1. ¹Department of Preventive Medicine, Rush University Hypertension Center, Chicago, IL, USA
2. ²Chiropractic Health Center, Chicago, IL, USA
3. ³Barrington Family Medical Clinic, Barrington, IL, USA
4. ⁴Atlas Research Foundation, Barrington, IL, USA

Correspondence: Professor G Bakris, Department of Medicine, Pritzker School of Medicine, University of Chicago, 5841 S. Maryland Avenue, MC 1027, Room 267, Chicago, IL 60637, USA. E-mail:gbakris@earthlink.net

Received 27 July 2006; Revised 28 September 2006; Accepted 28 September 2006; Published online 2 March 2007.

Abstract

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. This pilot study tests the hypothesis that correcting mal-alignment of the Atlas vertebra reduces and maintains a lower BP. Using a double blind, placebo-controlled design at a single center, 50 drug naïve (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 52.79.6 years, consisted of 70% males. At week 8, there were differences in systolic BP (-179 mm Hg, NUCCA versus -311 mm Hg, placebo; P<0.0001) and diastolic BP (-1011 mm Hg, NUCCA versus -27 mm Hg; P=0.002). Lateral displacement of Atlas vertebra (1.0, baseline versus 0.04° week 8, NUCCA versus 0.6, baseline versus 0.5°, placebo; P=0.002). Heart rate was not reduced in the NUCCA group (-0.3 beats per minute, NUCCA, versus 0.5 beats per minute, placebo). 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.