Wiener Medizinische Wochenschrift Printed in Austria Komplementäre/alternative Medizin bei Bluthochdruck: ein Mini-Review Zusammenfassung. Viele Hypertoniker setzen alter- native Methoden zur Blutdruckkontrolle ein. Basierend auf umfangreichen elektronischen Literaturerecherchen wird hier die Datenlage zusammengefasst. Zahlreiche Phyto- therapeutika, nicht-pflanzliche Supplements und andere Behandlungsformen wurden in klinischen Studien getes- tet, und für einige Therapien wurden antihypertensive Ef- fekte gefunden. Die Effektgröße ist in aller Regel mode- rat, und unabhängige Überprüfungen fehlen häufig. Die vielversprechendsten Daten liegen vor für Knoblauch, Au- togenes Training, Biofeedback und Yoga. Weitere For- schung ist notwendig, bevor diese Ergebnisse in Thera- pieempfehlungen umgesetzt werden können. Schlüsselwörter: Alternativmedizin, Phytotherapie, Bluthochdruck. Summary. Many hypertensive patients try comple- mentary/alternative medicine for blood pressure control. Based on extensive electronic literature searches, the evi- dence from clinical trials is summarised. Numerous her- bal remedies, non-herbal remedies and other approaches have been tested and some seem to have antihyperten- sive effects. The effect size is usually modest, and inde- pendent replications are frequently missing. The most en- couraging data pertain to garlic, autogenic training, bio- feedback and yoga. More research is required before firm recommendations can be offered. Key words: Complementary/alternative medicine, herbalism, hypertension. Introduction Complementary/alternative medicine (CAM) is increa- singly popular [1]. Many CAM options exist [2], and nu- merous interventions are regularly advocated for lowe- ring elevated blood pressure [3]. When we extracted the information from only 7 popular CAM books (of which hundreds can be found in most bookshops), we found that 95(!) different CAM interventions were recommended for hypertension [2]. There was embarrassingly little con- sensus amongst the authors, and for the vast majority of these treatments there is no evidence for anti-hyperten- sive action. In this article, I aim to summarise the clinical trial evidence for or against those treatments for which clini- cal studies are available. The review is based on searches in Medline, Embase, Amed, and the Cochrane Library as well as in my own, extensive files of articles. Even though the search strategy was comprehensive, this is not strictly speaking a systematic review. Lifestyle CAM is defined as “diagnosis, treatment and/or preven- tion which complements mainstream medicine by contri- buting to a common whole, by satisfying a demand not met by orthodoxy or by diversifying the conceptual frameworks of medicine” [4]. This indicates that certain lifestyles associated with anti-hypertensive effects might be included under the umbrella term of CAM. On the other hand, one could argue that they are more firmly rooted in conventional medicine. Clearly it is far from ea- sy to decide who “owns” any given approach. Weight re- duction, exercise and stress management have all been shown to lower blood pressure (BP) [5]. While stress ma- nagement might be seen as CAM, weight reduction and exercise are generally considered mainstream. Diet Any categorisation of dietary interventions is equally problematic. Salt restriction and reduction of alcohol in- take will result in a modest decrease of BP [5, 6]. Few experts would, however, argue that these approaches are CAM. Increasing the intake of dietary fibre in popula- Complementary/alternative medicine for hypertension: a mini-review Edzard Ernst Complementary Medicine, Peninsula Medical School, Exeter, United Kingdom Received June 7, 2005, accepted July 19, 2005 © Springer-Verlag 2005 Wien Med Wochenschr (2005) 155/17–18: 386–391 DOI 10.1007/s10354-005-0205-1 Correspondence: Edzard Ernst, MD, PhD, FRCP, FRCPEd, Complementary Medicine, Peninsula Medical School, Univer- sities of Exeter & Plymouth, 25 Victoria Park Road, Exeter EX2 4NT, U. K. Fax: +44-1392-427562 E-mail: Edzard.Ernst@pms.ac.uk