Trial reportJournal of human hypertension2007
Atlas vertebra realignment and achievement of arterial pressure goal in hypertensive patients: a pilot study.
Trial report in Journal of human hypertension, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature.Chiropractic & manual therapies · 2021Pooled it
- Nondrug therapies for hypertensive patients complicated with cervical spondylosis: A systematic review and meta-analysis.Medicine · 2020Pooled it
- Autonomic nervous system and endocrine system response to upper and lower cervical spine mobilization in healthy male adults: a randomized crossover trial.The Journal of manual & manipulative therapy · 2023Trial
- Effect of Atlas Vertebrae Realignment in Subjects with Migraine: An Observational Pilot Study.BioMed research international · 2015Trial
- Review
- Review
- Conservative Treatment Using Chiropractic Care and Orofacial Myofunctional Therapy for Obstructive Sleep Apnea: A Case Report.Journal of chiropractic medicine · 2023Article
- A systematic review and meta-analysis on effect of spinal mobilization and manipulation on cardiovascular responses.Hong Kong physiotherapy journal : official publication of the Hong Kong Physiotherapy Association Limited = Wu li chih liao · 2020Article
- Chiropractic care for hypertension: Review of the literature and study of biological and genetic bases.Acta bio-medica : Atenei Parmensis · 2020Review
- Chiropractic Management of Performance Related Musculoskeletal Disorder in a Career Violist.The American journal of case reports · 2020Article
- Pulse pressure findings following upper cervical care: a practice-based observational study.The Journal of the Canadian Chiropractic Association · 2019Article
- The Kaleidoscope Model of Integrative Healthcare as a collaborative paradigm for cardiology and chiropractic: a call to action.Integrative medicine research · 2018Review
- Essential literature for the chiropractic profession: Results and implementation challenges from a survey of international chiropractic faculty.The Journal of chiropractic education · 2017Article
- Glucose Metabolic Changes in the Brain and Muscles of Patients with Nonspecific Neck Pain Treated by Spinal Manipulation Therapy: A [Evidence-based complementary and alternative medicine : eCAM · 2017Article
- Atlantoaxial Misalignment Causes High Blood Pressure in Rats: A Novel Hypertension Model.BioMed research international · 2017Article
- Analysis and Adjustment of Vertebral Subluxation as a Separate and Distinct Identity for the Chiropractic Profession: A Commentary.Journal of chiropractic humanities · 2016Review
- Craniocervical chiropractic procedures - a précis of upper cervical chiropractic.The Journal of the Canadian Chiropractic Association · 2015Article
- Effects of Upper and Lower Cervical Spinal Manipulative Therapy on Blood Pressure and Heart Rate Variability in Volunteers and Patients With Neck Pain: A Randomized Controlled, Cross-Over, Preliminary Study.Journal of chiropractic medicine · 2015Article
- Immediate effects of upper thoracic spine manipulation on hypertensive individuals.The Journal of manual & manipulative therapy · 2015Article
- Blood pressure changes in African American patients receiving chiropractic care in a teaching clinic: a preliminary study.Journal of chiropractic medicine · 2013Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
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 52.7+/-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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.