Hypertension and Relaxation Therapies
Because stress plays a role in hypertension, relaxation therapies are often recommended as treatments for high blood pressure. A number of therapies have been studied for this purpose, including biofeedback, breathing exercises, and meditation.
Transcendental meditation (TM), music-guided slow breathing, yoga, tai chi, and qigong have demonstrated good promise for helping to lower blood pressure (see Research Evidence). Because relaxation therapies may have numerous benefits beyond the control of blood pressure, and because they essentially have no side effects, it may be worthwhile for you to experiment with other methods as well.
Effect of Relaxation Therapies on Hypertension
Relaxation therapies may help counteract the stress response that can cause or worsen hypertension.
Research Evidence on Relaxation Therapies
A review of 9 randomized trials concluded that the regular use of transcendental meditation significantly reduced both systolic and diastolic blood pressure compared to a control.126 Similarly, an analysis of 17 randomized controlled trials of various relaxation therapies found that only transcendental meditation resulted in significant reductions in blood pressure. Biofeedback, progressive muscle relaxation, and stress management training produced no such benefit.127
A trial of 86 patients with hypertension suggested that daily, music-guided slow breathing reduced systolic blood pressure measured over a 24-hour period.143
Hatha yoga,68 Qigong,113 and Tai Chi76 have shown a hint of potential benefit for high blood pressure, the mechanism of action probably being similar for each. A recent review of multiple studies investigating the effectiveness self-practiced Qigong, for example, concluded that it was more effective at lowering blood pressure than no treatment controls. It was not more effective than standard treatments for hypertension: antihypertensive medications or conventional exercise.124
In a review of 25 studies investigating various relaxation therapies (totaling 1,198 participants), researchers found that those studies employing a control group had no significant effect on lowering blood pressure compared to sham (placebo) therapies.125
Biofeedback is widely advocated for treating hypertension. In an analysis of 22 studies, real biofeedback when used alone was found to be no more effective than sham (fake) biofeedback.63 This does not necessarily mean that biofeedback is ineffective; it is possible that the experience of biofeedback, regardless of whether it is "real" or "fake," has some healing effect. A subsequent review of 36 trials with 1,660 participants found inconsistent evidence for the effectiveness of biofeedback for treatment of hypertension in comparison to drug therapy, sham biofeedback, no intervention or other relaxation techniques.141
How to Use Relaxation Therapies
There are many kinds of relaxation therapies. Some techniques are very low-tech; you can do them anywhere, at anytime, and can learn them on your own. Other techniques are more elaborate and might involve the instruction of a trained professional, such as a yoga therapist.
The bottom line is that you should find something that fits with you and your life, and do it regularly. Relaxation is like any other "muscle"--you have to build it and maintain it if you want to experience the greatest benefits.
Consider the following:
Types of Professionals That Would Be Involved with This Treatment
You can learn and practice many stress management and relaxation techniques on your own, and for little or no money. You can also consult with a variety of professionals who offer personalized guidance and instruction. Consider the following:
- Meditation instructor; yoga therapist
- Practitioner of guided imagery and relaxation
- Biofeedback specialist
Side Effects and Warnings
There are no known or proposed safety risks with relaxation therapies.
- Nakao M, Yano E, Nomura S, Kuboki T. Blood pressure-lowering effects of biofeedback treatment in hypertension: a meta-analysis of randomized controlled trials. Hypertens Res. 2003;26:37-46.
- van Montfrans GA, Karemaker JM, Wieling W, et al. Relaxation therapy and continuous ambulatory blood pressure in mild hypertension: a controlled study. BMJ. 1990;300:1368-1372.
- Tsai JC, Wang WH, Chan P, et al. The beneficial effects of tai chi chuan on blood pressure and lipid profile and anxiety status in a randomized controlled trial. J Altern Complement Med. 2003;9:747-754.
- Lee MS, Pittler MH, Guo R, et al. Qigong for hypertension: a systematic review of randomized clinical trials. J Hypertens. 2007;25:1525-1532.
- Guo X, Zhou B, Nishimura T, et al. Clinical effect of Qigong practice on essential hypertension: a meta-analysis of randomized controlled trials. J Altern Complement Med. 2008 Jan 16.
- Heather OD, Fiona C, Fiona RB, et al. Relaxation therapies for the management of primary hypertension in adults. Cochrane Database Syst Rev. 2008;CD004935
- Anderson JW, Liu C, Kryscio RJ. Blood pressure response to transcendental meditation: a meta-analysis. Am J Hypertens. 2008;21:310-316.
- Rainforth MV, Schneider RH, Nidich SI, et al. Stress reduction programs in patients with elevated blood pressure: a systematic review and meta-analysis. Curr Hypertens Rep. 2007;9:520-528.
- Greenhalgh J, Dickson R, Dundar Y. Biofeedback for hypertension: a systematic review. J Hypertens. 2010 Jan 19 early online.
- Modesti PA, Ferrari A, Bazzini C, et al. Psychological predictors of the antihypertensive effects of music-guided slow breathing. J Hypertens. 2010;28(5):1097.