Hypertension is one of the dangerous health problems which is mentioned when the systolic blood pressure is greater than or equal to 140mmHg. According to Joint National Committee on Prevention, Detection, Evaluation and Treatment of High blood pressure, for adults normal is less than or equal to 120/ less than or equal to 80 mmHg, Pre hypertension is 120-139/80-89 mmHg, Stage 1 hypertension 140-159/90-99 mmHg, Stage 2 hypertension more than or equal to 160/ more than or equal to 100 mmHg. An estimated 1.28 billion adults aged 30-79 years worldwide have hypertension. Approximately 1 in 5 adults (21 percent) with hypertension. Hypertension is a major cause of premature death worldwide. One of the global targets for non-communicable diseases is to reduce the prevalence of hypertension 33 percent between 2010 and 2030. The cross-sectional survey study of Indian adults shows more than 1in 4 people had hypertension, and of these, only 1 in3 received a diagnosis, less than 1 in 5 were treated, and only 1 in 12 had blood pressure control. National mean values hide considerable state-level and district-level variation in the continuum suggesting the need for targeted decentralized solutions to improve the hypertension care continuum in India. Hypertension may lead to cerebrovascular and cardiovascular complications. Bakhru (2000) declared modern medical treatment of hypertension as highly unscientific because it brings down the pressure of drugs without making any effort to remove the underlying causes. Hypertension signifies homeostasis in coordination which could be managed well by applying nondrug therapies with physiological justification which is possible through naturopathy only. Rosenthal (2020) has rightly remarked that “Doctors should first treat high blood pressure patients with non-pharmacological methods like calorie and food restrictions, weight control and reduction in salt intake. Every drug has some side effects. There is no drug without side effects”. High blood pressure is existing circulation problems that may cause heart attacks, stroke, or other disabling conditions, when the cause of high blood pressure is removed, both the high blood pressure and the resulting dangers may disappear. Out of 1380 papers, 52 papers up to March 2022 were eligible for review obtained results, the most widely used medicinal plants for Aroma therapy in patients with cardiovascular diseases are Lavender, Damask rose, and peppermint. Most studies on the effect of Aromatherapy in cardiovascular performance on Anxiety, sleep quality, and Hemodynamic parameters. Today it has been proven that stress and Anxiety affect cardiovascular regulation and subsequently negatively affect cardiovascular parameters and tissue perfusion. In addition to cardiovascular complications, depending on the severity and duration of exposure to stress and Anxiety, a person may be prone to certain diseases such as sleep disorders, neurological diseases, High blood pressure, Multiple sclerosis, and even a weakened immune system. The active principles of lavender oil (linalool, linalyl acetate) stimulate parasympathetic nervous system and thereby reduces stress. Dermal application of lavender essential oil also includes the inhalational effect and helps to reduce serum cortisol level. According to Article in Biofeedback, December 2021 by Monica Almendras San Francisco State University that “Re activate Your Second Heart” - Tightening and relaxing the calf muscles can prevent the pooling of the blood. The inactivity of the calf muscles does not allow the blood to flow upward may result in “sitting disease” contributing to the development of diabetes and cardiovascular disease. Activating the calf muscles as well as other leg muscles are strategies to support cardiovascular health. So, calf massage stimulates the skeletal muscles, particularly the gastrocnemius and soleus which play a critical role in venous return by Muscle pump action -rhythmic compression and relaxation of calf muscles during massage enhance the muscle pump mechanism. This action facilitates the upward flow of blood through the veins, improving venous return to the heart and reducing the venous pooling. Enhanced venous return increases the preload which can lead to more efficient cardiac output. Improved cardiac output reduces the strain on the heart and can helps to lower blood pressure. Besides increasing blood circulation, the massage therapy strokes of effleurage, kneading and tapotement stimulate skin receptors that send messages of relaxation to the central nervous system. These reflexes cause vasodilation: where the blood vessels widen to decrease blood pressure and heart rate. As such, the massage strokes just described are known to aid hypertension – one of the most prominent forecasters of cardiovascular disease.

Therefore, this study aims to the effect of calf muscle massage with lavender oil on cardiovascular parameters in patients with hypertension: a randomized controlled trial.