Chronic high blood pressure causes heart disease, stroke, peripheral vascular disorders, retinopathy, kidney disease and other health problems. A large study reported in the journal "Hypertension" in 1995 reported that 24 percent of the U.S. adult population suffers from high blood pressure. Successful management of high blood pressure may be the most important step in reducing premature morbidity and mortality in people of developed nations. Chiropractors can play an important role in helping their patients avoid or manage high blood pressure.
Types of Hypertension
In only a minority of cases is a specific medical cause of high blood pressure identified. These cases of high blood pressure are labeled as "secondary hypertension." Most people diagnosed with high blood pressure have "primary" or "essential" hypertension. A specific cause for primary hypertension has not been found, but according to the National Institutes of Health, the condition is closely linked with lifestyle. People who smoke, are overweight, eat salt and fat regularly, are stressed, drink excessively or are inactive are at increased risk. These lifestyle issues usually do not require treatment by drugs or surgery, and can certainly be addressed by chiropractors who often take a holistic approach to health problems.
Nutritional Influences
Total caloric intake, hydration status, dietary fat, dietary fiber, alcohol intake carbohydrate types and sources are examples of dietary factors that may impact blood pressure. Salt intake, for example has been clearly linked to hypertension in developed nations. A chiropractor can be a resource for patients seeking specific dietary guidelines, including which supplements may be appropriate. Chiropractic education, with its emphasis on conservative therapies, includes specific courses on clinical nutrition. In contrast, curriculum specifically devoted to nutrition is found to be limited in most medical school settings. A survey of 126 U.S. medical schools, published in the April 2006 "American Journal of Clinical Nutrition," revealed an average of fewer than 24 contact hours of nutrition instruction.
Exercise And Lifestyle
Stress, excessive weight and inactivity have been identified as independent risk factors for high blood pressure. Each of these may respond favorably to exercise. A chiropractor can assist patients in selecting the type, intensity and frequency of exercise most suited to them. The chiropractor can also provide important instruction and feedback on exercise techniques that will reduce the likelihood of injury. Chiropractors can also provide direct assistance or serve as referral sources for smoking cessation or substance-abuse treatment programs.
Spinal Manipulation
Before 2007, the literature on the effects of chiropractic manipulation on blood pressure was limited mostly to case studies. There was no compelling evidence that chiropractic manipulation was a promising treatment for hypertension. In May 2007, a well-constructed randomized trial was published in the "Journal of Human Hypertension" in which a specific type of upper cervical chiropractic treatment was used. In this study, the group receiving the chiropractic treatment had marked and sustained reductions in blood pressure that far surpassed the results of the placebo group. Although more research is needed to validate these results, it appears that upper cervical chiropractic manipulation holds promise as an additional tool in the treatment of high blood pressure.
Perspective
The effort to avoid or reduce the dosage of blood pressure medications should never supersede the primary goal of controlling the high blood pressure. Blood pressure not adequately managed by conservative means may require the addition of a prescription medication. The chiropractor should, in these cases, work cooperatively with the prescribing physician to co-manage the condition.
References
- "Hypertension"; Prevalence of Hypertension in the US Adult Population; V. Burt; P. Whelton; E. Roccella, et al; 1995
- National Institutes of Health: Essential Hypertension
- "American Journal of Clinical Nutrition"; Status of Nutrition Education in Medical Schools; K. Adams, K. Lindell, M. Kohlmeier and S. Zeisel; April 2006
- "Journal of Human Hypertension"; Atlas Vertebra Realignment and Achievement of Arterial Pressure Goal in Hypertensive Patients: A Pilot Study; G. Bakris, M. Dickholtz, P. Meyer, et al; May 2007
