Features July 2013 Issue

Which Complementary Therapies Can Lower Your Blood Pressure?

Research shows these techniques won’t hurt and just might help reduce your dependence on blood-pressure medications.

More than one-fourth of the population suffers from hypertension (high blood pressure), a condition implicated in half of all strokes and heart attacks. The condition is treatable, however. Many people are able to achieve the optimal blood pressure goal of approximately 115/75 mm Hg with anti-hypertension medications and certain lifestyle changes, particularly regular aerobic exercise, a low-salt diet and weight loss.

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Complimentary therapies could include swimming, weightlifting, yoga.

Yet high blood pressure remains a serious problem, with thousands of people unable to reach their goal or unwilling to take the necessary measures to attain it. For their benefit, the American Heart Association (AHA) evaluated a number of other modalities that have limited, but encouraging, data in favor of their ability to lower blood pressure. Their findings were published online April 22, 2013, in Hypertension.

According to David Frid, MD, a preventive cardiologist at Cleveland Clinic, most of these so-called “alternative approaches” are actually “adjunct approaches,” because they should be considered in addition to, not in place of, medications.

“Most people with high blood pressure need to be treated with medications first, with nonmedical approaches added later to further lower blood pressure. In patients who are being treated aggressively, but who are still unable to meet their blood pressure goals, these new approaches might also be worth trying,” he says.

For people with prehypertension, less caution may be needed. “In this group, these approaches just might lower blood pressure enough to prevent the need for medication,” he says.

From acupuncture to yoga:

Inconsistent findings
The AHA examined all published clinical trials of meditation, yoga, other relaxation techniques, biofeedback, acupuncture, device-guided slow breathing, endurance exercise, dynamic resistance exercise and isometric exercise. They looked at the level (quality) of evidence available from the published literature and rated each modality A, B or C. Then they looked at how well the literature supported the effectiveness of these techniques in lowering blood pressure and provided a class of recommendation.

Of all the treatments evaluated, dynamic aerobic exercise stood out as having the best evidence supporting its usefulness in lowering blood pressure. Although the extent of the benefit correlated with the intensity of the exercise, raising the heart rate uniformly caused blood pressure to drop, even in people whose hypertension was resistant to four or more medications. Additionally, aerobic exercise was the only modality that lowered mortality risk.

Isometric handgrip exercises (squeezing a spring-loaded hand grip), dynamic resistance exercises (such as lifting weights or using Nautilus-type equipment) and device-guided deep breathing also fared well.

At the other end of the spectrum, transcendental meditation, other meditation techniques, yoga, other relaxation therapies, biofeedback and acupuncture showed “modest, mixed, or no consistent evidence demonstrating their efficacy.”

No harm in trying
These conclusions not withstanding, each approach was supported by one or more clinical trial in which it was shown to lower blood pressure. This means each modality works for some people. Who are they?

“The effect of any approach depends on the individual. With the exception of aerobic exercise, it’s hard to say how any one person will respond,” says Dr. Frid.

In general, people with very high blood pressure tended to benefit the most, while those with normal blood pressure saw very little change.
Moreover, none of the approaches are likely to cause harm. Strenuous aerobic, isometric and resistance exercises might raise blood pressure temporarily, so they require a physician’s approval to proceed. But the other approaches are generally safe.

Moreover, since any of the modalities might work in a given individual, they are worth trying, said the authors of the paper. “It is reasonable for all individuals with blood pressure levels greater than 120/80 mm Hg to consider trials of alternative approaches as adjuvant methods to help lower blood pressure when clinically appropriate,” they said.

Dr. Frid agrees. He recommends his patients give some of these techniques a try—in addition to exercise, the Dietary Approaches to Stop Hypertension (DASH) diet and weight loss.

“I have found slow-guided breathing, relaxation techniques, tai-chi or basic yoga can be helpful. Yoga may not have strong data for blood pressure-lowering, but it lowers stress, and this has other cardiovascular benefits,” he says. “None of these modalities has shown overwhelming benefits. But if a patient’s blood pressure is 130/85 mm Hg, and one of these approaches brings it closer to 120/80 mm Hg, I’m happy.”

Comments (2)

Thanks for the advice it was well needed!

Posted by: Unknown | September 30, 2013 4:21 PM    Report this comment

Yours comentaries about blood pressure save my live. I know now the correct form to take my pressure, fit, excersices, etc,....and other value information in yours medicals articules. You're highly profesional. Im female, 44y/o, very sickness, im diabetic, fibromialgic, bipolar dissorder, hihg blood pressure,migraine,etc,etc, etc. I need to know abaout my health. Im puertorrican and diabetic.

Posted by: Unknown | September 20, 2013 11:49 PM    Report this comment

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