Online publication only
This article describes a protocol using soft-tissue
reflexes to lower high blood pressure that has worked surprisingly
well in many doctors' practices. At seminars over the past seven
years, we've often demonstrated instant reductions as much as 60
mm hg systolic!
Jawad Bhatti, an urgent care physician in Midlothian, Virginia,
reports: "I've gotten very significant results with hypertension
using these techniques. Thirteen out of 16 patients with hypertension
had a substantial drop in blood pressure (BP); the average BP in
11 patients dropped from 158/89 to 131/75. One patient with hypertensive
urgency had a drop of 70 points systolic in 2 minutes! At follow-up,
this patient did not have to go to the ER, as her blood pressure
stayed low. With symptomatic HTN urgency cases, I usually admit
them to the hospital for 24 hours; but in her case it wasn't needed."
Kerry Randa, DC, of Loveland, Colorado, states that 60 out of 75
patients in his practice showed a significant reduction in BP. (Although
my experiences are similar, I haven't verified these doctors' reports.
Obviously, there are also patients that don't respond at all to
Here's What Didn't Work
When I started out in practice over 30 years ago, I routinely measured
all my patients' blood pressures (BP). If it was high, I used acupuncture,
craniosacral therapy, chiropractic, and other procedures to try
to normalize it. Most patients showed no immediate change from treatment.
After a year or so of frustration, I abandoned attempts to produce
immediate change in BP and resorted to nutritional supplementation,
weight loss, exercise recommendations, and so on, to achieve gradual
Elevated blood pressure is the number one risk factor for death
around the world. The World Health Organization states that suboptimal
BP (>115 mm/Hg systolic blood pressure, >75 mg/HG diastolic)is
the cause of 62% of cerebrovascular disease and 49% of ischemic
heart disease, our major killers. Even small reductions in systolic
BP (e.g., 3–5 mm Hg) produce dramatic reduction in adverse
cardiac events and stroke.
Note that the method described here is not chemical or pharmaceutical.
It certainly can be used along with nutritional approaches and/or
medication. If a patient is on medication but not fully controlled,
these soft-tissue reflex techniques may bring the BP down to normal.
If the patient is not already on medication, the BP may go down
enough to make medication unnecessary. The procedures are not a
substitute for medication but may work along with drug therapy.
In no case should medication be discontinued without the approval
of the prescribing physician.
Three Components of
the Hypertension Reflexes
The hypertension protocol consists of several different soft-tissue
manipulations that address different physiological elements:
1. Ensure adequate blood flow into the head
by making certain that the cervical column has full rotation.
Chronic restriction in the ability to turn one's head all the way
may affect the vertebral or carotid arteries, and reduce circulation
into the brain. As cranial blood supply is critical, the body may
attempt to maintain normal flow by elevating blood pressure. I and
other doctors have seen many cases where normalizing full cervical
rotation has immediately caused a significant drop in BP.
In this system we don't use spinal manipulation to increase rotation,
as I have rarely found this to be effective. We use a number of
different soft-tissue procedures to immediately restore motion.
2. Inhibit sympathetic overactivity.
We often find a large number of myofascial trigger points in the
upper back, indicating overreactivity of the sympathetic nervous
system. We use soft-tissue reflexes (previously discussed in the
Townsend Letter) to immediately
eliminate these trigger points.
3. Influence the carotid baroreceptors in
the neck to produce parasympathetic stimulation. Our hypothesis
was that an abnormally high BP might be improperly maintained by
the carotid baroreceptors in the neck and accompanied by excess
tone in the scalene muscles. This might be indicated by tightness
and/or pain when the scalene muscles are palpated, on either side
of the neck. In other words, tight scalene muscles might influence
the carotid baroreceptors to maintain an improperly high blood pressure.
If we could reduce the excess tension in the scalene muscles, the
baroreceptors might reset the blood pressure to a lower, more physiological
norm. We examine the scalene muscles for a myofascial trigger point
(TP) or tender area. It's often present bilaterally. We never treat
this trigger point by pressing on it – this can cause fainting
or dizziness! Once we find a TP, we'll usually neutralize it by
using various neurological reflexes (as described in Townsend
Letter, November 2007, "Can
Pain Be Turned Off Instantly by Using Neuromuscular Reflexes?").
The Carotid Baroreceptors
Strongly Influence Blood Pressure
The carotid baroreceptors lie bilaterally underneath the scalene
muscles on the lateral sides of the neck and affect blood pressure.
They transmit signals to the brain via the glosspharyngeal (9th
cranial) nerve. According to Uppulori et al., "The carotid
baroreceptors are important in regulating blood pressure in chronic
hypertension by centrally mediated sympathoinhibitory effects and
other effects." Baroreflex sensitivity is lowered in hypertensive
Various efforts have been made to develop electrical signaling devices
that would reduce BP by stimulating the carotid baroreceptors. Although
effective, these methods are invasive.
My own blood pressure has for years been around 120/70. Using just
the carotid baroreceptor procedure on myself one night, my systolic
BP immediately dropped to 103 mm hg, and stayed between 100 and
110 for several months! (Usually repeated treatments are necessary
to maintain a lower blood pressure.)
I have a special interest in preventing hypertension and cardiovascular
disease (CVD). My mother died of CVD at age 49. My dad had his first
heart attack in his 20s, eventually dying at age 66 from a fourth
event. About 20 years ago, I developed mild hypertension, in spite
of being thin, athletic, and a nonsmoking vegetarian taking no salt,
and actively practicing meditation and yoga.
I eventually found that I could keep my BP around 120/70 by taking
coenzyme Q10, 200 mg daily. This is what it remained until I lowered
it recently. Studies now show that a systolic blood pressure (SBP)
of 120 is actually prehypertensive – it's better to keep it
at 115 or below.
Three Overlooked Factors
in Blood Pressure Measurement
It's important to measure blood pressure correctly and consistently.
Three factors that may affect the reading are often overlooked by
support personnel taking BP in doctors' offices:
1. Before measurement, the patient needs to be seated for at least
5 minutes; it shouldn't be measured immediately after a patient
walks into the exam room.
2. The arm that has the cuff on it should be across the patient's
chest, supported by a desk or table, not dangling down.
3. The patient should not talk during the reading.
Alarming Stats –
A National Emergency!
(Warning: just reading these could give
you a heart attack!)
Several of my older doctor-students have reported to me that they
had "always" had high blood pressure, even as youths.
Since they were apparently healthy in spite of this, they thought
there was no need to take any remedial measures. These doctors were
unaware of the enormous danger involved in uncontrolled hypertension,
as are many of the patients in the following studies. Ignorance
of these dangers and the failure to provide a massive program of
education of the importance of blood pressure control may constitute
America's number one threat, far greater than terrorism, cancer,
AIDS, and other more newsworthy situations.
According to a study by the American Heart Association, 73,000,000
people in the US have high blood pressure. That's one out of three
adults. Seventy-one percent were aware of their condition, but almost
a third did not know they have hypertension! Sixty-one percent were
under treatment, but 65% percent did not have it controlled. The
reasons for this are ignorance of the consequences of hypertension,
side effects of medications, and failure to respond to drug therapy.
Even patients with normal blood pressure at 55 years old will have
a 90% lifetime risk of developing hypertension; this is almost all
of us! Therefore prehypertensive individuals(those with systolic
BP 120–139 mm Hg or diastolic BP 80–89mm Hg) require
lifestyle modifications to prevent progressive rise in blood pressure
and cardiovascular disease. It's estimated that 37% of the adult
US population has prehypertension, about 70,000,000 people.
In patients above age 50, a systolic BP higher than 140 mm Hg is
a more important cardiovascular disease (CVD) risk than diastolic
BP. Starting at 115/75 mmHg, the CVD risk doubles for each increment
of 20/10 mm Hg.
According to the National Center for Health Statistics, if all forms
of major CVD were eliminated, life expectancy would rise by almost
7 years. In contrast, if all forms of cancer were eliminated, the
gain would be "only" 3 years.
At age 50, the total life expectancy is 5.1 years longer for men
with normal blood pressure, and 4.9 years longer for women with
normal blood pressure, than for those with hypertension.
Obviously, it's important to explore nontoxic procedures that can
lower blood pressure (even to a small degree). Avoiding the side
effects of medication would provide a greater degree of patient
acceptance. Educating our patients about the importance of proper
blood pressure is of utmost importance, whatever our profession.
More information on soft-tissue reflexes to eliminate pain and regulate
other autonomic functions, including blood pressure, can be found
or call Stephen Kaufman, DC, in Denver at 800-774-5078 or 303-756-9567.
American Heart Association. Heart Disease and Stroke Statistics:
2008 Update. Available at: www.americanheart.org/downloadable/heart/1200078608862HS_Stats
Burt VL, Whelton P, Roccella EJ, et al. Prevalence of hypertension
in the US adult population. Results from the Third National Health
and Nutrition Examination Survey, 1988–1991. Hypertension.
Centers for Disease Control. Eliminating certain causes of death,
1989-91. U.S. Decennial Life Tables for 1989-91. 1:4. Available
Chaturvedi A, Dash HH. Sympathetic blockade for the relief of chronic
pain. J Indian Med Assoc. 2001 Dec;99(12):698–703.
Chobanian AV, Bakris GL, Black HR, et al. The seventh report of
the Joint National Committee on Prevention, Detection, Evaluation,
and Treatment of High Blood Pressure: the JNC 7 Report. JAMA.
Edwards L, McIntyre D, Carroll D, et al. The human nociceptive flexion
reflex threshold is higher during systole than diastole. Psychophysiology.
Filippone JD, Bisognano J. Baroreflex stimulation in the treatment
of hypertension. Curr Opin Nephrol Hypertens.
Filippone JD, Sloan JA, Illig KA, Bisognano JD. Electrical stimulation
of the carotid sinus for the treatment of resistant hypertension.
Curr Hypertens Rep. 2006 Oct;8(5):420–424.
Flack J, Peters R, et al. Prevention of hypertension and its complications:
theoretical basis and guidelines for treatment. J
Am Soc Nephrol. 2003 Jul;14(7 suppl 2):S92–S98.
Forouzanfar T, van Kleef M, et al. Radiofrequency lesions of the
stellate ganglion in chronic pain syndromes: retrospective analysis
of clinical efficacy in 86 patients. Clin
J Pain. 2000 Jun;16(2):164–168.
Ge H, Fernández-de-las-Peñas C, Arendt-Nielsen L.
Sympathetic facilitation of hyperalgesia evoked from myofascial
tender and trigger points in patients with unilateral shoulder pain.
Clin Neurophysiol. 2006 Jul;117(7):1545–1550.
Gmitrov J. Static magnetic field effect on the arterial baroreflex-mediated
control of microcirculation: implications for cardiovascular effects
due to environmental magnetic fields. Radiat
Environ Biophys. 2007 Aug;46(3):281–290.
Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment,
and control of hypertension in the United States, 1988–2000.
Honzíková N, Fišer B. Baroreflex sensitivity
and essential hypertension in adolescents. Physiol
Res. 2008 Nov 4. Epub ahead of print.
Ino-Oka E, Sekino H, Kajikawa S, Inooka H, Imai Y, Hashimoto J.
Involvement of carotid baroreceptor function in blood pressure control
in the chronic phase: effect on 24-hour ambulatory blood pressure.
Clin Exp Hypertens. 2008 Jan;30(1):69–78.
Israili ZH, Hernández-Hernández R, Valasco M. The
future of antihypertensive treatment. Am
J Ther. 2007 Mar-Apr;14(2):121–134.
Kaplan N. Kaplan's Clinical Hypertension. 9th ed. Lippincott Williams
& Wilkins; 2005.
Kaufman S. Can pain be turned
off instantly by using neuromuscular reflexes? Townsend
Letter. November 2007.
Kaufman S. Even most
doctors have chronic pain – who knew? Townsend
Letter. May 2008.
La Rovere MT, Pinna GD, Raczak G. Baroreflex sensitivity: measurement
and clinical implications. Ann Noninvasive
Electrocardiol. 2008 Apr;13(2):191–207.
Osborn JW, Jacob F, Guzman P. A neural set point for the long-term
control of arterial pressure: beyond the arterial baroreceptor reflex.
Am J Physiol Regul Integr Comp Physiol.
Raven PB, Fadel PJ, Ogoh S. Arterial baroreflex resetting during
exercise: a current perspective. Exp Physiol.
Report of the National High Blood Pressure Education Program Working
Group on High Blood Pressure in Pregnancy. Am
J Obstet Gynecol. 2000;183:S1–S22.
Ring C, Edwards L, et al. Effects of isometric exercise on pain
are mediated by blood pressure. Biol Psychol.
Sica DA, Lohmeier TE. Baroreflex activation for the treatment of
hypertension: principles and practice. Expert
Rev Med Devices. 2006 Sep;3(5):595–601.
Uppuluri SC, Storozynsky E, Bisognano JD. Baroreflex device therapy
in the treatment of hypertension. Curr
Hypertens Rep. 2009 Feb;11(1):69–75.
US Department of Health and Human Services, National Heart, Lung,
and Blood Institute. National High Blood Pressure Education Program
[Web page]. http://www.nhlbi.nih.gov/about/nhbpep/index.htm.
Accessed November, 2003.
World Health Organization. World Health
Report 2002: Reducing Risks, Promoting Healthy Life. Geneva,
Switzerland: World Health Organization; 2002. Available at: www.who.int/whr/2002.