Our heart expertSimeon Margolis, M.D., Ph.D.is professor of medicine and biological chemistry, Johns Hopkins.
If you've been diagnosed with high blood pressure, your doctor has probably recommended certain lifestyle measuresand possibly prescribed medicationto keep it under control. For certain people, including those who aren't able to lower their blood pressure with dietary changes or who have stage I hypertension (140/90 mm Hg to 159/99 mm Hg), alternative methods may help.
An American Heart Association (AHA) panel recently published an evidence-based look at certain alternative approaches in the journal Hypertension. In general, the panel found that a three-month trial of an alternative therapywith trials of up to 12-months in low-risk peoplewas sufficient to allow any benefits to take effect.
Here are the six alternative therapies that showed the most positive effects on blood pressure. (Note: Because the effects of many of these approaches are relatively modest, the AHA stresses that none of them should replace your standard treatment plan.)
- Aerobic exercise For more than 40 years, experts have recommended aerobic activities such as walking, jogging and running to help control blood pressure numbers. Current guidelines recommend at least 30 minutes of moderate physical activity on most days of the week.
- Dynamic resistance exercise Research into the effect of resistance exercise on the heart has been uneven. However, many studies have shown at least modest positive benefits. The AHA panel concluded that dynamic resistance exercise (where your muscles work to overcome a workload that is greater than normal) can modestly lower blood pressure. The Centers for Disease Control and Prevention (CDC) recommends performing a muscle-strengthening activity such as lifting weights or heavy gardening (digging, shoveling) at least twice a week.
- Isometric exercise One study found that four weeks of performing isometric handgrip exercises could reduce blood pressure by as much as 10 mm Hg. (With isometric exercises, you contract muscles strongly but don't move them.) Handgrip exercises can be done by squeezing an inexpensive spring-loaded device, available at most sporting goods stores. The AHA panel recommended holding handgrip contractions for two minutes at a time, for a total of 12 to 15 minutes a session, at least three times a week.
- Biofeedback Biofeedback techniques are based on recognizing cues from your body. With the help of a biofeedback specialist and special equipment, you learn how to control involuntary processes, such as blood pressure. Methods include cognitive behavioral therapy, relaxation therapy, guided imagery and psychological education. Biofeedback's effect on blood pressure has been highly variable, with the AHA panel finding reductions in systolic blood pressure (the top number) ranging from none to about 15 mm Hg.
- Transcendental Meditation TM uses specific mantras, or chants, to move past distracting thoughts and toward a state of increased awareness. Some studies have shown TM to have modest effects on blood pressure. The AHA says patients can try TM to help lower blood pressure but couldn't recommend other forms of meditation because of insufficient evidence.
- Device-guided slow breathing Taking deep breaths at the rate of six per 30 seconds may reduce systolic blood pressure by up to 3.9 mm Hg within minutes, according to a study published in Hypertension Research. Additional research suggests that deep-breathing techniques done over the course of weeks and months may produce long-term blood pressure reduction. The Food and Drug Administration has approved a device, Resperate, as a complement to high blood pressure treatment. The device prompts you to match your breathing rate to musical tones through headphones. The AHA panel said Resperate may be worth a try, but more research is needed to find out whether similar outcomes can be duplicated without using the pricey (about $300–$400) over-the-counter device.
From our sister publication Diabetes Focus Spring 2014