Robust statistically significant effects were found for improved diet , aerobic exercise , alcohol and sodium restriction , and fish oil supplements : mean reductions in systolic blood pressure of 5.0 mmHg [ 95 % confidence interval ( CI ) : 3.1 - 7.0 ] , 4.6 mmHg ( 95 % CI : 2.0 - 7.1 ) , 3.8 mmHg ( 95 % CI : 1.4 - 6.1 ) , 3.6 mmHg ( 95 % CI : 2.5 - 4.6 ) and 2.3 mmHg ( 95 % CI : 0.2 - 4.3 ) , respectively , with corresponding reductions in diastolic blood pressure .
Relaxation significantly reduced blood pressure only when compared with non-intervention controls .
We found no robust evidence of any important effect on blood pressure of potassium , magnesium or calcium supplements .
Available evidence does not support relaxation therapies , calcium , magnesium or potassium supplements to reduce blood pressure
PURPOSE To quantify effectiveness of lifestyle interventions for hypertension .
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.
OBJECTIVE To determine the feasibility of conducting a r and omized clinical trial in the private practice setting examining short- and long-term effects of chiropractic adjustments for subjects with essential hypertension compared with a brief soft tissue massage , as well as a nontreatment control group . DESIGN R and omized controlled-comparison trial with 3 parallel groups . SETTING Private practice outpatient chiropractic clinic . PATIENTS Twenty-three subjects , aged 24 to 50 years with systolic or diastolic essential hypertension . INTERVENTIONS Two months of full-spine chiropractic care ( ie , Gonstead ) consisting primarily of specific-contact , short-lever-arm adjustments delivered at motion segments exhibiting signs of subluxation . The massage group had a brief effleurage procedure delivered at localized regions of the spine believed to be exhibiting signs of subluxation . The nontreatment control group rested alone for a period of approximately 5 minutes in an adjustment room . MAIN OUTCOME MEASURES Cost per enrolled subject , as well as systolic and diastolic blood pressure ( BP ) measured with a r and om-0 sphygmomanometer and patient reported health status ( SF-36 ) . Pilot study outcome measures also included an assessment of cooperation of subjects to r and omization procedures and drop-out rates , recruitment effectiveness , analysis of temporal stability of BPs at the beginning of care , and the effects of inclusion /exclusion criteria on the subject pool . RESULTS Thirty subjects enrolled , yielding a cost of $ 161 per enrolled subject . One subject was later determined to be ineligible , and 6 others dropped out . In both the chiropractic and massage therapy groups , all subjects were classified as either overweight or obese ; in the control group there were only 2 classified as such . SF-36 profiles for the groups were similar to that of a normal population . The mean change in diastolic BP was -4 ( 95 % confidence interval [ CI ] : -8.6 , 0.5 ) in the chiropractic care group , 0.5 ( 95 % CI : -3.5 , 4.5 ) in the brief massage treatment group , and -4.9 ( 95 % CI : -9.7 , -0.1 ) in the no treatment control group . At the end of the study period , this change was -6.3 ( 95 % CI : 13.1 , 0.4 ) , -1.0 ( 95 % CI : -7.5 , 15.6 ) , -7.2 ( 95 % CI : -13.3 , -1.1 ) in the 3 study groups . The mean improvements in the chiropractic care and no treatment control groups remained consistent over the follow-up period . CONCLUSIONS This pilot study eluci date d several procedural issues that should be addressed before undertaking a full-scale clinical trial on the effects of chiropractic adjustments in patients with essential hypertension . A multidisciplinary approach to recruitment may need to be used in any future efforts because of the limited subject pool of patients who have hypertensive disease but are not taking medications for its control . Measures need to be used to assure comparable groups regarding prognostic variables such as weight . Studies such as these demonstrate the feasibility of conducting a full-scale 3-group r and omized clinical trial in the private practice setting
Robust statistically significant effects were found for improved diet , aerobic exercise , alcohol and sodium restriction , and fish oil supplements : mean reductions in systolic blood pressure of 5.0 mmHg [ 95 % confidence interval ( CI ) : 3.1 - 7.0 ] , 4.6 mmHg ( 95 % CI : 2.0 - 7.1 ) , 3.8 mmHg ( 95 % CI : 1.4 - 6.1 ) , 3.6 mmHg ( 95 % CI : 2.5 - 4.6 ) and 2.3 mmHg ( 95 % CI : 0.2 - 4.3 ) , respectively , with corresponding reductions in diastolic blood pressure .
Relaxation significantly reduced blood pressure only when compared with non-intervention controls .
We found no robust evidence of any important effect on blood pressure of potassium , magnesium or calcium supplements .
Available evidence does not support relaxation therapies , calcium , magnesium or potassium supplements to reduce blood pressure
PURPOSE To quantify effectiveness of lifestyle interventions for hypertension .