Key result
Shirodhara combined with Ayurvedic medication did not reduce systolic blood pressure and only minimally lowered diastolic BP.
Why the study?
Shirodhara has shown potential for stress reduction and relaxation, but its effects on blood pressure and clinical symptoms in essential hypertension needed systematic evaluation.
Does Shirodhara therapy as an adjunct to Ayurvedic medication reduce systolic and diastolic blood pressure and relieve clinical symptoms compared to Ayurvedic medication alone in patients with essential hypertension?
Meta-Analysis (n=100)
Does Shirodhara therapy as an adjunct to Ayurvedic medication reduce systolic and diastolic blood pressure and relieve clinical symptoms compared to Ayurvedic medication alone in patients with essential hypertension?
Answers are grounded in this paper and cite their sources.
Adjunctive Shirodhara therapy provides notable subjective symptom relief in essential hypertension, but yields no statistically significant reduction in systolic blood pressure and a clinically negligible (-0.40 mmHg) reduction in diastolic blood pressure.
Essential hypertension, a common multifactorial condition, is a significant public health concern. In India, the prevalence of hypertension is high, with estimates indicating a rising trend. Shirodhara, an Ayurvedic therapy, has exhibited the potential for stress reduction and relaxation. Thus, the review investigates the effect of Shirodhara on systolic and diastolic blood pressure and its impact on clinical symptoms like palpitation, insomnia, giddiness, fatigue, and headache in essential hypertensive patients. We searched PubMed, Embase, Scopus, Google Scholar, and Shodhganga, Web of Science search for this systematic review and meta-analysis from inception to June 2023. Evidence from RCTs was synthesized as a standardized mean difference (SMDs) for systolic and diastolic blood pressure, comparing participants who received Shirodhara intervention along with Ayurveda medication and those who received only Ayurveda medication. The Revised Cochrane Risk of Bias tool for randomized control trials (RoB-2) was used for the quality assessment of randomized control trials. Analysis was done using Medcalc software. The comparison table is provided for the percentage of relief in clinical symptoms in both groups. Out of four RCTs, only three were included for quantitative analysis, which mentioned the mean and standard deviation of systolic and diastolic blood pressure. Meta-analyses revealed the effects of Shirodhara on systolic blood pressure ( n = 100), the mean difference (MD) was − 1.257 mmHg, (2.660–0.145), I 2 = 89.3%, and diastolic blood pressure ( n = 100) MD was − 0.40 mmHg, (−0.79–0.01) I 2 = 0. The percentage of relief in clinical symptoms was notably higher in the Shirodhara and Ayurveda groups than in the Ayurvedic drug group. Shirodhara lowered diastolic blood pressure significantly, but it has low clinical value. Shirodhara’s effect on systolic blood pressure remained unclear. Relief in clinical symptom score was notable. Larger, well-designed research is needed to prove Shirodhara’s effectiveness in hypertension management and optimize therapy methods.
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Khapre et al. (2025) conducted a meta-analysis in Essential hypertension (n=100). Shirodhara therapy adjunct to Ayurveda medication vs. Ayurveda medication alone (Tagaradi Kwatha, Jatamansyadi Kwatha, or Mansyadi Yoga) was evaluated on Change in systolic blood pressure (MD -1.257 mmHg, 95% CI -2.660 to 0.145, p=0.07). Shirodhara combined with Ayurvedic medication did not reduce systolic blood pressure and only minimally lowered diastolic BP.
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