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 malalignment 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, placebocontrolled design at a single center, 50 drug naı¨ve (n¼26) or washed out (n¼24) 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 8/5mm Hg difference at week 8 over the placebo group. The study cohort had a mean age 52.779.6 years, consisted of 70% males. At week 8, there were differences in systolic BP (“1779mm Hg, NUCCA versus “3711mm Hg, placebo; Po0.0001) and diastolic BP (“10711mm Hg, NUCCA versus “277mm Hg; P¼0.002). Lateral displacement of Atlas vertebra (1.0, baseline versus 0.041 week 8, NUCCA versus 0.6, baseline versus 0.51, placebo; P¼0.002). 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 withmarked and sustained reductions in BP similar to the use of two-drug combination therapy.

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