title: Effects of Massage on Blood Pressure in Patients With Hypertension and Prehypertension: A Meta-analysis of Randomized Controlled Trials.
abstract: BACKGROUND
  Massage may help reduce blood pressure; previous studies on the effect of massage on blood pressure have presented conflicting findings. In addition, no systematic review is available.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the evidence concerning the effect of massage on blood pressure in patients with hypertension or prehypertension.
  
  
  METHODS
  A search was performed on electronic database records up to October 31, 2013, based on the following medical subject headings or keywords: hypertension, massage, chiropractic, manipulation, and blood pressure. The methodological quality of randomized controlled trials was assessed based on the Cochrane collaboration tool. A meta-analysis was performed to evaluate the effect of massage on hypertension. The study selection, data extraction, and validation were performed independently by 2 reviewers.
  
  
  RESULTS
  Nine randomized controlled trials met our inclusion criteria. The results of this study show that massage contributes to significantly enhanced reduction in both systolic blood pressure (SBP) (mean difference, -7.39 mm Hg) and diastolic blood pressure (DBP) (mean difference, -5.04 mm Hg) as compared with control treatments in patients with hypertension and prehypertension. The effect size (Hedges g) for SBP and DBP was -0.728 (95% confidence interval, -1.182 to -0.274; P = .002) and -0.334 (95% confidence interval, -0.560 to -0.107; P = .004), respectively.
  
  
  CONCLUSIONS
  This systematic review found a medium effect of massage on SBP and a small effect on DBP in patients with hypertension or prehypertension. High-quality randomized controlled trials are urgently required to confirm these results, although the findings of this study can be used to guide future research.
authors.affiliation: I-Chen Liao, MSN, RN Doctoral Student, Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei; and Department of Nursing, College of Medicine and Nursing, Hung Kuang University, Taichung, Taiwan. Shiah-Lian Chen, PhD Associate Professor, Department of Nursing, National Tai-Chung University of Science and Technology, Taichung, Taiwan. Mei-Yeh Wang, PhD Associate Professor, Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, New Taipei City, Taiwan. Pei-Shan Tsai, PhD Professor and Associate Dean, Graduate Institute of Nursing, College of Nursing, Taipei Medical University; and Sleep Science Center, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: I-Chen
authors.initials: IC
authors.lastname: Liao
authors.forename: Shiah-Lian
authors.initials: SL
authors.lastname: Chen
authors.forename: Mei-Yeh
authors.initials: MY
authors.lastname: Wang
authors.forename: Pei-Shan
authors.initials: PS
authors.lastname: Tsai
mesh_terms: D006801:Humans; D006973:Hypertension / Q000628:therapy*; D008405:Massage; D058246:Prehypertension / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome