Massage lowered blood pressure by 7.39 mmHg systolic in pooled trials

High blood pressure is one of the most consequential numbers in health, and plenty of people look for ways to improve it beyond medication. Massage has long been suggested as one of them, on the logic that it promotes relaxation, yet the studies testing it had produced conflicting findings. Until this review, nobody had systematically gathered and weighed that scattered evidence. The question it set out to answer is simple and practical: does massage actually move blood pressure in people whose readings are high or heading that way, or is the idea wishful thinking?

The reviewers searched electronic databases for studies published up to 31 October 2013, using terms including hypertension, massage, chiropractic, manipulation and blood pressure. They restricted the analysis to trials where participants were assigned at random, and judged the quality of each using the Cochrane collaboration's standard tool. Two reviewers independently handled study selection, data extraction and validation to reduce the chance of bias. Nine trials in people with hypertension or prehypertension met the inclusion criteria, and their results were pooled in a meta-analysis comparing massage against control treatments.

Massage came out ahead of control treatments on both numbers. Systolic blood pressure, the top figure, fell by an average of 7.39 mmHg more with massage, while diastolic pressure fell by 5.04 mmHg more. In statistical terms the reviewers describe the systolic effect as medium and the diastolic effect as small, and both reached significance. No results favoured the control treatments. The authors are careful to note, however, that the quality of the underlying trials leaves the conclusion in need of confirmation.

This was, by the authors' account, the first systematic review on the question, so it turns a pile of conflicting single studies into a coherent, if provisional, answer. It supports the idea that massage can contribute to blood pressure reduction rather than merely feeling pleasant. What it cannot settle is just as important: which styles of massage work, how often it would need to be repeated, and whether the reductions persist over time are all left open. The authors state plainly that high-quality randomised trials are urgently required to confirm these results.

If your blood pressure is high or creeping upwards, this review is a reason to take massage seriously as a possible complement to whatever else you and your doctor are doing, not a replacement for it. The average drops reported here are of a size that would matter if they held up, which is exactly why the reviewers want better trials before anyone declares the case closed. It is also worth remembering that pooled averages hide variation: some trials will have shown more, some less. For now, the honest reading is encouraging but unconfirmed.