this comparison. It is less convenient and more expensive than app-only training, but gives you something a phone cannot: real physical inspiratory resistance.
🥉 3. Airofit — Best Smart IMST / Respiratory Training Experience
Best for: People who want a sophisticated connected breathing trainer with strong app guidance and feedback.
Airofit combines a physical respiratory trainer with an app that performs breathing-strength tests, provides personalized programs and tracks progress.
What stands out
🫁 Physical respiratory resistance
📲 Connected app
📊 Inspiratory-pressure testing
🎯 Personalized programs
🔴 Real-time breathing feedback
📈 Progress history
🔔 Reminders
🌬️ Multiple breathing exercises
📱 iPhone and Android support
What to consider
Airofit is positioned primarily as a respiratory-muscle and performance-training product rather than a hypertension-treatment system.
It also does not replace a blood-pressure tracker, so anyone using it specifically for BP management should separately record readings with a validated monitor.
What users say
Users commonly value the feedback and training structure, while some reviews report app or connectivity problems.
U.S. Apple App Store: ⭐ 4.0/5, Google Play: ⭐ 4.3/5
Our verdict
Airofit offers one of the most polished hardware + app combinations.
It makes particular sense for someone interested in respiratory performance as well as IMST rather than somebody who wants BP management alone.
4️⃣ 4. BREATHER FIT + Breather Coach — Best Lower-Cost Hardware Option
Best for: People who want physical resistance without moving into the more expensive smart-device category.
BREATHER FIT is a manual respiratory muscle trainer with adjustable resistance for both inhalation and exhalation.
It offers six inspiratory and five expiratory settings and works alongside the Breather Coach app.
What stands out
🫁 Physical inspiratory resistance
💨 Expiratory resistance as well
⚙️ Six inspiratory settings
⚙️ Five expiratory settings
📱 Breather Coach companion app
🧭 Guided training plans
📈 Progress tracking
💰 Less expensive than many electronic trainers
What to consider
Its numbered resistance settings do not automatically translate into a precise percentage of your maximal inspiratory pressure.
The companion app also receives substantially more mixed reviews than Airofit's Android app.
What users say
Feedback on the physical trainer itself is generally more favorable than the companion-app scores.
U.S. Apple App Store: ⭐ 2.6/5, Google Play: ⭐ 3.4/5
Our verdict
BREATHER FIT is appealing if you want real resistance at a relatively accessible hardware price and do not need sophisticated electronic measurements.
5️⃣ 5. PrO2 Fit — Best for Advanced Inspiratory-Pressure Feedback
Best for: Athletes, clinicians and data-oriented users who want detailed real-time information about inspiratory pressure.
PrO2 combines a resisted inspiratory trainer with an app that displays pressure against time and adjusts training relative to the user's performance.
What stands out
🫁 Physical inspiratory resistance
📊 Real-time pressure graph
💪 Maximal inspiratory-pressure testing
🎯 Performance targets
📲 Bluetooth companion app
📈 Session history and cloud reporting
🏃 Strong performance-training focus
What to consider
PrO2 is a more specialized and relatively expensive system.
Its consumer app-review base is also extremely small, making store ratings much less informative than for BreathNow or Airofit.
What users say
Too little public feedback to draw strong conclusions about app satisfaction.
U.S. Apple App Store: ⭐ 3.3/5, Google Play: no rating available
Our verdict
A sophisticated choice for users interested in measuring inspiratory performance, not simply following a breathing timer. For someone primarily interested in lowering BP, the extra performance metrics may be more than necessary.
🫁 What Is Inspiratory Muscle Training?
Inspiratory muscle training strengthens the muscles used to inhale — particularly the diaphragm and other inspiratory muscles.
Think of it as resistance training for breathing muscles.
With traditional IMST:
You inhale forcefully against resistance.
Your inspiratory muscles work harder than during normal breathing.
Resistance is progressively adjusted as your muscles become stronger.
Sessions can be surprisingly short.
One of the best-known BP studies used just 30 breaths per day, six days per week for six weeks.
That is why searches for inspiratory muscle training, IMST, IMST device and IMST training without a device have grown: the technique potentially offers a very time-efficient addition to traditional exercise and lifestyle measures.
🔬 What Does the Science Say About IMST and Blood Pressure?
The evidence has developed considerably since the original version of this article was published.
2021: High-Resistance IMST Reduced Systolic BP by About 9 mmHg
A randomized controlled trial published in the Journal of the American Heart Association studied 36 adults aged 50–79 with above-normal systolic blood pressure.
Participants performed:
30 breaths per day
6 days per week
6 weeks of training
High resistance at about 75% of maximal inspiratory pressure
Systolic blood pressure fell from approximately 135 to 126 mmHg in the high-resistance group — around a 9 mmHg reduction.
The researchers also reported improved endothelial function, greater nitric-oxide availability and approximately 95% adherence. Around three quarters of the systolic improvement was still present six weeks after training stopped.
2023: Meta-Analysis of 12 Studies Strengthened the Evidence
A newer 2023 systematic review and meta-analysis included 12 studies involving 386 participants.
Across the studies, IMST was associated with an average reduction of approximately:
7.9 mmHg in systolic BP
3.8 mmHg in diastolic BP
The authors concluded that both high-resistance training and some lower-resistance protocols combined with slow breathing showed potential, while emphasizing that protocols varied significantly between studies.
2023: Meta-Analysis Specifically in People With Hypertension
Another 2023 meta-analysis examined eight randomized controlled trials involving 215 people with hypertension.
It reported reductions in systolic BP, diastolic BP, heart rate and pulse pressure following inspiratory muscle training.
🆕 2025: IMST Compared Directly With Aerobic Exercise
A 2025 randomized study provides useful newer evidence.
Twenty-eight people with hypertension, average age about 61, were assigned to either:
IMST: 30 breaths at 75% maximal inspiratory pressure, about 8 minutes, 5 days per week
or
Aerobic exercise: 30 minutes at 70% heart-rate reserve, 5 days per week.
After eight weeks, brachial systolic BP fell by approximately 9.1 mmHg with IMST and 6.2 mmHg with aerobic training. The difference between the two groups was not statistically significant.
A 2021 systematic review found that respiratory training with a load reduced both systolic and diastolic BP. Training without a load was associated with a smaller reduction in systolic BP and did not significantly reduce diastolic BP in the pooled analysis.
⚖️ IMST Device vs IMST Training Without a Device
This is probably the most important decision for readers arriving through searches for “IMST device” or “IMST training without a device.” An app can guide an IMST exercise without a device where user creates a resistance while inhaling through squeezed nostrils. This is what makes BreathNow such an appealing solution.
Advantages of IMST training without a device
An app-only approach has different strengths:
💰 Lower cost: No specialized breathing trainer has to be purchased.
📱 Always available: Your phone or watch is probably already with you.
🔔 Better habit support: Apps can provide reminders and guided sessions.
🩺 BP tracking: An app can track whether your blood-pressure trend changes during training.
🌬️ More flexibility: You are not limited to IMST and can switch to slow breathing, 4-7-8, box breathing or meditation.
📈 Long-term records: BP and breathing activity can be kept together.
🤖 Personalization: An app can use health information to suggest different activities.
The trade-off is important: convenience and flexibility versus measurable physical resistance.
📲 Why Combining BP Tracking With Breathing Training Makes Sense
An IMST device measures the exercise.
A blood-pressure app measures the outcome you may actually care about.
For example, a user can:
Measure BP → Perform regular breathing training → Track weekly BP → Compare trends
T
his is more useful than judging effectiveness from one reading immediately before and after an exercise.
Blood pressure changes naturally throughout the day, so trends over several weeks are much more informative.
🌬️ IMST Is Not the Same as Slow Breathing
The two techniques are often confused.
Feature | IMST | Slow Breathing |
Main goal | Strengthen inspiratory muscles | Calm breathing / autonomic response |
Resistance | Usually moderate-high | Usually none |
Breathing rate | Not necessarily slow | Often ~5–6 breaths/min |
Typical session | Short, forceful repetitions | Longer, gentle breathing |
Device normally used in research? | Often ✅ | Usually ❌ |
BP research | ✅ | ✅ |
That is another reason an app can be useful: you can practice both resistance-style training and completely different non-resistance breathing exercises rather than treating one method as the only option.
⏱️ What IMST Protocol Has Actually Been Studied?
A frequently cited high-resistance protocol is:
30 breaths per session
About 75% maximal inspiratory pressure
Once per day
5–6 days per week
6–8 weeks
The newer research shows that different loads and breathing rates have been tested, and the ideal protocol may differ with age, fitness, blood pressure, respiratory health and tolerance.
⚠️ Is IMST Safe?
Clinical studies generally report good adherence and tolerability, but high-resistance breathing is still a form of physical training.
Speak with a healthcare professional before beginning high-resistance IMST if you have significant cardiovascular or respiratory disease, uncontrolled hypertension, recent chest or abdominal surgery, or another condition that could make forceful breathing inappropriate.
Stop if training causes chest pain, severe shortness of breath, faintness or unusual symptoms.
IMST should complement — not replace — prescribed medication, regular physical activity or medical care.
👤 Why I Became Interested in Breathing and Blood Pressure
My interest in this subject is personal as well as professional.
Around age 50, a routine medical check found that I had stage 1 hypertension. Rather than looking only at individual readings, I began systematically exploring how regular aerobic activity, breathing, stress management and other sustainable habits affected my blood pressure over time.
You can read the full story here:
That experience ultimately contributed to the development of BreathNow.
I have also personally experimented with device-free IMST-style breathing. In the original version of this article I reported seeing systolic readings approximately 5–9 mmHg lower during a short period when I practiced the exercise regularly.
My background is a PhD in computer science rather than medicine, so I approach these tools from the perspective of digital health, measurement and personal behavior — while relying on peer-reviewed cardiovascular research for medical claims.
What Makes BreathNow Different?
Most dedicated IMST devices follow a simple model:
Resistance → Train → Measure breathing strength
BreathNow follows a broader BP-management model:
Measure BP → Breathe → Track → Try other interventions → Measure again
Alongside IMST-style breathing, BreathNow offers:
🩺 Blood-pressure tracking
🤖 AI BP Coach
🌬️ Slow breathing
🫁 4-7-8 breathing
🧘 Meditation
💪 Isometric exercise
🏃 Aerobic activity
❤️ HRV and stress tracking
⌚ Apple Watch activities
🍎 Apple Health integration
🤖 Android Health Connect support
The advantage is flexibility and outcome tracking.
Final Verdict
Randomized trials and meta-analyses now provide meaningful evidence that resistance-based inspiratory muscle training (IMST) reduce blood pressure in some populations.
If your priority is reproducing high-resistance clinical IMST, choose a resistance device. POWERbreathe has the clearest connection to the kind of protocols used in the landmark BP research, while Airofit and PrO2 provide more sophisticated digital feedback and BREATHER FIT offers a simpler, lower-cost hardware approach.
If your priority is low cost, convenience, BP tracking and the ability to combine IMST breathing without a device with other breathing exercises, BreathNow offers a solid solution.
❓ Frequently Asked Questions (FAQs)
1. What is inspiratory muscle training?
Inspiratory muscle training strengthens the muscles involved in inhalation by making them work harder, usually against resistance. IMST is a higher-intensity form that has been studied for blood pressure and cardiovascular outcomes.
2. Can IMST lower blood pressure?
Randomized trials and meta-analyses have found reductions in systolic and diastolic blood pressure after regular IMST. The size of the effect varies considerably between studies and should not be interpreted as a guaranteed personal result.
3. Do I need an IMST device?
A resistance device is the best way to reproduce the calibrated high-resistance IMST protocols used in major clinical studies. Device-free training is cheaper and more convenient.
4. Can I perform IMST training without a device?
You can perform app-guided IMST-style breathing without buying specialized hardware. It is perfdomed by squeezing your nostrils during inhale. An app alone cannot verify that you are training at a particular percentage of maximal inspiratory pressure.
5. What is the best IMST device for lowering blood pressure?
POWERbreathe is particularly relevant because resistance-based POWERbreathe equipment has been used extensively in respiratory research and closely resembles the type of loading studied in high-resistance IMST trials. Other devices such as Airofit, BREATHER FIT and PrO2 also provide inspiratory resistance but should not automatically be assumed to produce identical BP effects.
6. How long does IMST take?
Some high-resistance studies used just 30 breaths per day, taking approximately five to eight minutes. Benefits in published trials generally emerged after several weeks of consistent training rather than after one session.
7. Is app-only IMST cheaper?
Usually, yes, because there is no dedicated respiratory-training device to purchase. Subscription costs can still apply, so total long-term cost depends on the app and hardware being compared.
8. Can I combine IMST with slow breathing?
Yes, because they are different forms of breathing training and can be used at different times. An app such as BreathNow makes this particularly convenient because several breathing exercises are available in one place.
9. Can IMST replace blood-pressure medication?
No, IMST should be considered a complementary lifestyle intervention rather than a replacement for prescribed medication. Never stop or change blood-pressure medication based solely on an app, breathing exercise or home reading.
10. How can I tell whether IMST is helping my blood pressure?
Use a validated blood-pressure monitor and compare consistent measurements taken under similar conditions over several weeks. Tracking those readings in an app can make the trend easier to see, but changes should be discussed with a healthcare professional.
References
1. Slow Deep Breathing Reduces High Blood Pressure in Hypertensive Patients — Tarihoran et al., 2015.ResearchGate full publication
2. 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 — Craighead et al., Journal of the American Heart Association, 2021.PubMed | Journal of the American Heart Association
3. University of Colorado Boulder — “5-minute breathing workout lowers blood pressure as much as exercise, drugs” — ScienceDaily, 2021.Read the original ScienceDaily article
4. A Hypotensive Protocol of Inspiratory Muscle Strength Training: Systematic Review and Meta-analysis With Trial Sequential Analysis — Li et al., Journal of Clinical Hypertension, 2023.Read the systematic review
5. Effects of Inspiratory Muscle Training in Patients With Hypertension: A Meta-analysis — Zheng et al., 2023.PubMed
6. Comparison of Inspiratory Muscle Strength and Aerobic Exercise Training and Detraining on Blood Pressure in Hypertensive Patients — Jae et al., Clinical Hypertension, 2025.PubMed
7. Can Respiratory Muscle Training Change Blood Pressure Levels in Hypertension? A Systematic Review With Meta-analysis — da Silva et al., 2021.PubMed
Medical disclaimer: This article is for general information and wellness education only and is not medical advice. IMST should not replace prescribed medication, professional diagnosis or treatment, and people with cardiovascular or respiratory conditions should discuss high-resistance breathing training with a qualified healthcare professional.
