Background/Aims: Lifestyle therapies are recommended as initial treatment or adjunctive therapy for all patients with hypertension. We describe the alternative therapies and lifestyle changes reported by patients with uncontrolled blood pressure (BP) enrolled in a hypertension clinical trial.
Methods: Alternative therapies and lifestyle changes were self-reported in a survey administered at the participant’s pre randomization baseline visit. Patients were asked to report their use of alternative therapies and lifestyle changes specifically to control their high BP in the 12 months prior to starting the trial. Alternative therapies included yoga, meditation, acupuncture, biofeedback, paced breathing, herbal medications and vitamin supplements. Lifestyle changes included low salt diet, other dietary, weight loss, alcohol reduction, and increased physical activity. Multiple alternative therapy or lifestyle changes could be indicated.
Results: Among the 296 participants who completed the baseline questionnaire, mean age was 62 years, 44% were female, 17% were minority race/ethnicity, and 49% were college graduates. Of these, 96 (32%) had tried an alternative therapy and 177 (60%) had made a lifestyle change to control BP. The most common alternative therapy reported for control of BP was vitamin supplements (20%), but other techniques, including meditation (12%), yoga or paced breathing (both 5%), herbal medications (4%), and acupuncture (1%) were used. No participants had tried biofeedback. Of the lifestyle changes, increasing physical activity was most popular (34%), followed by other dietary changes (27%), weight loss (22%), low salt diet (16%), and alcohol reduction (11%). The 89 (30%) of participants who tried neither an alternative therapy nor a lifestyle change were slightly younger (mean age 60), less likely to be female (33%, p 0.01), less likely to be minority race/ethnicity (11%, p 0.1) but have similar education (52% college graduates, p 0.5).
Conclusion: Patients with uncontrolled BP who volunteered for a clinical trial report using a variety of non-pharmacologic methods to control hypertension; however, many of the methods used have scanty or inconsistent evidence for efficacy in lowering blood pressure. Health care providers should ask about alternative therapies and attempt to re-direct patients to more efficacious non-pharmacologic treatment modalities.