Ways to Treat High Blood Pressure...Without a Pill!

Looking to control blood pressure without pills? See what works/ what doesn't

Woman meditating on rocks in the forest
Could alternative therapies lower your blood pressure?. Thomas Barwick/Taxi/Getty Images

Alternative therapies are increasingly receiving more attention for treatment of everything from heart disease ​to chronic kidney disease (CKD) and now high blood pressure (or hypertension). The overarching principle to always keep in mind, though, is that while it might be "cool and fashionable" to treat your maladies with alternative therapies, not all such treatments are backed by hard science.

Some interventions work, some don't. And yes, they could have harmful side effects as well. The best and brightest of us have fallen gullible victims to mumbo-jumbo alternative therapies for various illnesses; Steve Jobs tryst with pancreatic cancer being a case in point. Long story short, approach every treatment (including conventional medicine) as a level-headed, scientific sceptic. 

Hypertension (high blood pressure) is an extremely common disease. A little under a half, or 40% of all adults aged 25 years and over, have high blood pressure (most of them residing in the developed world). This number is about 30% for US adults over the age of 18. About 7.5 million people die every year around the world from consequences of high blood pressure. I guess you get my point...uncorrected high blood pressure is a big deal, and you don't want to ignore it! 

Conventional allopathic medicines and lifestyle modifications still remain the backbone of hypertension management.

What about alternative treatments, though? Well, recently in 2013, the American Heart Association came out with an official statement addressing this issue. This was published in the journal Hypertension. The statement runs about 59 pages, but I will try to summarize this statement's conclusion's addressing the efficacy of approaches like acupuncture, yoga, meditation, etc in treating high blood pressure.

 Please note that these conclusions apply only to treatment of high blood pressure, and not to other health/psychological benefits that may be derived from doing these activities.

What Works

Exercise

This may sound too obvious, but the AHA actually looked at data from studies which compared different kinds of exercise based on their types, duration, intensity, etc, to try and answer a simple question. Are all kinds of exercise equal when it comes to lowering blood pressure? 

Most types of exercise: aerobic, weight training, and isometric hand-grip exercises helped patients lower blood pressure, with people doing isometric hand-grip exercises showing the most blood pressure reduction (about 10 percent).

This was greater than the benefit obtained from a mild aerobic exercise like walking. However, the researchers speculated that this could be related to the lack of intensity or shorter duration of walking done by the subjects. Some older studies have indicated that intense walking over 35 minutes done regularly confers the same cardiovascular benefits. Comparing various alternative approaches, exercise has some of the strongest evidence out there for lowering high blood pressure. 

Meditation

The American Health Association actually looked at different kinds of meditation techniques ranging from focussed attention to Transcendental meditation (TM), and contemplative forms like Zen and mindfulness techniques. Out of these, TM was found to have a modest effect on blood pressure reduction, but whether it is superior to other techniques is hard to say since head-to-head trials have not taken place.

TM was developed in India in the 1950s by Maharishi Mahesh Yogi. It has had it fair share of celebrities from the Beatles to Madonna, swear by it. The technique involves using mantra (sounds or chants) to focus meditate while one sits for about 15 minutes with the eyes closed. It gained some notoriety/free publicity in 1977 when a US Court ruled against a TM program being taught in New Jersey schools as being "overtly religious in nature". The program ended up getting scrapped, but the case also helped TM get even more attention in the US. This was followed paradoxically by a comeback by TM when in a sort of "quasi-recognition" by the establishment, the Maharishi University in Fairfield, Iowa, received $20 million in NIH (National Institute of Health) funding to study the effects of TM on human health!

Biofeedback

Biofeedback, often referred to as "Yoga of the West", is a technique that involves being aware of your internal physiology (using our own senses, or artificial sensors like an EKG machine), and then controlling or adjusting one's behavior to get a favorable outcome. It is used, among other things, for the treatment of urinary incontinence, chronic pain, and stress reduction. Though the resutls were mixed, per the AHA, biofeedback can still be recommended to lower blood pressure since the likelihood for harm is low.

   

Breathing Devices

Certain commercial devices available in the market today help people gather data about their breathing rate and depth, relay the information back to them ​and play soothing music via headphones to help them relax. One such device quoted by the researchers was Resperate. I tend to think of such devices as basically a type of "assisted-biofeedback" therapy. Such devices could have a role to play in treating hypertension.

 

What Does Not Work

  • Yoga. Surprisingly, practicing yoga and other meditation/relaxation techniques (other than TM) did not translate into better blood pressure control (however, it is also acknowledged that it is hard to measure the "dose" or intensity of yoga, for any health study).  
  • Acupuncture. The ancient Chinese technique did not lower blood pressure demonstrably for subjects, as per the American Heart Association's statement. 

The Caveats

There are three important facts about these conclusions that I cannot overstate:

  • All the above techniques produced small modest reductions in blood pressure; sometimes as little as 2 mm (compared to 10-15 mm for most medications). 
  • The conclusions apply only to effects of these approaches on blood pressure, and nothing else. If you are doing yoga because it helps you relax, you should still go ahead and do it!
  • As much as I want, these alternative therapies do not replace traditional approaches for blood pressure control (low salt diet, medications). The best way to look at them is as strategies to complement what your doctor has already been prescribing you for your high blood pressure. This could really help if you have mild hypertension, where alternative therapies could potentially help you get off your blood pressure medications, but I highly doubt anyone with severe hypertension is getting off their Norvasc just because they started doing transcendental meditation. 

    The Bottom Line

    My take home message: if you happen to love any of the above alternative approaches, or are doing it as part of your healthy lifestyle, you can continue to do so. Remember they complement, and not necessarily replace traditional approaches and medications that your doctor suggests. You might see only a modest reduction in your blood pressure, but you know what...it is probably not going to hurt either!

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