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Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study


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 52.7±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). 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.

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This trial was an investigator-initiated study funded by the ATLAS Research Foundation and the NIH K25, HL68139-01A1 who supported Dr Meyer's effort. Additionally, we are grateful to Dr Y Chung who donated his time and expertise in the performance of this trial.

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Correspondence to G Bakris.

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Please note that this manuscript is a correction of an original version that was published in advance online (AOP) on 25 January 2007. The changes made were grammatical in nature and have not affected the scientific content of the article.

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Bakris, G., Dickholtz, M., Meyer, P. et al. Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study. J Hum Hypertens 21, 347–352 (2007).

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  • atlas
  • vertebra
  • antihypertensive therapy

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