Evidence Based Paper
Critically Appraised Topic
Essential Oils and Hypertension
Date: March 26, 2014
Appraised By: Kami Peterson, BSN, RN, FNP-S
Case Presentation:
Herbal therapies seem to be more and more popular every day. Many individuals swear
that essential oils help them with many different problems they are struggling with including
anxiety, depression, nausea, restlessness, headaches and hypertension. I saw a patient who has
been on hydrochlorothiazide and diltiazem for years. Over the last few months she started using
a blend of topical essential oils (lavender, ylang-ylang, and marjoram) and her blood pressure is
the best it has ever been. She hasn’t seen much of an effect on her systolic blood pressure but
states her diastolic blood pressure has decreased 7-20mm Hg (depending on the day) since she
started using the oils. The positive outcomes I have been hearing about led me to my PICO
question in order to see how effective these oils have been in clinical trials.
PICO Question
Is there a significant reduction in blood pressure in individuals with hypertension who
use essential oils versus individuals who do not use essential oils?
Articles:
Kim, I., Kim, C., Seong, K., Hur, M., Lim, H., Lee, M. (2012). Essential oil inhalation on blood
pressure and salivary cortisol levels in prehypertensive and hypertensive subjects.
Evidence-Based Complementary & Alternative Medicine. Doi: 10.1155/2012/984203
Shikov, A., Pozharitskaya, O., Makarov, V., Demchenko, D., Shikh E. (2011). Effect of
Leonurus cardiaca oil extract in patients with arterial hypertension accompanied by
anxiety and sleep disorders. Phytotherapy Research Journal. 25(4). Pg 540-43.
Summary and Appraisal of Key Evidence
Article 1
The article by Shikov, Pozharitskaya, Makarov, Demchenko and Shikh (2011), was a
level I randomized control trial and found that leonurus cardiac (motherwort) and soybean oil has
a positive effect on blood pressure, anxiety, headaches and sleep.
The data showed an 11-12mm Hg reduction in both systolic and diastolic blood pressure
in 9% of the patients given an oral capsule containing motherwort and soybean oil. It also
showed that patients with type I hypertension had slightly better effects than those who had type
II hypertension. There was other positive effects seen from these oils as well which were a
significant decreased in anxiety and depression in 32% of the patients, moderately in 48%, weak
in 8% and 12% had felt no effect.
Article 2:
The second article by Kim, Kim, Seong, Hur ,Lim and Lee (2012), was a level II nonrandomized controlled study. This study looked at the effect that a mixture of essential oils
(lavender, ylang-ylang, marjoram, and neroli) had on blood pressure reductions. The oils were
infused into a necklace and worn by the subjects throughout the day.
Data analysis found that there was a significant reduction in blood pressure in the
experimental group versus the placebo and control groups. They found that the systolic blood
pressure decreased by 4.7mm Hg and the diastolic blood pressure decreased 1.21mm Hg in four
weeks. The subjects were required to take their blood pressures independently at home twice a
day and record their results. After four weeks of therapy a 24 hour ambulatory blood pressure
monitoring was conducted and found that there was a 10.77 mm Hg decrease systolically and a
7.11mm Hg decrease in diastolic blood pressure.
Limitations:
Each study had a small sample size. Both studies also reported no side effects or adverse
reactions, however, neither study listed how they assessed for these issues. Blood pressure
monitoring was done independently in the home which could possible lead to error and
inconsistencies. There are also numerous essential oils, these two studies only touched on a few
specific ones.
Clinical Bottom Line:
Essential oils have been shown to have a positive immediate and long-term effect on
blood pressure if used consistently over time. A Study by the Angio-Scandinavian Cardiac
Outcomes Trial-BP-Lowering Arm referenced in Kim et al. (2012) found that calcium channel
blockers and ACE inhibitor combination therapy significantly lowers blood pressure by 2.7mm
Hg. Essential oils may have a better effect on reducing the blood pressure of hypertensive
patients. Even a small sustained reduction in blood pressure has been proven to be beneficial in
reducing the risk of stroke and cardiovascular death.
There is still research that is needed to be done on aromatherapy. It does seem to be
beneficial. However, side effects, adverse reactions and specific dosages need to be looked at
more closely before being able to fully recommend this as a treatment option.