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Because one quarter of all Americans have it, massage therapists should have a plan of action when encountering hypertension. Some practitioners automatically assume that the work they do will have an overall positive effect on cardiovascular health. However, this is not always the case. Because some techniques with a specific therapeutic application can cause blood pressure to temporarily rise, massage therapists must be cognizant to avoid these approaches on hypertensive clients.

About Hypertension

Otherwise known as high blood pressure, hypertension affects approximately 50 million Americans. Blood pressure is the force of the blood pushing against the walls of the arteries. A blood pressure reading is composed of two numbers:

  • Systolic – Better known as the top number of a blood pressure reading, the systolic pressure describes the maximum pressure that occurs with each contraction of the heart.
  • Diastolic – Also known as the bottom number of a blood pressure reading, the diastolic pressure describes the lowest pressure that occurs when the heart rests in between beats.

While there is some debate about the exact numbers that indicate hypertension, it is generally understood to be an average systolic blood pressure above 140 mm Hg, a diastolic blood pressure above 90 mm Hg, or both. While hypertension alone does not have many symptoms, it dramatically increases the risk of heart disease and stroke – the first and third most common causes of death among Americans.

Causes of Hypertension

There are many contributing causes of high blood pressure. There are two major types of hypertension: essential (primary) and secondary. Essential hypertension is by far the most common, accounting for more than 95 percent of all cases. While secondary hypertension is generally caused by an internal disease or substance abuse, essential hypertension is suspected to be due to a combination of the following:

  • Genetics
  • Low nitric oxide levels (a naturally occurring agent responsible for the dilation of blood vessels)
  • Insulin resistance
  • Obesity

Reducing Hypertension

Lifestyle modifications are a critical component to lowering blood pressure, and are always indicated regardless of the need for prescription medication. In addition to regular exercise, maintaining a desirable weight, reducing sodium intake, increasing fruit and vegetable consumption, stopping smoking and minimizing alcohol, massage therapy is a valuable tool for reducing high blood pressure.

Interestingly, researchers have found that some modalities are effective at reducing the pressure inside the artery’s walls, while others increase that pressure. The techniques regarded as good blood pressure reducers include:

  1. Swedish Massage – Published in the January 2006 edition of The Journal of Alternative and Complementary Medicine, American researchers looked at the effects of different types of massage on blood pressure. They found that Swedish massage had the greatest effect on blood pressure reduction.
  2. Cranial-Sacral Therapy – While not confirmed in a randomized study, advocates of cranial-sacral therapy tout its ability to lower blood pressure. According to the London-based integrated medical physician Dr. Andrew Logan, advanced cranial-sacral therapy can ease hypertension by relaxing the sub-clavian and femoral arteries.
  3. Aromatherapy – A study published in a Korean medical journal in December 2006 evaluated the effects of an aromatherapy blend on blood pressure. The researchers found that inhaling blends of lavender, ylang ylang and bergamot once daily for four weeks reduced the blood pressure of those with hypertension.

Raising Blood Pressure

There are many ways to raise blood pressure – including being stressed out, drinking lots of caffeine, taking pseudoephedrine or steroids or receiving a painful type of bodywork. The January 2006 study that found Swedish massage to be most effective at lowering blood pressure also found that certain modalities increased blood pressure.

More specifically, the researchers determined trigger point therapy and sports massage both capable of increasing the systolic blood pressure. Recipients who received both types of massage within one session had both their systolic and diastolic blood pressure readings significantly increased. Since the conclusion was made that potentially painful massage techniques can result in a blood pressure increase, practitioners can assume that other aggressive therapies such as friction massage or Rolfing have the potential to exacerbate hypertension.

The goal in treating hypertension is to reduce the risk of serious complications, including heart disease and stroke. Although massage therapy is not a standalone treatment for high blood pressure, choosing the right bodywork modality can help reduce hypertension’s associated risks. For clients with high blood pressure, avoid techniques that could be painful. Instead, rely on Swedish massage, cranial-sacral therapy and aromatherapy to give your clients’ blood vessels a respite from the pathological pressure they routinely endure.

Editor’s Note: For more information about massage safety with hypertension, read Hypertension: Massage Indication or Contraindication?


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More Information:

Hypertension / High Blood Pressure: Description and Massage Precautions