Relaxation techniques may offer short-term relief for high blood pressure, but their long-term effectiveness is uncertain, according to a comprehensive analysis published in BMJ Medicine. The findings underscore the need for more rigorous and extended studies to determine whether these techniques can play a lasting role in managing hypertension.
High blood pressure, affecting approximately a third of individuals aged 30 to 79, is a major contributor to cardiovascular diseases and one of the leading causes of death worldwide. While pharmaceutical treatments are available, their effectiveness is often hindered by poor adherence, prompting interest in alternative methods such as relaxation techniques.
These techniques, which include practices like breath control, mindfulness, yoga, Tai Chi, and biofeedback, aim to alleviate one of the key risk factors for high blood pressure: stress. However, the relative effectiveness of these approaches remains unclear.
To shed light on this issue, researchers reviewed studies published in English up until February 2024, evaluating the impact of relaxation techniques on individuals with high blood pressure (defined as 140/90 mm Hg or above) and elevated blood pressure (pre-hypertension, 120/80 mm Hg or above). The review included 182 studies, with 166 focused on high blood pressure and 16 on elevated blood pressure.
The analysis employed network meta-analysis, a statistical method that allows for the comparison of multiple treatments simultaneously. The pooled results from 54 studies indicated that most relaxation techniques could reduce both systolic and diastolic blood pressure in individuals with hypertension after three months or less. The most commonly studied methods included breath control (13 studies), yoga/Tai Chi (11), biofeedback (8), progressive muscle relaxation (7), and music (7).
Among these interventions, the greatest reductions in systolic blood pressure were observed with mindfulness (a decrease of 9.90 mm Hg), meditative movement such as yoga and Tai Chi (9.58 mm Hg), and meditation (7.71 mm Hg). Breath control was associated with a reduction of 6.65 mm Hg, while progressive muscle relaxation, music, and psychotherapy showed varying levels of improvement.
However, the analysis found no statistical evidence to support the continued effectiveness of these techniques after three to 12 months. The certainty of the evidence at this timepoint was very low. Few studies included long-term follow-ups, and the results from three studies suggested that self-directed autogenic training might lower both systolic and diastolic blood pressure. Yet, the evidence supporting this conclusion was also weak.
Limited data were available for elevated blood pressure, with only two studies comparing relaxation techniques to no treatment. These studies showed minimal effects on systolic blood pressure.
The researchers also noted several limitations in the existing body of research, including incomplete descriptions of the relaxation interventions, a lack of data on cost-effectiveness, and insufficient information on the risk of cardiovascular events or deaths. They emphasized that while relaxation techniques might result in meaningful short-term reductions in blood pressure, the uncertainty surrounding the effectiveness of these methods calls for caution.
“Hypertension is a chronic condition that often requires long-term medication or lifestyle changes,” the researchers stated. “Interventions that offer only temporary benefits are unlikely to provide clinically significant improvements.”
The review also called for future studies to address key gaps in the research, including reporting on participant adherence to relaxation techniques and the long-term effects of these methods beyond three months. This information could help clarify the potential role of relaxation techniques in the ongoing management of high blood pressure.
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