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 these procedures.)

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 change.

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 patients.

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.

©2009 Stephen Kaufman, DC

More information on soft-tissue reflexes to eliminate pain and regulate other autonomic functions, including blood pressure, can be found at www.painneutralization.com; or call Stephen Kaufman, DC, in Denver at 800-774-5078 or 303-756-9567.

References
American Heart Association. Heart Disease and Stroke Statistics: 2008 Update. Available at: www.americanheart.org/downloadable/heart/1200078608862HS_Stats
%202008.final.pdf. (2.68MB)
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. 1995;25:305–313.
Centers for Disease Control. Eliminating certain causes of death, 1989-91. U.S. Decennial Life Tables for 1989-91. 1:4. Available at: http://www.cdc.gov/nchs/products/pubs/pubd/lftbls/decenn/vol1_4.htm.
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. 2003;289:2560–2572.
Edwards L, McIntyre D, Carroll D, et al. The human nociceptive flexion reflex threshold is higher during systole than diastole. Psychophysiology. 2002 Sep;39(5):678–681.
Filippone JD, Bisognano J. Baroreflex stimulation in the treatment of hypertension. Curr Opin Nephrol Hypertens. 2007 Sep;16(5):403–408.
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. JAMA. 2003;290:199–206.
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. 2005 Apr;288(4):R846–R855.
Raven PB, Fadel PJ, Ogoh S. Arterial baroreflex resetting during exercise: a current perspective. Exp Physiol. 2006 Jan;91.
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. 2008 Apr;78(1):123–128.
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.