High blood pressure. How safe is it to have massage?

High blood pressure or hypertension is a fairly common and serious condition. It occurs when the force with which blood is pushed against the walls of the arteries is too high. Blood pressure too high is defined as a reading above 140/90 mm Hg. 140mm Hg being the force with which the heart pumps the blood into the arteries, and 90 mm Hg being the force with which the blood travels in between beats or when the heart is at rest. High blood pressure can go unnoticed for years, as it has few symptoms, however it does increase the risk of heart disease and strokes. 

Massage and Hypertension

High blood pressure is often taught and seen as a contraindication for massage. The theory behind this line of thought is that where a person already has too much pressure exerted against the walls of the blood vessels, massage will further increase circulation and increase the pressure, leading to potentially dangerous scenarios. 

However, there is now much evidence to the contrary. Overwhelmingly, massage has been shown to actually reduce blood pressure. As far back as 1999, researchers found that high blood pressure was reduced by massage therapy, as well as cortisol stress-hormone levels. At the end of this article you can find a list of the most recent studies supporting the benefits of massage for high blood pressure.

Boris Prilutsky, a medical massage expert, explains that massage stimulates receptors that send messages of relaxation to the central nervous system. These reflexes cause vasodilation (widening of the blood vessels), resulting in decreased blood pressure and heart rate.

So why is high blood pressure still stated as a contraindication in traditional texts? It probably comes down to the fact that extra vigilance should be taken and that the massage should be specifically tailored to the condition. This includes using certain types of massage as well as other therapeutic treatments which will bring about the desired relaxation and blood reducing effect. Needless to say a vigorous deep tissue massage will not be suitable for this purpose. However, Swedish Massage and Reflexology are both considered a good choice. As always it is best to consult with your GP before starting treatment, and should your high blood pressure not be controlled, you will be asked to get written permission for massage treatment from your GP.

Massage can be an effective method of lowering blood pressure when combined with standard hypertensive treatment. The increase in circulation (and subsequent rise in pressure) associated with massage is counteracted by the dilation of the blood vessels due to increased relaxation, with the net result being a reduction in body tension and blood pressure.

For the latest research in massage and high blood pressure see the list below:

1. Mahshid Givi. Durability of Effect of Massage Therapy on Blood Pressure. Int J Prev Med. 2013 May; 4(5): 511–516.

Conclusion: Findings of the study indicated that massage therapy was a safe, effective, applicable and cost-effective intervention in controlling BP of the pre-hypertension women and it can be used in the health care centres and even at home.

2. Izreen Supa'at, Zaiton Zakaria, Oteh Maskon, Amilia Aminuddin and Nor Anita Megat Mohd Nordin. Effects of Swedish Massage Therapy on Blood Pressure, Heart Rate, and Inflammatory Markers in Hypertensive Women. Evid Based Complement Alternat Med. 2013; 2013: 171852.

Conclusion: Study showed that Swedish Massage Therapy or resting an hour weekly significantly reduced BP, HR, and VCAM-1. However, the effect of rest on BP does not extend to four weeks as compared to Swedish Massage Therapy. In addition, massage also reduces resting HR in hypertensive women.

3. Garakyaraghi, Givi, Moeini, Eshghinezhad.Qualitative study of women's experience after therapeutic massage. Iran J Nurs Midwifery Res. 2014 Jul;19(4):390-5.

Conclusion: This study demonstrates that a body-centered intervention like massage can be valuable in a multidisciplinary approach to women with prehypertension. This method is easy to learn and relatively short (10-15 min) to administer as a suitable complement in nursing care for this group of patients.

4. Mohebbi Z, Moghadasi M, Homayouni K, Nikou MH. The effect of back massage on blood pressure in the patients with primary hypertension in 2012-2013: a randomized clinical trial. Int J Community Based Nurs Midwifery. 2014 Oct;2(4):251-8.

Conclusion: The obtained results were indicative of the effectiveness of back massage in reducing blood pressure in the study participants. Using stress control methods, such as massage, is a simple, acceptable, and teachable method for families to control blood pressure. After conducting more studies on this issue, back massage can be recommended as a non-pharmacological method to control blood pressure.