Acupuncture lowering blood pressure for secondary prevention of stroke: a study protocol for a multicenter randomized controlled trial

Abstract

BackgroundStroke is the prime cause of morbidity and mortality in the general population, and hypertension will increase the recurrence and mortality of stroke. We report a protocol of a pragmatic randomized controlled trial (RCT) using blood pressure (BP)-lowering acupuncture add-on treatment to treat patients with hypertension and stroke.MethodsThis is a large-scale, multicenter, subject-, assessor- and analyst-blinded, pragmatic RCT. A total of 480 patients with hypertension and ischemic stroke will be randomly assigned to two groups: an experimental group and a control group. The experimental group will receive “HuoXueSanFeng” acupuncture combined with one antihypertensive medication in addition to routine ischemic stroke treatment. The control group will only receive one antihypertensive medication and basic treatments for ischemic stroke. HuoXueSanFeng acupuncture will be given for six sessions weekly for the first 6 weeks and three times weekly for the next 6 weeks. A 9-month follow-up will, thereafter, be conducted. Antihypertensive medication will be adjusted based on BP levels. The primary outcome will be the recurrence of stroke. The secondary outcomes including 24-h ambulatory BP, the TCM syndrome score, the Short Form 36-item Health Survey (SF-36), the National Institute of Health Stroke Scale (NIHSS), as well as the Barthel Index (BI) scale will be assessed at baseline, 6 weeks and 12 weeks post initiating treatments; cardiac ultrasound, carotid artery ultrasound, transcranial Doppler, and lower extremity ultrasound will be evaluated at baseline and 12 weeks after treatment. The safety of acupuncture will also be assessed.DiscussionWe aim to determine the clinical effects of controlling BP for secondary prevention of stroke with acupuncture add-on treatment.Trial registrationClinicalTrials.gov, ID: NCT02967484. Registered on 13 February 2017; last updated on 27 June 2017.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-2171-5) contains supplementary material, which is available to authorized users.

Can Acupuncture Treatment of Hypertension Improve Brain Health? A Mini Review

“…Meta-analyses have challenged the efficacy of acupuncture for the treatment of hypertension as a risk factor for stroke (Sibbritt et al, 2018). However, controlling BP via acupuncture as an additive treatment is an effective secondary prevention of stroke (Du et al, 2017). In stroke patients complicated with hypertension, antihypertensive acupuncture improved the National Institutes of Health stroke scale and Barthel index, both of which are indicative of stroke-related neurologic deficit.…”

Effects of Acupuncture on Lowering Blood Pressure in Postmenopausal Women with Prehypertension or Stage 1 Hypertension: A Propensity Score-Matched Analysis

“…Several studies have confirmed the effect of acupuncture interventions on BP control [ 14 , 15 , 16 , 17 , 18 ] and acupuncture was found to lower BP and relieve hypertension symptoms in various cases. Therefore, acupuncture treatment may also be effective in the management of BP in postmenopausal women.…”

Effects of acupuncture in postmenopausal women with prehypertension or stage 1 hypertension: study protocol for a prospective, comparative, interventional cohort study

“… 9 Long-term use of antihypertensive medication may result in side effects and increase the cost of medical care, thereby lowering the quality of life. 10 …”

“…In several studies, acupuncture showed a BP-lowering effect in men and women in the prehypertension and hypertension stages. 9 , 10 , 11 , 12 Acupuncture has also been shown to be effective in controlling vasomotor symptoms, such as hot flushes in menopausal women. 13 Recent studies have shown that the use of acupuncture is increasing and it is effective for lowering blood pressure.…”

“… 12 , 14 Another study reported that the use of acupuncture in combination with pharmacological therapy is effective in decreasing arterial BP in patients with prehypertension or hypertension. 15 Although several studies have shown that acupuncture is effective in lowering blood pressure, 10 , 11 , 12 , 13 , 14 , 15 , 16 the evidence from well-designed studies that is needed to introduce acupuncture treatment for hypertension in postmenopausal women in clinical practice is still lacking.…”