Substituting Lifestyle Management for Pharmacological Control of Blood Pressure: A Pilot Study in Australian General Practice
There were no changes attributable to the lifestyle intervention in the subjects continuing drug therapy in BP or lifestyle variables over the study period. However, the group stopping therapy had a 6% reduction in body mass index after 9 months. These data suggest that a proportion of motivated patients willing to trial a lifestyle approach can cease drug therapy and be adequately maintained by the prescription of lifestyle advice via their GP for at least a 9-month period. Cessation of drug therapy may be an important motivating factor to achieve weight loss in this group.
Even a small decrease in average BP can dramatically lower your risk for cardiovascular disease and death. Whether or not you currently have high blood pressure, maintain a consistent regimen of aerobic exercise to ward off disease, premature death, and obesity.
Lifestyle change, including diet, exercise, and stress management, may contribute significantly to lowering of blood pressure. Supplements such as potassium, magnesium, CoQ10, omega-3 fatty acids, amino acids L-arginine and taurine, and vitamins C and E have been effectively used in the treatment of cardiovascular disease, including hypertension. Botanicals have been used for centuries to treat various diseases including cardiovascular disorders. It is no surprise they have proven effective in lowering blood pressure and improving heart function. Among the most researched and frequently utilized for hypertension are hawthorne, Terminalia arjuna, olive leaf, European mistletoe, yarrow, black cumin seeds, forskolin, Indian snakeroot, and garlic. More research is indicated to determine the full potential that alternative medicine has to offer in the management of hypertension. With the increasing numbers of patients suffering from hypertension and conventional medicine failing to effectively control the problem, alternative therapies offer hope.
The Management of Hypertensive Disease: A Review of Spinal Manipulation and the Efficacy of Conservative Therapeusis
When considering the ailments that plague mankind, certainly one of the enigmatic conditions is hypertensive disease. This perplexing disorder is recognized insidiously in the clinical setting. It is believed to occur because of the complex interactions of a variety of factors which act on the components of the blood vasculature. Although afflicted individuals may appear relatively asymptomatic, the additive influences of such factors eventually culminate in deleterious sequelae. Overall, hypertension appears to be related to stress, diet and lifestyle. The autonomic nervous system, particularly its sympathetic component, appears to mediate such accumulated factors, affecting the overall clinical scenario of hypertension. Although generally aligned with the aging process, this condition also may affect younger individuals. Hypertension, therefore, may be regarded as a prime condition warranting specialized care that includes proper education during the formative years, modification of dietary habits in conjunction with daily exercise regimens, and regular spinal maintenance, all of which are covered by modern chiropractic clinical practice.
The C1 Area of the Brainstem in Tonic and Reflex Control of Blood Pressure. State of the Art Lecture
Recent studies have demonstrated that the neurons of the lower brainstem that are responsible for maintaining normal levels of arterial pressure reside in a specific area of the rostral ventrolateral medulla. In rat, the critical zone corresponds to a small region containing a subpopulation of the adrenergic C1 group, defined immunocytochemically by the presence of the epinephrine-synthesizing enzyme phenylethanolamine N-methyltransferase. Neurons of this region (the C1 area), possibly including the adrenergic neurons, directly innervate preganglionic neurons in the spinal cord, and are tonically active and sympathoexcitatory.
This study examined the effects of chiropractic adjustments of the thoracic spine (T1-T5) on blood pressure and state anxiety in 21 patients with elevated blood pressure. Subjects were randomly assigned to one of three treatment conditions: active treatment, placebo treatment, or no treatment control. The adjustments were performed by a mechanical chiropractic adjusting device. Dependent measures obtained pre- and post-treatment included systolic and diastolic blood pressure, and state anxiety. Results indicated that systolic and diastolic blood pressure decreased significantly in the active treatment condition, whereas no significant changes occurred in the placebo and control conditions. State anxiety significantly decreased in the active and control conditions. Results provide support for the hypothesis that blood pressure is reduced following chiropractic treatment. Further study is needed to examine the long-term effects of chiropractic treatment on blood pressure.
The purpose of this study was to evaluate the reliability of clinical blood pressure readings and to begin a series of experiments to determine if chiropractic adjustments cause any significant changes in blood pressure. Seventy-five students undergoing routine chiropractic health care at Palmer College of Chiropractic Clinic volunteered to participate in the blood pressure measurement protocol in one 10-min visit. Blood pressure was recorded by right arm cuff sphygmomanometer by an experienced chiropractor immediately before and again immediately after either the specific cervical adjustment or the control procedure, which was simply motion palpation. The doctors measuring blood pressures did not know to which group the subject had been assigned. Both systolic and diastolic blood pressures were statistically significantly lowered in the Experimental but not the Control group (p less than 0.01). The difference in the mean blood pressures was small and was brought about by 14 of the Experimental subjects who experienced a clinically relevant 10-20 mm hg drop. Reliability of blood pressure measurements by two doctors was established under similar conditions in an additional 25 subjects.
Time Course Considerations for the Effect of Lower Cervical Adjustments with Respect to the Amelioration of Cervical Lateral Flexion Passive End–range Asymmetries, and on Blood Pressure, Heart Rate, and Plasma Catecholamine Levels
Additionally, based on simultaneous serial monitoring of heart rate, blood pressure, and plasma catecholamine concentrations, it does not appear that the therapeutic procedure used in these studies is particularily stressful or traumatic, at least in otherwise asymptomatic subjects.
Effects of Cervical Adjustments on Lateral Flexion Passive End–range Asymmetry and on Blood Pressure, Heart Rate and Plasma Catecholamine Levels
Posttreatment goniometric measurements revealed that in sham-adjusted controls, mean lateral-flexion asymmetries had not changed significantly during the 4-hr time period examined. However, in subjects who received lower cervical adjustments, dramatic ameliorations of asymmetry magnitude were observed which persisted throughout the entire 4-hr posttreatment time period. On the other hand, in the face of this rather robust biomechanical effect, heart rate and blood pressure measurements obtained at -60 and -15 min prior to treatments, and at 5, 30, 60, 120 and 240 min following treatments, revealed no significant differences between adjusted and sham-adjusted subjects at any of the time periods examined.
Specific contact short lever arm spinal adjustments may cause a hypotensive effect in a medicated hypertensive patient that may lead to complications (e.g., hypotension). Since a medicated hypertensive patient’s blood pressure may fall below normal while he or she is undergoing chiropractic care, it is advised that the blood pressure be closely monitored and medications adjusted, if necessary, by the patient’s medical physician.
Significant Changes in Systolic Blood Pressure Post Vectored Upper Cervical Adjustment vs Resting Control Groups: A Possible Effect of the Cervicosympathetic and/or Pressor Reflex
Palpation and vectored adjustment of subjects (n = 40) with putative upper cervical joint dysfunction diagnosed by postural distortions significantly lowered systolic BP both from pretreatment to posttreatment (P < .001) and in comparison with a similar resting control group (n = 40; P < .001). Another test in which subjects (n = 30) were used as their own controls also showed a significant decrease in systolic BP from resting to postadjustment values (P < .001). I propose that the sudden decrease in systolic BP noted in both of these tests was due to stimulation of cervicosympathetic reflexes or possibly to moderation of muscle tone and elimination of the effects of the pressor reflex. This study also found a greater decrease in systolic BP after adjustment in subject patients with increasing age. Associations between the effects of the pressor reflex and thermographic findings and the potential for alterations of visceral physiology in joint dysfunction have been discussed. Further studies involving (1) blinding, (2) testing for direct connections between joint dysfunction, muscle hypertonicity, and the pressor reflex, and (3) the possibility of long-term reduction in systolic BP, are recommended.
Practice-based Randomized Controlled-comparison Clinical Trial of Chiropractic Adjustments and Brief Massage Treatment at Sites of Subluxation in Subjects with Essential Hypertension: Pilot Study
This pilot study elucidated several procedural issues that should be addressed before undertaking a full-scale clinical trial on the effects of chiropractic adjustments at sites of subluxation in patients with essential hypertension. Among the most important of these is using measures to assure comparable groups regarding prognostic variables such as weight. A multidisciplinary approach to recruitment may need to be used in any future efforts due to the limited subject pool of patients who have hypertensive disease but are not taking medications for its control. A 1-week run-in period may be necessary before randomization, to exclude subjects who may only be exhibiting white coat hypertension. Studies such as these demonstrate the feasibility of conducting a full-scale 3-group randomized clinical trial of patients with hypertension in the practice-based setting.
Atlas Vertebra Realignment and Achievement of Arterial Pressure Goal in Hypertensive Patients: A Pilot Study
Anatomical abnormalities of the cervical spine at the level of the Atlas vertebra are associated with relative ischaemia of the brainstem circulation and increased blood pressure (BP). Manual correction of this mal-alignment has been associated with reduced arterial pressure. Using a double blind, placebo-controlled design at a single center, 50 drug naive (n=26) or washed out (n=24) patients with Stage 1 hypertension were randomized to receive a National Upper Cervical Chiropractic (NUCCA) procedure or a sham procedure. Patients received no antihypertensive meds during the 8-week study duration. The primary end point was changed in systolic and diastolic BP comparing baseline and week 8, with a 90% power to detect an 8/5 mm Hg difference at week 8 over the placebo group. The study cohort had a mean age 52.7+/-9.6 years, consisted of 70% males. At week 8, there were differences in systolic BP (-17+/-9 mm Hg, NUCCA versus -3+/-11 mm Hg, placebo; P<0.0001) and diastolic BP (-10+/-11 mm Hg, NUCCA versus -2+/-7 mm Hg; P=0.002). No adverse effects were recorded. We conclude that restoration of Atlas alignment is associated with marked and sustained reductions in BP similar to the use of two-drug combination therapy.
Sympathetic and Parasympathetic Responses to Specific Diversified Adjustments to Chiropractic Vertebral Subluxations of the Cervical and Thoracic Spine
It is preliminarily suggested that cervical adjustments may result in parasympathetic responses, whereas thoracic adjustments result in sympathetic responses. Furthermore, it appears that these responses may demonstrate the relationship of autonomic responses in association to the particular segment(s) adjusted.