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June 18, 2026Journal of Integrative Nursing0 citationsOpen Access

Reflexology for blood pressure control: A comprehensive evidence-based umbrella review

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SSSoheila ShamsikhaniMHMahsa Hosseini

Key Result

Reflexology for blood pressure control yielded uncertain, low-certainty evidence, with findings ranging from no significant effect to mild or moderate blood pressure reduction.

Key Points

  • This review aims to synthesize existing systematic reviews and meta-analyses on reflexology's impact on blood pressure.
  • Conducted a comprehensive search in multiple databases (PubMed, Scopus, Web of Science, Epistemonikos) until August 25, 2025.
  • Evaluated methodological quality using the A MeaSurement Tool to Assess Systematic Reviews 2.
  • Identified nine reviews (five meta-analyses and four systematic reviews) assessing reflexology effects on adult blood pressure.
  • Meta-analytic results revealed heterogeneity, with some studies showing no effect and others demonstrating mild to moderate blood pressure reductions.
  • All reviews were rated critically low quality due to inadequate publication bias assessment and risk evaluation.
  • Primary study overlap was low with a CCA of 3.77%.

Study Design

Type

Systematic Review

Structured PICO

Does reflexology reduce systolic and diastolic blood pressure in adults?

P
Population
9 systematic reviews and meta-analyses comprising 43 primary studies evaluating the effects of reflexology on adult systolic and diastolic blood pressure.
I
Intervention
Reflexology
O
Outcome
Systolic blood pressure and diastolic blood pressuresurrogate

Current evidence on the efficacy of reflexology for blood pressure control is of critically low quality and insufficient to support strong clinical recommendations.

Limitations

  • All included reviews were rated as critically low quality
  • Inadequate assessment of publication bias
  • Insufficient evaluation of risk of bias in primary studies
  • inadequate assessment of publication bias
  • insufficient evaluation of risk of bias in primary studies

Abstract

Reflexology has recently gained attention as a complementary therapy, but existing evidence on its effectiveness for blood pressure (BP) remains scattered and inconsistent. This study aimed to synthesize and critically evaluate published systematic reviews and meta-analyses examining the impact of reflexology on BP. A comprehensive search was conducted in PubMed, Scopus, Web of Science, and Epistemonikos up to until August 25, 2025. Eligible studies included systematic reviews and meta-analyses assessing the effects of reflexology on adult systolic BP and diastolic BP. Methodological quality was evaluated using the A MeaSurement Tool to Assess Systematic Reviews 2 tool, and overlap among primary studies was measured using the Corrected Covered Area (CCA) index. The review process followed the Preferred Reporting Items for Overviews of Reviews checklist. Nine reviews (five meta-analyses and four systematic reviews), including 43 primary studies, were identified. Meta-analytic results showed considerable heterogeneity, with findings ranging from no significant effect to mild or moderate BP reduction after reflexology. All included reviews were rated as critically low quality, mainly due to inadequate assessment of publication bias and insufficient evaluation of risk of bias in primary studies. Primary study overlap was low (CCA = 3.77%). The current evidence on the efficacy of reflexology for BP control remains uncertain and low in certainty. While reflexology appears safe and may contribute to small BP reductions, the evidence is insufficient to support strong clinical recommendations. Robust, large-scale randomized controlled trials and methodologically sound systematic reviews are needed to clarify the role of reflexology in hypertension management.

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Cite This Study

Shamsikhani et al. (2026) conducted a systematic review in Blood pressure control. Reflexology was evaluated on Systolic and diastolic blood pressure. Reflexology for blood pressure control yielded uncertain, low-certainty evidence, with findings ranging from no significant effect to mild or moderate blood pressure reduction.

synapsesocial.com/papers/6a33cfcf14a9c556e66778fdhttps://doi.org/10.4103/jin.jin_17_26
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