1. Introduction

Hypertension is one of the most important risk factors for the development of cardiovascular disease, kidney failure which causes great costs for the individual and society, and in general in Iran 25 to 35% of middle-aged adults with Are hypertensive [5, 7]. The mechanism of massage on the physiopathology of hypertension is that following relaxation by massage movements in response to the parasympathetic nerve, it reduces the heartbeat rate and blood pressure [12]. As a hypothesis, inflammation is a factor in increasing blood pressure [13]. High levels of C-reactive protein as an inflammatory indicator can be a risk factor for cardiovascular disease in people with hypertension [11, 13], which increases in overweight and obese people [15]. The aim of this study was to investigate the effect of eight weeks of massage on systolic and diastolic blood pressure, heart rate and C-reactive protein in women with hypertension.

2. Materials and Methods

This quasi-experimental study was performed on a statistical population with hypertension referred to the specialized polyclinic of Arak Oil Industry. During 3 months of reporting by specialized physicians, 44 female volunteers aged 35-55 years, with a mean Body Mass Index (BMI) of 30.3±1.54 kg/m2, and with mild systolic and diastolic blood pressure of more than 142.4 and 85.6 mmHg, were selected, 4 of whom withdrew from cooperation for some reason, and the rest were selected by available sampling method and placed in two groups of “experimental massage” (20 people) and “control” (20 people). 

At the beginning, personal information questionnaires were completed and then in the pre-test and post-test stages, blood pressure, heart rate and hs-CRP test were measured in both groups. Massage protocol was performed during 8 weeks (3 sessions per week and each session for 45-60 minutes), including effleurage, petrissage, friction, vibration and tapotement techniques on the whole body. After collecting and entering the data in SPSS software V. 25, the results were analyzed and the Mean±SD of the data were calculated using descriptive statistics. A significance level of 95% (P≤0.05) was considered.

3. Results 

Demographic information of patients with hypertension in terms of age, weight, height, BMI, Waist-to-Hip Ratio (WHR) and duration of disease is given in Table 1. In terms of demographic information, there was no significant difference between weight, height and BMI.

Table 2 shows the decrease in systolic and diastolic blood pressure before and after the massage intervention with the control group. Also, the massage program had a more significant effect on reducing the serum level of C-reactive protein than the control group (P≤0.05).

Table 3 shows that the massage program had a significant effect on systolic and diastolic blood pressure in women with hypertension (P≤0.05). In other words, the massage program had a more favorable effect on reducing systolic and diastolic blood pressure compared to the control group (P≤0.05). Mean±SD of systolic and diastolic blood pressure in the experimental group before the activity were 150.4±15.3 and 95.5±0.86 mmHg, respectively, and after the activity was decreased to 125.2±12.4 and 90.3±0.82 mmHg, respectively

The results of the analysis showed that by comparing the mean systolic and diastolic blood pressure of the control and experimental groups, there was a statistically significant difference (P≤0.05). The results of this study were consistent with the findings of previous studies, including Al-Tu’maa et al. [18].

4. Discussion

Prolonged hypertension eventually damages arteries throughout the body, including the arteries of vital organs such as the brain, kidneys, heart, and eyes. In this study, systolic and diastolic blood pressure as well as C-reactive protein in the experimental (massage) group were significantly reduced compared to the control group [20]. The present study was consistent with the study of Aourella M (2005), which performed 5 weeks of massage on 30 patients with hypertension, the results of which were a reduction in systolic and diastolic blood pressure as well as stress control [22]. 

The present study was also consistent with the study of Skuriti et al. (2018), which included 10 minutes of back and leg massage for women and men aged 40-60 years admitted to the hospital care ward [23]. But it was not consistent with the study of Bost and Wallis (2006) who performed the effect of 15 minutes of massage once a week on patients with hypertension. Massage reduced stress and anxiety but had no effect on systolic and diastolic blood pressure. The reason for this discrepancy could be related to the number of massage sessions and its duration [25]. Also, the effect of massage on the amount of C-reactive protein was consistent with the research of Sheikhsaraf et al. (2015) who compared aerobic exercise with massage on C-reactive protein [29]. 

Massage stimulates pressure receptors and nerves in internal organs such as the liver and artery walls, reduces sympathetic activity and increases parasympathetic activity, and ultimately reduces inflammation and C-reactive protein [30]. As a result, massage can be used as a non-pharmacological action like other complementary and alternative therapies, in addition to being an economical method and in almost all cases it does not have any serious side effects or drug interactions.

Ethical Considerations

Compliance with ethical guidelines

This study was approved by the Ethics Committee of Arak University of Medical Sciences (Code 92-160-26).

Funding

This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors. 

Conflicts of interest

The author declared no conflict of interest. 

Acknowledgements

The author is very grateful for the efforts of our colleagues in the Oil Industry Polyclinic of Markazi Province, as well as the patients who encouraged us with their trust and support.


 

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