Contributed by MK Brennan, Beth Barberree & Renee Stenbjorn

Elevated blood pressure has often been called the "silent killer" due to the fact that one may never know that hypertension is a problem until a heart attack or stroke strikes. One in every three adults in developed countries has hypertension, including approximately 50 million adults in the U.S., according to information from 2009 cited in this month's article, "Durability of Effect of Massage Therapy on Blood Pressure," which was published in the International Journal of Preventive Medicine.

Clinicians have known that hypertension is a predictor for an increased risk of cardiovascular disease and myocardial infarction. To help reduce the prevalence of hypertension, there is a new recommendation to increase awareness of and treatment for patients with "pre-hypertension." Pre-hypertension is defined as systolic blood pressure readings between 120–140 and diastolic readings between 80–90. Treating pre-hypertension may be one way to prevent hypertension and is the rationale for carrying out this study.

This month, we present information about a clinical trial conducted through the Isfahan University of Medical Sciences in Iran and published in May 2013. Changing lifestyle and using non-pharmacological treatments for pre-hypertension is recommended by many clinicians. Within these non-pharmacological treatments, complementary and alternative therapies are commonly used with massage therapy being the most popular. There have been studies that indicate massage is effective in reducing blood pressure, but not necessarily over a long period of time. This study explored the sustainable effects of using massage therapy in the treatment of pre-hypertension.

The study was a single-blind clinical trial that used a simple random sampling of pre-hypertensive women. Randomization to either the massage group or the relaxation without massage group was done by having the patients from a cardiovascular center choose a card from a box. On the cards was written either "control" or "test." Inclusion criteria was two separate blood pressure measurements with the average reading of less than 140/90 and more than 120/80, no disease that affects blood pressure, no skin disorders in the massage area, no medication that affects blood pressure, no specific diet, no obesity and no stress or lack of relaxing techniques use. Demographic information indicated that there was no significant difference between the individuals in the test and control groups. There were 25 individuals in each group.

The control group relaxed without a massage in the same environment as those in the test group who received a massage. They laid on a bed with eyes closed and deep breathing with self-muscle relaxation techniques. Blood pressure was measured before and after each session as well as 72 hours after the test period. Both the test and the control group were asked not to change their life-style and diet, and measurements were done with calibrated equipment.

The Swedish massage sessions were scheduled three times a week and lasted 10 to 15 minutes each using non-aromatic lotion on the face, neck, shoulders and upper chest of the individuals. Superficial and deep stroking was used in the massage protocol. There were a total of 10 sessions during which the subject's blood pressure was checked by one of the researches before and after each intervention.

Following the 10 sessions, the results showed that both systolic and diastolic blood pressures were lowered in the massage group immediately after the final session when compared to the control group. Additionally, there continued to be a significant difference between the test and control groups 72 hours after the finishing the study.

The researchers acknowledge that their study has limitations that include the fact that the study subjects were only women and there were uncontrollable variables as the subjects dealt with daily incidents and stress. They also recommend that post intervention, different measurement timelines be explored, which would give a better sense of the sustainable effects of the massage on blood pressure. That said, the results of this study led to a shift in patient care practices to include massage as a suitable non-pharmacological intervention to manage pre-hypertension.

Does this study peak your interest in pursuing research? Do you have a project in mind? Now is the time to look at applying for a Massage Therapy Foundation Research Grant. The deadline is March 2, 2015. For more information, visit www.massagetherapyfoundation.org/research-grants/.

Resource:

• Givi, M. (2013). Durability of Effect of Massage Therapy on Blood Pressure. International Journal of Preventive Medicine, 2013; 4:5 11-16.