FROM: Journal of Human Hypertension 2007 (May);   21 (5):   347–352

Bakris G, Dickholtz M, Meyer PM, Kravitz G, Avery E, Miller M, Brown J, Woodfield C, Bell B

Department of Preventive Medicine, Rush University Hypertension Center, Chicago, IL, USA


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 naive (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 degrees week 8, NUCCA versus 0.6, baseline versus 0.5
degrees , 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.