***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Swedish Massage Therapy ( SMT ) is known for its therapeutic relaxation effects . Hypertension is associated with stress and elevated endothelial inflammatory markers . This r and omized control trial measured the effects of whole body SMT ( massage group ) or resting ( control group ) an hour weekly for four weeks on hypertensive women .  Blood pressure ( BP ) and heart rate ( HR ) were measured before and after each intervention and endothelial inflammatory markers : vascular endothelial adhesion molecules 1 ( VCAM-1 ) and intracellular adhesion molecules 1 ( ICAM-1 ) were measured at baseline and after the last intervention . Massage group ( n=8 ) showed significant systolic BP ( SBP ) reduction of 12 mmHg ( P=0.01 ) and diastolic BP ( DBP ) reduction of 5 mmHg ( P=0.01 ) after four sessions with no significant difference between groups . Reductions in HR were also seen in massage group after sessions 1 , 3 , and 4 with significant difference between groups . VCAM-1 showed significant reduction after four sessions : the massage group showed reduction of 998.05 ng/mL ( P=0.03 ) and the control group of 375.70 ng/mL ( P=0.01 ) with no significant differences between groups . There were no changes in ICAM-1 . In conclusion , SMT or resting an hour weekly has effects on reducing BP , HR , and VCAM-1 in hypertensive women OBJECTIVE To determine the feasibility of conducting a r and omized clinical trial in the private practice setting examining short- and long-term effects of chiropractic adjustments for subjects with essential hypertension compared with a brief soft tissue massage , as well as a nontreatment control group . DESIGN R and omized controlled-comparison trial with 3 parallel groups . SETTING Private practice outpatient chiropractic clinic . PATIENTS Twenty-three subjects , aged 24 to 50 years with systolic or diastolic essential hypertension . INTERVENTIONS Two months of full-spine chiropractic care ( ie , Gonstead ) consisting primarily of specific-contact , short-lever-arm adjustments delivered at motion segments exhibiting signs of subluxation . The massage group had a brief effleurage procedure delivered at localized regions of the spine believed to be exhibiting signs of subluxation . The nontreatment control group rested alone for a period of approximately 5 minutes in an adjustment room . MAIN OUTCOME MEASURES Cost per enrolled subject , as well as systolic and diastolic blood pressure ( BP ) measured with a r and om-0 sphygmomanometer and patient reported health status ( SF-36 ) . Pilot study outcome measures also included an assessment of cooperation of subjects to r and omization procedures and drop-out rates , recruitment effectiveness , analysis of temporal stability of BPs at the beginning of care , and the effects of inclusion /exclusion criteria on the subject pool . RESULTS Thirty subjects enrolled , yielding a cost of $ 161 per enrolled subject . One subject was later determined to be ineligible , and 6 others dropped out . In both the chiropractic and massage therapy groups , all subjects were classified as either overweight or obese ; in the control group there were only 2 classified as such . SF-36 profiles for the groups were similar to that of a normal population . The mean change in diastolic BP was -4 ( 95 % confidence interval [ CI ] : -8.6 , 0.5 ) in the chiropractic care group , 0.5 ( 95 % CI : -3.5 , 4.5 ) in the brief massage treatment group , and -4.9 ( 95 % CI : -9.7 , -0.1 ) in the no treatment control group . At the end of the study period , this change was -6.3 ( 95 % CI : 13.1 , 0.4 ) , -1.0 ( 95 % CI : -7.5 , 15.6 ) , -7.2 ( 95 % CI : -13.3 , -1.1 ) in the 3 study groups . The mean improvements in the chiropractic care and no treatment control groups remained consistent over the follow-up period . CONCLUSIONS This pilot study eluci date d several procedural issues that should be addressed before undertaking a full-scale clinical trial on the effects of chiropractic adjustments in patients with essential hypertension . A multidisciplinary approach to recruitment may need to be used in any future efforts because of the limited subject pool of patients who have hypertensive disease but are not taking medications for its control . Measures need to be used to assure comparable groups regarding prognostic variables such as weight . Studies such as these demonstrate the feasibility of conducting a full-scale 3-group r and omized clinical trial in the private practice setting BACKGROUND : Prehypertension is considered as a cardiovascular disease predicator . Management of prehypertension is an appropriate objective for clinicians in a wide range of medical centers . Treatment of prehypertension is primarily non-pharmacological , one of which is massage therapy that is used to control the blood pressure . This study aim ed to evaluate the effect of Swedish massage ( face , neck , shoulders and chest ) on blood pressure ( BP ) of the women with prehypertension . METHODS : This was a single-blind clinical trial study . Fifty prehypertensive women selected by simple r and om sampling which divided into control and test groups . The test group ( 25 patients ) received Swedish massage 10 - 15 min , three times a week for 10 sessions and the control groups ( 25 patients ) also were relaxed at the same environment with receiving no massage . Their BP was measured before and after each session . Analyzing the data was done using descriptive and inferential statistical methods ( chi square , Mann-Whitney , paired t-test and student t-test ) through SPSS software . RESULTS : The results indicated that mean systolic and diastolic blood pressure in the massage group was significantly lower in comparison with the control group ( p < 0.001 ) . CONCLUSIONS : Findings of the study indicated that massage therapy was a safe , effective , applicable and cost-effective intervention in controlling BP of the prehypertension women and it can be used in the health care centers and even at home Summary Background The associations of blood pressure with the different manifestations of incident cardiovascular disease in a contemporary population have not been compared . In this study , we aim ed to analyse the associations of blood pressure with 12 different presentations of cardiovascular disease . Methods We used  linked electronic health records from 1997 to 2010 in the CALIBER ( CArdiovascular research using LInked Bespoke studies and Electronic health Records ) programme to assemble a cohort of 1·25 million patients , 30 years of age or older and initially free from cardiovascular disease , a fifth of whom received blood pressure-lowering treatments . We studied the heterogeneity in the age-specific associations of clinical ly measured blood pressure with 12 acute and chronic cardiovascular diseases , and estimated the lifetime risks ( up to 95 years of age ) and cardiovascular disease-free life-years lost adjusted for other risk factors at index ages 30 , 60 , and 80 years . This study is registered at Clinical Trials.gov , number NCT01164371 . Findings During 5·2 years median follow-up , we recorded 83 098 initial cardiovascular disease presentations . In each age group , the lowest risk for cardiovascular disease was in people with systolic blood pressure of 90–114 mm Hg and diastolic blood pressure of 60–74 mm Hg , with no evidence of a J-shaped increased risk at lower blood pressures . The effect of high blood pressure varied by cardiovascular disease endpoint , from strongly positive to no effect . Associations with high systolic blood pressure were strongest for intracerebral haemorrhage ( hazard ratio 1·44 [ 95 % CI 1·32–1·58 ] ) , subarachnoid haemorrhage ( 1·43 [ 1·25–1·63 ] ) , and stable angina ( 1·41 [ 1·36–1·46 ] ) , and weakest for abdominal aortic aneurysm ( 1·08 [ 1·00–1·17 ] ) . Compared with diastolic blood pressure , raised systolic blood pressure had a greater effect on angina , myocardial infa rct ion , and peripheral arterial disease , whereas raised diastolic blood pressure had a greater effect on abdominal aortic aneurysm than did raised systolic pressure . Pulse pressure associations were inverse for abdominal aortic aneurysm ( HR per 10 mm Hg 0·91 [ 95 % CI 0·86–0·98 ] ) and strongest for peripheral arterial disease ( 1·23 [ 1·20–1·27 ] ) . People with  hypertension ( blood pressure ≥140/90 mm Hg or those receiving blood pressure-lowering drugs ) had a lifetime risk of overall cardiovascular disease at 30 years of age of 63·3 % ( 95 % CI 62·9–63·8 ) compared with 46·1 % ( 45·5–46·8 ) for those with normal blood pressure , and developed cardiovascular disease 5·0 years earlier ( 95 % CI 4·8–5·2 ) . Stable and unstable angina accounted for most ( 43 % ) of the cardiovascular disease-free years of life lost associated with hypertension from index age 30 years , whereas heart failure and stable angina accounted for the largest proportion ( 19 % each ) of years of life lost from index age 80 years . Interpretation The widely held assumptions that blood pressure has strong associations with the occurrence of all cardiovascular diseases across a wide age range , and that diastolic and systolic associations are concordant , are not supported by the findings of this high-resolution study . Despite modern treatments , the lifetime burden of hypertension is substantial . These findings emphasise the need for new  blood pressure-lowering strategies , and will help to inform the design of r and omised trials to assess them . Funding Medical Research Council , National Institute for Health Research , and Wellcome Trust Background : Pre-hypertension is considered as a cardiovascular disease predicator . Management of pre-hypertension is an appropriate objective for clinicians in a wide range of medical centers . Treatment of pre-hypertension is primarily non-pharmacological , one of which is massage therapy that is used to control the BP . This study aim ed to evaluate the survival effect of Swedish massage ( face , neck , shoulders , and chest ) on BP of the women with pre-hypertension . Methods : This was a single-blind clinical trial study . Fifty pre-hypertensive women selected by simple r and om sampling which divided into control and test groups . The test group ( 25 patients ) received Swedish massage 10 - 15 min , 3 times a week for 10 sessions and the control groups ( 25 patients ) also were relaxed at the same environment with receiving no massage . Their BP was measured before and after each session and 72 h after finishing the massage therapy . Analyzing the data was done using descriptive and inferential statistical methods ( Chi- square , Mann-Whitney , paired t-test and Student t-test ) through SPSS software . Results : The results indicated that mean systolic and diastolic BP in the massage group was significantly lower in comparison with the control group ( P < 0.001 ) . Evaluation of durability of the massage effects on BP also indicated that 72 h after finishing the study , still there was a significant difference between the test and control groups in systolic and diastolic BP ( P < 0.001 ) . Conclusions : Findings of the study indicated that massage therapy was a safe , effective , applicable and cost-effective intervention in controlling BP of the pre-hypertension women and it can be used in the health care centers and even at home OBJECTIVES The objective of this study was to determine the change in blood pressure ( BP ) in normotensive and prehypertensive adults result ing from a  therapeutic massage  , and the factors associated with such changes , including demographic and massage characteristics . DESIGN SETTING S/LOCATION National University of Health Sciences Massage Therapy Clinic , Lombard , IL . SUBJECTS The subjects were 150 current adult massage therapy clients with BP lower than 150/95 . INTERVENTIONS  BP was measured before and after a therapeutic massage . OUTCOME MEASURES Change in BP and potential associated factors such as type of massage , duration of massage , specific body area massaged , amount of massage pressure , and demographic characteristics were studied . RESULTS Overall , systolic BP decreased by 1.8 mm Hg and diastolic BP increased by 0.1 mm Hg . Demographic factors associated with BP decrease included younger age ( p = 0.01 ) and taller stature ( p = 0.09 ) . Type of massage was associated with change in BP : Swedish massage had the greatest effect at BP reduction . Trigger point therapy and sports massage both increased the systolic BP , and if both forms of massage were included in a session , both the systolic and diastolic BP readings significantly increased . No other massage factors were associated with a significant change in BP . CONCLUSIONS Type of massage was the main factor affecting change in BP . Increases in BP were noted for potentially painful massage techniques , including trigger point therapy Swedish massage technique includes mechanically activated muscular tissue and also skin , tendons , fascias , and connected tissue , which indirectly regulates the tonus of the autonomous nervous system . This study set out to examine the effects of  Swedish massage on blood pressure . Healthy males were given massage treatment at the Karolinska Hospital , Stockholm , Sweden . Treatment 
    Output:
    
This systematic review found a medium effect of massage on SBP and a small effect on DBP in patients with hypertension or prehypertension .