Complementary and alternative medicine approaches to blood pressure reduction

OBJECTIVE To review the evidence supporting complementary and alternative medicine approaches used in the treatment of hypertension.

QUALITY OF EVIDENCE MEDLINE and EMBASE were searched from January 1966 to May 2008 combining the key words hypertensionor blood pressure with acupuncture, chocolate, cocoa, coenzyme Q10, ubiquinone, melatonin, vitamin D, meditation, and stress reduction. Clinical trials, prospective studies, and relevant references were included.

MAIN MESSAGE Evidence from systematic reviews supports the blood pressure–lowering effects of coenzyme Q10, polyphenol-rich dark chocolate, Qigong, slow breathing, and transcendental meditation. Vitamin D deficiency is associated with hypertension and cardiovascular risk; supplementation lowered blood pressure in 2 trials. Acupuncture reduced blood pressure in 3 trials; in 1 of these it was no better than an invasive placebo. Melatonin was effective in 2 small trials, but caution is warranted in patients taking pharmacotherapy.

CONCLUSION Several complementary and alternative medicine therapies can be considered as part of an evidence-based approach to the treatment of hypertension. The potential benefit of these interventions warrants further research using cardiovascular outcomes.