Three Part Question
IN [adults with Hypertension] IS [Upper Cervical Manipulation] effective in [lowering blood pressure].
A 55 yr old male presents with a 10 year history of hypertension. The patient has been taking a combination of Lisinopril and Hydrochlorithiazide for the past 5 years. The patient has heard that chiropractic manipulation may have a lowering effect on blood pressure and would like to know if there is any evidence to support this.
Database: PubMed with MeSH for chiropractic and hypertension
Keywords: chiropractic, hypertension
Limits: Human, English, Clinical Trial, Randomized Control Trial, Adult
Full Query: (("chiropractic"[MeSH Terms] OR "chiropractic"[All Fields]) AND ("hypertension"[MeSH Terms] OR "hypertension"[All Fields])) AND ("loattrfull text"[sb] AND "humans"[MeSH Terms] AND (Clinical Trial[ptyp] OR Randomized Controlled Trial[ptyp]) AND English[lang] AND "adult"[MeSH Terms])
3 Papers were identified all of which were randomized controlled trials. The article by Bakris G. et.al. was chosen because it addressed chiropractic manipulation of the upper cervical spine and its effect on blood pressure.
|Author, date and country
||Study type (level of evidence)
|50 drug naïve patients with Stage 1 Hypertension||Randomized,Double Blind,with Placebo Control||Systolic Blood Pressure, Diastolic Blood Pressure, Pulse Rate, and Atlas Measurement||-17+or-9 mmHg change in Systolic blood pressure and – 10+or-11 mmHg change in Diastolic blood pressure||The study was dependent upon the manipulation skills of 1 practitioner. The sample size was relatively small given that it was a pilot study |
Clinical Bottom Line
In patients with Stage 1 Hypertension, there is evidence to suggest that upper cervical chiropractic manipulation can provide long-term amelioration in blood pressure.
- G Bakris, M Dickholtz Sr, PM Meyer, G Kravitz, E Avery, M Miller, J Brown, Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study Journal of Human Hypertension (2007)1–6