Lowering Blood Pressure with Alternative Therapies
Author: The American Heart Association/American Stroke Association
Synopsis and Key Points:
Alternative approach could help people with blood pressure levels higher than 120/80 mm Hg and those who do not respond well to standard medications.
Main DigestAlternative therapies such as aerobic exercise, resistance or strength training, and isometric hand grip exercises may help reduce your blood pressure, according to the American Heart Association.
In a new scientific statement published in its journal Hypertension, the association said alternative approaches could help people with blood pressure levels higher than 120/80 mm Hg and those who can't tolerate or don't respond well to standard medications.
However, alternative therapies shouldn't replace proven methods to lower blood pressure - including physical activity, managing weight, not smoking or drinking excess alcohol, eating a low sodium balanced diet and taking medications when prescribed, the association said.
High blood pressure - a major risk factor for heart attack and stroke - affects more than 26 percent of the population worldwide and contributes to more than 13 percent of premature deaths.
An expert panel assessed three alternative remedy categories: exercise regimens; behavioral therapies such as meditation; and non-invasive procedures or devices including acupuncture and device-guided slow breathing. The panel did not review dietary and herbal treatments.
"There aren't many large well-designed studies lasting longer than a few weeks looking at alternative therapies, yet patients have a lot of questions about their value," said Robert D. Brook, M.D., Chair of the panel and an associate professor of medicine at the University of Michigan in Ann Arbor. "A common request from patients is, 'I don't like to take medications, what can I do to lower my blood pressure' We wanted to provide some direction."
The alternative therapies rarely caused serious side effects and posed few health risks, but the analysis revealed some approaches were more beneficial than others and could be part of a comprehensive blood pressure-lowering treatment plan.
Brook and colleagues reviewed data published in 2006-11, including 1,000 studies on behavioral therapies, non-invasive procedures and devices, and three types of exercise (aerobic, resistance or weight training and isometric exercises, most commonly hand-grip devices).
The studies also examined the effects of yoga, different styles of meditation, biofeedback methods, acupuncture, device-guided breathing, relaxation and stress reduction techniques.
The panel found:
- All three types of exercise reduced blood pressure. Walking programs provided modest benefit while, somewhat surprisingly, four weeks of isometric hand grip exercises resulted in some of the most impressive improvements - a 10 percent drop in systolic and diastolic blood pressure. However, isometric exercise should be avoided among people with severely-uncontrolled high blood pressure (180/110 mm Hg or higher).
- Behavioral therapies such as biofeedback and transcendental meditation may help lower blood pressure by a small amount. However, there's not sufficient data to support using other types of meditation.
- Strong clinical evidence is also lacking to recommend yoga and other relaxation techniques for reducing blood pressure.
- There isn't enough evidence to recommend acupuncture for lowering blood pressure, particularly given the complexities involved in employing this treatment. However, device-guided slow breathing did prove effective in lowering blood pressure when performed for 15-minute sessions three to four times a week.
"Most alternative approaches reduce systolic blood pressure by only 2-10 mm Hg; whereas standard doses of a blood pressure-lowering drug reduce systolic blood pressure by about 10-15 mm Hg," Brook said. "So, alternative approaches can be added to a treatment regimen after patients discuss their goals with their doctors."
Given the global public health burden of high blood pressure more research is needed to look at the long-term cardiovascular health impact of alternative therapies and the effects of combining them together or adding them to other proven lifestyle measures, Brook said.
Co-authors are: Lawrence J. Appel, M.D., M.P.H.; Melvyn Rubenfire, M.D.; Olugbenga Ogedegbe, M.D., M.P.H.; John Bisognano, M.D., Ph.D.; William Elliott, M.D., Ph.D.; Flavio Fuchs, M.D., Ph.D.; Joel W. Hughes, Ph.D.; Daniel Lackland, Dr.PH., M.S.PH.; Beth Staffileno, Ph.D.; Raymond R. Townsend, M.D.; and Sanjay Rajagopalan, M.D.
The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association's science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical companies and device manufacturers, is available at www.heart.org/corporatefunding
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