Holistic Approaches To Reducing High Blood Pressure
Conventional medicine accepts that the dietary approach to reducing high blood pressure works. They introduced a strategy called DASH, Dietary Approaches to Stop Hypertension. The DASH trial demonstrated that a diet rich in fruits, vegetables, and low-fat dairy products and reduced in saturated and total fat, could achieve clinically important reductions in blood pressure, as compared with a typical American diet. Those with hypertension had a reduction of 11.4/5.5 mmHg, and those without hypertension had a reduction of 5.5/3.0 mmHg. These reductions occurred in the absence of changes in weight or sodium intake, appeared within 2 weeks of being on the diet, and persisted for the 8 weeks of feeding.
DASH has since been modified to DASH-Sodium to reduce salt levels in people’s diets. The results of the DASH-Sodium trial indicate that blood pressure can be lowered even further, although there have been critics of this trial.
Even though dietary changes and supplementation approaches are highly effective at reducing hypertension, there are other lifestyle factors that can also reduce elevated blood pressure.
Regular exercise is proven beneficial for the cardiovascular system, but it’s not so obvious whether those with preexisting hypertension will benefit, so several studies have sought to find this out.
A study of 642 men who were followed up after 25 years found that among the 173 men with hypertension, vigorous physical activity was associated with markedly reduced rates of all-cause and cardiovascular mortality. The relative risk was 0.43 for total mortality and 0.33 for cardiovascular disease mortality i.e a 57% and 67% reduced risk (J Hypertens. 1999 Jun;17(6):737-42).
Twenty-three mild hypertensive patients were divided randomly into two groups: control (no exercise) and moderate-intensity exercise. The training group exercised three times per week at the prescribed exercise intensity by using the Treadmill exercise test. Blood pressure, heart rate and other biochemical parameters were monitored regularly every 4 weeks for 12 weeks.
After 12 weeks regular exercise training, the exercise group showed significant resting blood pressure reduction. Mean maximal reduction of systolic pressure was 18 mmHg.
“These data suggest that after 12 weeks of exercise training in mild hypertensive patients, successful reduction of blood pressure...will be noted” (Clin Exp Hypertens. 2002 May;24(4):315-24).
The combined association of blood pressure and physical activity on cardiovascular mortality was assessed in a cohort of 30,597 women and 30,508 men, using standardised blood pressure measurements and information on usual frequency, duration, and intensity of physical exercise. Follow up was after 16 years.
Cardiovascular mortality increased continuously with increasing blood pressure, and, at each blood pressure level, risk was higher in men and women with no physical activity compared with those who reported high physical activity.
“The results support the hypothesis that cardiovascular health of individuals with moderate hypertension will benefit from regular physical exercise.” (J Hypertens. 2006 Oct;24(10):1939-46).
Two groups of 76 healthy subjects with blood pressure at high-normal or stage I hypertension were enrolled 3 times per week in a 12-week Tai Chi Chuan exercise training programme or were put in a control group. Each session included 10-minute warm-up, 30-minute Tai Chi exercise, 10-minute cool-down.
Exercise intensity was estimated to be approximately 64% of maximal heart rate.
After 12-weeks of Tai Chi training, the treatment group showed significant decrease in systolic blood pressure of 15.6 mmHg and diastolic blood pressure 8.8 mmHg.
“This study shows that under well-designed conditions, Tai Chi exercise training could decrease blood pressure.”
“Therefore, Tai Chi could be used as an alternative modality in treating patients with mild hypertension.” (J Altern Complement Med. 2003 Oct;9(5):747-54)
In another study fourteen patients were placed in the experimental group and fourteen in the control group. Members in the experimental group participated in a 6 week programme of Tai Chi exercise.
After 6 weeks there were significant differences in systolic and diastolic blood pressure in the experimental group when compared to the control group.
“These results suggest that a 6 week Tai Chi program can be utilized as an effective nursing program to reduce blood pressure for hypertensive patients.” (Taehan Kanho Hakhoe Chi. 2004 Aug;34(5):829-37)
Finally a recent study of 20 women who undertook two one hour Tai-Chi sessions per week for 10 weeks had a mean systolic reduction of 6 mmHg (Med Sci Monit. 2006 May;12(5):CR196-9).
A great fan of Tai Chi is holistic physician Robert Willix MD.
“If you have heart disease, practicing tai chi regularly not only lowers your blood pressure and helps you lose weight, it also defuses negative feelings, such as anger, frustration and depression which can trigger a heart attack.
“Also the moves are simple, gentle and easy to learn. They need no special skill and can be done anywhere, indoors or outdoors, alone or with a group. Anyone can become a ‘master’. It takes just a little practice, focus and a good teacher.
“Tai chi is ideal if you want the pleasure and benefit of exercise, but can’t subject your bones and joints to jarring, strenuous activity.
“Tai chi works wonders for my patients.”
One would assume that massage would be beneficial for its effect on stress reduction. However there has been little published research in this area.
Thirty-four subjects were assigned to foot reflexology or control. It was administered twice a week for 6 weeks.
There was a significant decrease in systolic blood pressure in the reflexology group compared to the control group.
“The results proved that foot reflexology was an effective nursing intervention to decrease systolic pressure.” (Taehan Kanho Hakhoe Chi. 2004 Aug;34(5):739-50).
A preliminary study tested the effects of regularly applied back massage on the blood pressure of patients with clinically diagnosed hypertension.
10 minute back massage was given to the experimental group comprising 8 people, three times a week for 10 sessions. The six in the control group relaxed in the same environment for 10 minutes, three times a week for 10 sessions.
Systolic blood pressure changed significantly between groups over time as did the diastolic blood pressure.
“This preliminary study suggests that regular massage may lower BP in hypertensive persons.” (Biol Res Nurs. 2005 Oct;7(2):98-105).
150 current adult massage therapy clients with blood pressure lower than 150/95 were measured before and after a therapeutic massage.
Overall, systolic blood pressure decreased by 1.8 mmHg and diastolic increased by 0.1 mmHg. Demographic factors associated with blood pressure decrease included younger age and taller stature.
Type of massage was associated with change in blood pressure: Swedish massage had the greatest effect at blood pressure reduction. Trigger point therapy and sports massage both increased the systolic blood pressure, and if both forms of massage were included in a session, both the systolic and diastolic readings significantly increased. No other massage factors were associated with a significant change in blood pressure.
“Type of massage was the main factor affecting change in blood pressure. Increases in blood pressure were noted for potentially painful massage techniques, including trigger point therapy.” (J Altern Complement Med. 2006 Jan-Feb;12(1):65-70).
Scientific research has demonstrated through hundreds of studies that many favourable changes occur in the body when one is meditating including reduction in hypertension. However most of these studies have been criticised for weak design and methodological problems.
One well conducted trial has reported that three months' practice of transcendental meditation (TM) significantly reduced clinic measured diastolic and systolic blood pressure over group controls given education. Progressive muscle relaxation produced an intermediate effect size. The mean adjusted changes in the TM group were 10.7 mmHg in systolic and 6.4 mmHg in diastolic blood pressure.
“This and several other studies by authors associated with the TM organisation indicate a positive effect on blood pressure” (Hypertension. 1995 Nov;26(5):820-7).
Data were pooled from 2 published randomised controlled trials that compared TM, other behavioural interventions, and usual therapy for high blood pressure. There were 202 subjects, including 77 whites (mean age 81 years) and 125 African-American (mean age 66 years) men and women.
In these studies, average baseline blood pressure was in the prehypertensive or stage I hypertension range. Follow-up of vital status and cause of death over a maximum of 18.8 years was determined.
Compared with combined controls, the TM group showed a 23% decrease in the primary outcome of all-cause mortality. There was a 30% decrease in the rate of cardiovascular mortality and a 49% decrease in the rate of mortality due to cancer in the TM group compared with combined controls.
“These results suggest that a specific stress-decreasing approach used in the prevention and control of high blood pressure, such as the TM program, may contribute to decreased mortality from all causes and cardiovascular disease in older subjects who have systemic hypertension” (Am J Cardiol. 2005 May 1;95(9):1060-4).
Autogenic training (AT) is a very powerful technique for dealing with stress. It can bring about mental results similar to Eastern meditation. On the physical level it produces physiological changes as found with intense athletic training. It helps to maintain balance between the sympathetic and parasympathetic nervous system.
Of 90 patients with hypertension, half undertook AT while the other had no behavioural intervention. By the end of the 5 year follow-up period, the AT group was significantly different from the control group, with reduced blood pressure (by 5.8 mmHg systolic and 3.2 mmHg diastolic vs. 4.3 mmHg systolic and 2.0 mm Hg diastolic).
“AT appeared to be more effective in patients with mild hypertension than in those with moderate hypertension and the results were comparable with those obtained with regular medication.”
Exercise, tai chi, massage, meditation, AT plus others not covered - biofeedback and yoga - have been demonstrated to reduce hypertension. Together with the dietary and supplementation approaches in another article Nutritional Solutions To High Blood Pressure, the vast majority of people with elevated blood pressure have enough options to control their condition without resorting to drugs.
This article was first published in Enzyme Digest No. 74 Autumn 2006
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