A Scientific Statement From the American Heart Association (AHA)

Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure - A Scientific Statement From the American Heart Association

Abstract:

"This American Heart Association scientific statement aims to summarize the blood pressure–lowering efficacy of several alternative approaches and to provide a class of recommendation for their implementation in clinical practice based on the available level of evidence from the published literature."(Abstract - page 2)

Further in the abstract:

"It is the consensus of the writing group that it is reasonable for all individuals with blood pressure levels >120/80 mm Hg to consider trials of alternative approaches as adjuvant methods to help lower blood pressure when clinically appropriate. A suggested management algorithm is provided, along with recommendations for prioritizing the use of the individual approaches in clinical practice based on their level of evidence for blood pressure lowering, risk-to-benefit ratio, potential ancillary health benefits, and practicality in a real-world setting" (Abstract - page 2)

Methods and Evidence Review (page 3)

"The writing group then classified the approaches into 3 broad categories: behavioral therapies, including meditation techniques, yoga, biofeedback, and relaxation or stress-reduction programs; noninvasive procedures or devices, including device-guided breathing modulation and acupuncture; and exercise-based regimens, including aerobic, resistance, and isometric exercise methods."

Behavioral Therapies

(The broad categorie of behavioral therapies is devide in 4 sub-groups):

1. Meditation Techniques:  "we have divided practices into focused attention (ie, mantra and training awareness); Transcendental Meditation (TM), a technique to transcend thought and to experience pure awareness, typically by employing specific mantras; and contemplative forms (eg, Zen and mindfulness), including the Mindfulness-Based Stress Reduction (MBSR) program."
2. Biofeedback Techniques: "Techniques that may be used include cognitive behavioral therapy, relaxation therapy, guided imagery, and psychological education."
3. Yoga: "The term yoga (Sanskrit meaning union) has many connotations. It originated in ancient India as primarily a word to describe a contemplative state with the aim of cessation of mental activity and attainment of a state of superior consciousness."
4. Other Relaxation Techniques: Relaxation and stress-reduction programs can be heterogeneous in nature and often comprise a multitude of approaches used in conjunction. This makes a uniform assessment of the treatment-associated BP-lowering responses difficult. There may also be overlap in the methods used to elicit a relaxation response with the approaches previously reviewed (eg, meditation).

The Summary and Clinical Recommendations (concerning the group of Behavioral Therapies)(page 6)

"The writing group conferred to TM a Class IIB, Level of Evidence B recommendation in regard to BP-lowering efficacy. TM may be considered in clinical practice to lower BP.

Because of many negative studies or mixed results and a paucity of available trials, all other meditation techniques (including MBSR) received a Class III, no benefit, Level of Evidence C recommendation. Thus, other meditation techniques are not recommended in clinical practice to lower BP at this time."

Conclusion :

TM is the only among the behavioral therapy that has proven its efficiency to lower BP and is recommended by AHA as adjuvant methods to help lower blood pressure.