Bien que les résultats ne peuvent être prévisibles pour un patient souffrant d'hypertension en particulier, des soins chiropratiques semblent être justifiés, en particulier lorsque le dysfonctionnement est identifié le long de la colonne vertébrale. Un mode de vie sain, des conseils et des soins médicaux devraient être concurrents aux ajustements chiropratiques. Les auteurs conseillent une surveillance étroite de la tension artérielle pour tous les patients chiropratiques sous médication contre l'hypertension... les effets conjugués de l'ajustement et des médicaments pourraient conduire à une réduction de la tension artérielle du patient, en dessous de la normale.
D'ailleurs, une étude récente a démontrée que des ajustements chiropratiques étaient également efficaces pour diminuer la tension artérielle. Voir la vidéo ci-dessous:
Journal of Human Hypertension 2007 (May); 21 (5): 347–352
Anatomical abnormalities of the cervical spine at the level of the Atlas vertebra are associated with relative ischaemia of the brainstem circulation and increased blood pressure (BP). Manual correction of this mal-alignment has been associated with reduced arterial pressure. Using a double blind, placebo-controlled design at a single center, 50 drug naive (n=26) or washed out (n=24) patients with Stage 1 hypertension were randomized to receive a National Upper Cervical Chiropractic (NUCCA) procedure or a sham procedure. Patients received no antihypertensive meds during the 8-week study duration. The primary end point was changed in systolic and diastolic BP comparing baseline and week 8, with a 90% power to detect an 8/5 mm Hg difference at week 8 over the placebo group. The study cohort had a mean age 52.7+/-9.6 years, consisted of 70% males. At week 8, there were differences in systolic BP (-17+/-9 mm Hg, NUCCA versus -3+/-11 mm Hg, placebo; P<0.0001) and diastolic BP (-10+/-11 mm Hg, NUCCA versus -2+/-7 mm Hg; P=0.002). No adverse effects were recorded. We conclude that restoration of Atlas alignment is associated with marked and sustained reductions in BP similar to the use of two-drug combination therapy.
Vous pouvez également lire sur WebMD l'article intitulé: Chiropractic Cuts Blood Pressure ainsi que celle sur ABC News, intitulé: Could a Neck Adjustment Lower Your Blood Pressure?
Practice-based Randomized Controlled-comparison Clinical Trial of Chiropractic Adjustments and Brief Massage Treatment at Sites of Subluxation in Subjects with Essential Hypertension: Pilot Study
J Manipulative Physiol Ther 2002 (May); 25 (4): 221–239
This pilot study elucidated several procedural issues that should be addressed before undertaking a full-scale clinical trial on the effects of chiropractic adjustments in patients with essential hypertension. A multidisciplinary approach to recruitment may need to be used in any future efforts because of the limited subject pool of patients who have hypertensive disease but are not taking medications for its control. Measures need to be used to assure comparable groups regarding prognostic variables such as weight. Studies such as these demonstrate the feasibility of conducting a full-scale 3-group randomized clinical trial in the private practice setting.
Chiropractic Management of a Hypertensive Patient
J Manipulative Physiol Ther 1993; 16 (8) Oct: 544–549
Specific contact short lever arm spinal adjustments may cause a hypotensive effect in a medicated hypertensive patient that may lead to complications (e.g., hypotension). Since a medicated hypertensive patient's blood pressure may fall below normal while he or she is undergoing chiropractic care, it is advised that the blood pressure be closely monitored and medications adjusted, if necessary, by the patient's medical physician.
Hypertension and the Atlas Subluxation Complex
Chiropractic: The J Chiro Res & Clin Invest 1992; 8 (2): 30–32
This report represents observations on eight patients presenting with hypertension. A multiple baseline across subjects deisgn is used in this study. Changes or relief of symptoms is affected by adjusting the occipito-atlanto-axial subluxation complex. The author suggests a relationship between the displaced skull and the cervical spine with hypertension.
Effects of Cervical Adjustments on Lateral Flexion Passive End–range Asymmetry and on Blood Pressure, Heart Rate and Plasma Catecholamine Levels
J Manipulative Physiol Ther 1991 (Oct); 14 (8): 450–456
Posttreatment goniometric measurements revealed that in sham-adjusted controls, mean lateral-flexion asymmetries had not changed significantly during the 4-hr time period examined. However, in subjects who received lower cervical adjustments, dramatic ameliorations of asymmetry magnitude were observed which persisted throughout the entire 4-hr posttreatment time period. On the other hand, in the face of this rather robust biomechanical effect, heart rate and blood pressure measurements obtained at -60 and -15 min prior to treatments, and at 5, 30, 60, 120 and 240 min following treatments, revealed no significant differences between adjusted and sham-adjusted subjects at any of the time periods examined.
Time Course Considerations for the Effect of Lower Cervical Adjustments with Respect to the Amelioration of Cervical Lateral Flexion Passive End–range Asymmetries, and on Blood Pressure, Heart Rate, and Plasma Catecholamine Levels
FCER's International Conference on Spinal Manipulation, 1990; 345–351
Additionally, based on simultaneous serial monitoring of heart rate, blood pressure, and plasma catecholamine concentrations, it does not appear that the therapeutic procedure used in these studies is particularily stressful or traumatic, at least in otherwise asymptomatic subjects.
Preliminary Study of Blood Pressure Changes in Normotensive Subjects Undergoing Chiropractic Care
J Manipulative Physiol Ther 1988 (Aug); 11 (4): 261–266
The purpose of this study was to evaluate the reliability of clinical blood pressure readings and to begin a series of experiments to determine if chiropractic adjustments cause any significant changes in blood pressure. Seventy-five students undergoing routine chiropractic health care at Palmer College of Chiropractic Clinic volunteered to participate in the blood pressure measurement protocol in one 10-min visit. Blood pressure was recorded by right arm cuff sphygmomanometer by an experienced chiropractor immediately before and again immediately after either the specific cervical adjustment or the control procedure, which was simply motion palpation. The doctors measuring blood pressures did not know to which group the subject had been assigned. Both systolic and diastolic blood pressures were statistically significantly lowered in the Experimental but not the Control group (p less than 0.01). The difference in the mean blood pressures was small and was brought about by 14 of the Experimental subjects who experienced a clinically relevant 10-20 mm hg drop. Reliability of blood pressure measurements by two doctors was established under similar conditions in an additional 25 subjects.
Effects of Chiropractic Treatment on Blood Pressure and Anxiety: A Randomized, Controlled Trial
J Manipulative Physiol Ther 1988 (Dec); 11 (6): 484–488
Results indicated that systolic and diastolic blood pressure decreased significantly in the active treatment condition, whereas no significant changes occurred in the placebo and control conditions. State anxiety significantly decreased in the active and control conditions. Results provide support for the hypothesis that blood pressure is reduced following chiropractic treatment. Further study is needed to examine the long-term effects of chiropractic treatment on blood pressure.
The Management of Hypertensive Disease: A Review of Spinal Manipulation and the Efficacy of Conservative Therapeusis
J Manipulative Physiol Ther 1986 (Mar); 9 (1): 27–32
When considering the ailments that plague mankind, certainly one of the enigmatic conditions is hypertensive disease. This perplexing disorder is recognized insidiously in the clinical setting. It is believed to occur because of the complex interactions of a variety of factors which act on the components of the blood vasculature. Although afflicted individuals may appear relatively asymptomatic, the additive influences of such factors eventually culminate in deleterious sequelae. Overall, hypertension appears to be related to stress, diet and lifestyle. The autonomic nervous system, particularly its sympathetic component, appears to mediate such accumulated factors, affecting the overall clinical scenario of hypertension. Although generally aligned with the aging process, this condition also may affect younger individuals. Hypertension, therefore, may be regarded as a prime condition warranting specialized care that includes proper education during the formative years, modification of dietary habits in conjunction with daily exercise regimens, and regular spinal maintenance, all of which are covered by modern chiropractic clinical practice.
The management of hypertensive disease: a review of spinal manipulation and the efficacy of conservative therapeusis
Crawford JP, Hickson GS, Wiles MR., J Manipulative Physiol Ther 1986 (Mar);9 (1): 27-32
This is a discussion of the literature relating high blood pressure to various factors, including stress and how that relates to the autonomic nervous system.
As the author writes (from the abstract): "Hypertension, therefore, may be regarded as a prime condition warranting specialized care that includes proper education during the formative years, modification of dietary habits in conjunction with daily exercise regiments, and regular spinal maintenance, all of which are covered by modern chiropractic clinical practice."
Improvements Following the Combination of Chiropractic Adjustments, Diet, and Exercise therapy.
GS, Sauer AD, Wahl DR, Kessinger J., Chiropractic: The Journal of Chiropractic Research and Clinical Investigation 1990; 5:37-39.
Author's abstract: Case reports of four individuals and the effects of chiropractic adjustments on their cardiac dysfunctions as monitored by ECG are presented. Patients with varying symptoms had a baseline ECG taken. A treatment plan was implemented consisting of adjustments combined with exercise and diet recommendations. At the end of the treatment period, a follow-up ECG was performed and three of the four patients showed improvement.
Hypertension and the atlas subluxation complex.
Goodman R. Chiropractic: J of Chiropractic Research and Clinical Investigation. Vol 8 No. 2, July 1992.
Six of eight patients under chiropractic experienced relief of symptoms and lowered blood pressure after chiropractic care. The blood pressures of two subjects remained unchanged or increased sometime during the test period. "Although individual readings of the six subjects with lowered blood pressure showed some random variation during the two-month period there was a general decrease in blood pres-sure. Systolic pressure was lowered by an average of 27 mm Hg, and the diastolic pressure by an average of 13 mm Hg. In several subjects, other symptoms such as low back pain, thoracic tightness, headaches, and general malaise, diminished following the adjustments. Those subjects who were not on medication showed the greatest change."
Preliminary study of blood pressure changes in normotensive subjects undergoing chiropractic care
McKnight ME, DeBoer KF,J Manipulative Physiol Ther. 1988 (Aug);11 (4): 261-266
Seventy-five people were tested after specific chiropractic cervical adjustments. Both systolic and diastolic blood pressure decreased significantly in the adjusted group. No significant changes occurred in the control group. In those with the highest pre-treatment blood pressures, the treatment effect was greatest, indicating that the effective in hypertensives may be even more significant.
Effects of chiropractic treatment on blood pressure and anxiety
Yates RG, Lamping DL, Abram NL, Wright C, J Manipulative Physiol Ther. 1988 (Dec);11 (6): 484-488
In this patient-blinded, assessor-blinded, placebo-controlled study, the authors state that the data "lend support to the hypothesis that chiropractic manipulation of the thoracic spine significantly reduces blood pressure in patients with elevated blood pressure." Both systolic and diastolic blood pressure decreased significantly in the adjusted group. No significant changes occurred in the placebo or control groups. Adjustments were delivered to segments T-1 to T-5.
The effects of upper cervical adjustment upon the normal physiology of the heart
TranAT, Kirby JD. J Am., Chiropractic Association, 1977; 11/S: 58-62.
Upper cervical adjustments were found to have a hypotensive effect.
Effect of osteopathic manipulative therapy on autonomic tone as evidenced by blood pressure changes and activity of the fibrinolytic system
Fichera AP; Celander DR, J Am Osteopath Assoc. 1969 (Jun);68 (10): 1036-1038
Manipulation of cervical and thoracic vertebrae reduces moderate (140/90) hypertension. Manipulation caused a decrease in plasma fibrinogen, favoring the PSNS.
Changes in presence of a segmental dysfunction pattern associated with hypertension: Part 2. A long-term longitudinal study.
Johnston WL, Kelso AF, J Am Osteopath Assoc. 1995 (May);95 (5): 315-318
The C6,T2,T6 pattern's long-term persistence in hypertensive subjects and changes in its presence corresponding to the subjects' hypertensive status indicate an important relationship between this pattern of segmental motion dysfunctions and disturbances in regulation of blood pressure.
Effects of Chiropractic Treatment on Blood Pressure and Annxiety: A Randomized Controlled Trial
Yates RG, Lamping DL, Abram NL, Wright C, J Manipulative Physiol Ther 1988 (Dec);11 (6): 484-488
Abstract: This study examined the effects of chiropractic adjustments of the thoracic spine (T1-T5) on blood pressure and state anxiety in 21 patients with elevated blood pressure. Subjects were randomly assigned to one of three treatment conditions: active treatment, placebo treatment, or no treatment control. The adjustments were performed by a mechanical chiropractic adjusting device (Activator adjusting instrument). Dependent measures obtained pre- and post-treatment included systolic and diastolic blood pressure, and state anxiety. Results indicated that systolic and diastolic blood pressure decreased significantly in the active treatment condition, whereas no significant changes occurred in the placebo and control conditions. State anxiety significantly decreased in the active and control conditions. Results provide support for the hypothesis that blood pressure is reduced following chiropractic treatment. Further study is needed to examine the long-term effects of chiropractic treatment on blood pressure.
The Effect of Cranial Adjusting on Hypertension: a Case Report
Connelly, DM, Rasmussen, SA, Chiropractic Technique May 1998; 10(2): 75-78.
This is a report of three patients suffering from hypertension who were treated using the sacro-occipital cranial technique, specifically the cranial ranges of motion, and the cranial technique for reducing hypertension. Favorable results were achieved in all three cases. This paper discusses the outcome of these patient's treatments, and provides a possible mechanism for the results.
Case Studies:
Chiropractic Management of a Hypertensive Patient: A Case Study
Plaugher G, Bachman TR., J Manipulative Physiol Ther. 1993 (Oct);16 (8): 544-549
A case study of a 38-year-old male presented with a complaint of hypertension of 14 years duration and side effects of medication (Minipress and Corgard) which included bloating sensations, depression, fatigue, and impotency. Chiropractic analysis revealed vertebral subluxation complex at levels C6-7, T3-4, and T7-8 motion units; adjusted using Gonstead technique. After three visits patient's M.D. stopped the Minipress and reduced the Corgard. After six adjustments Corgard was reduced again. All medications were stopped after seven adjustments. Medication side effects had abated as well. After 18 months patient's blood pressure remained at normal levels.
Hypertension: a case study
McGee D. Chiropractic: J of Chiropractic Research and Clinical Investigation. Vol.7. No.4, Jan. 1992.
Case history of a 46-year-old woman's rapid decrease in blood pressure following initial chiropractic adjustment.
Additional Publications:
An effect of sacro occipital technique on blood pressure.
Unger J; Sweat S; Flanagan S, Chudowski S. Proceedings of the International Conference on Spinal Manipulation. 1993 A/M. pp 87.
Data demonstrates that a single chiropractic intervention can bring about a significant reduction in blood pressure in a hypertensive group of subjects. Not only was the reduction in systolic blood pressure statistically significant; more important was the clinical significance of this effect.
Randomized clinical trial of chiropractic adjustments and brief message treatment for essential hypertension: A pilot study
Plaugher G, Meker W, Shelsy A, Lotun K, Jansen R. Conf Proc Chiro Cent Found 1995; Jul: 366-367.
Conservative management of patients with mild hypertension
Mootz RD Top Clin Chiro 1995; 2:37-44.
Evidence for a possible anti-hypertensive effect of basic technique apex contact adjusting
Dulgar G, Hill D, Sirucek A, Davis BP, ACA J of Chiropractic, 1980;14:97-102.
References from the Koren Publications' brochure:
- Healthier Blood Pressure. Science News, Vol. 146 p.200. Sept. 24, 1994. Bernard, O.D., Richmond, Michigan, Letter to the Editor.
- The People's Doctor Vol. 8, No.5., 1986. Mendelsohn R.S., The People's Doctor Newsletter Vol. 8, No.5., 1986.
- Norris T.A., Study of the effect of manipulation on blood pressure. Academy of Applied Osteopathy, 1964 Year Book pp. 184-188.
- Blood H.A., Manipulative Management of Hypertension, Academy of Applied Osteopathy, 1964 Yearbook pp. 189-195.
- Yates et. al. Effects of Chiropractic Treatment on Blood Pressure and Anxiety: A Randomized, Controlled Trial. J Manipulative Physiol Ther 1988; 11:484-488.
- Gutzeit K., The Vertebral Column As A Factor In Disease. Dtsch. Med. Wschr., 1 (1951):3-7.
- Fichera, A.P., Calender, D.R. Effect of Osteopathic Manipulative Therapy on Autonomic Tone as Evidenced by Blood Pressure Changes and Activity of the Fibrinolytic System. June, 1969: 1036-1038.
- Ward L.E., Spinal Column Stressology, Spinal Stress Seminars, Long Beach, CA 1982.
|
