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AHA Statement: Alternative Therapies May Help Lower Blood Pressure, But Effects Are Modest

Therapies shouldn’t replace standard hypertension treatments (Apr. 22)

Alternative therapies, such as aerobic exercise, resistance or strength training, and isometric hand grip exercises, may help reduce blood pressure, according to the American Heart Association (AHA).

In a scientific statement published in Hypertension, the association said alternative approaches could help people with blood pressure levels higher than 120/80 mm Hg as well as 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.

The AHA estimates that hypertension — a major risk factor for heart attack and stroke — affects more than 26% of the population worldwide and contributes to more than 13% of premature deaths.

An expert panel assessed three alternative-remedy categories: exercise regimens; behavioral therapies, such as meditation; and noninvasive procedures or devices, including acupuncture and device-guided slow breathing. The panel did not review dietary and herbal treatments.

The experts looked at data published from 2006 to 2011, including 1,000 studies on behavioral therapies, on noninvasive procedures and devices, and on three types of exercise: aerobic, resistance or weight training, and isometric exercises (most commonly handgrip devices).

The researchers also examined the effects of yoga, different styles of meditation, biofeedback methods, acupuncture, device-guided breathing, relaxation, and stress-reduction techniques.

Their key findings include:

  • All three types of exercise reduced blood pressure. Walking programs provided a modest benefit while, surprisingly, 4 weeks of isometric hand grip exercises resulted in some of the most impressive improvements — a 10% drop in systolic and diastolic blood pressure. However, isometric exercise should be avoided by people with severely uncontrolled hypertension (180/110 mm Hg or higher).
  • Behavioral therapies, such as biofeedback and transcendental meditation, may help lower blood pressure by a small amount. However, the data are not sufficient 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 the treatment. However, device-guided slow breathing was effective in lowering blood pressure when performed for 15-minute sessions three or four times a week.
  • Source: AHA; April 22, 2013.

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