Is Acupuncture Effective for Hypertension? A Systematic Review and Meta-Analysis

Abstract

ObjectiveTo determine the efficacy of acupuncture for hypertension.MethodSeven electronic databases were searched on April 13, 2014 to include eligible randomized controlled trials (RCTs). Data were extracted and risk of bias was assessed. Subgroup analyses and meta- analysis were performed.Results23 RCTs involving 1788 patients were included. Most trials had an unclear risk of bias regarding allocation concealment, blinding, incomplete outcome data and selective reporting. Compared with sham acupuncture plus medication, a meta-analysis of 2 trials revealed that acupuncture as an adjunct to medication was more effective on systolic (SBP) and diastolic (DBP) blood pressure change magnitude (n=170, SBP: mean difference (MD)= -7.47,95% confidence intervals (CI):-10.43 to -4.51,I2 =0%; DBP: -4.22,-6.26 to -2.18, 0%).A subgroup analysis of 4 trials also showed acupuncture combined with medication was superior to medication on efficacy rate (n=230, odds ratio (OR)=4.19, 95%CI: 1.65 to 10.67, I2 =0%). By contrast, compared with medication, acupuncture alone showed no significant effect on SBP /DBP after intervention and efficacy rate in the subgroup analysis. (7 trials with 510 patients, SBP: MD=-0.56, 95%CI:-3.02 to 1.89,I2 =60%; DBP: -1.01,-2.26 to 0.24, 23%; efficacy rate: 10 trials with 963 patients, OR=1.14, 95% CI: 0.70 to 1.85, I2 =54%).Adverse events were inadequately reported in most RCTs.ConclusionOur review provided evidence of acupuncture as an adjunctive therapy to medication for treating hypertension, while the evidence for acupuncture alone lowing BP is insufficient. The safety of acupuncture is uncertain due to the inadequate reporting of it. However, the current evidence might not be sufficiently robust against methodological flaws and significant heterogeneity of the included RCTs. Larger high-quality trials are required.

Regulation of Hypertension for Secondary Prevention of Stroke: The Possible ‘Bridging Function' of Acupuncture

“…Objectively speaking, acupuncture can be used as an adjunct to antihypertensive drugs for a larger reduction of high BP [11] in patients with both hypertension and stroke, particularly when they experience the side effects of drugs [12,13]; this aspect of acupuncture for the treatment of hypertension can support the judgment of the above-mentioned meta-analysis by Katsanos et al [7]. On the other hand, the meta-analysis by Wang et al [6] indicates that multiple targets other than regulation of the BP are needed for preventing stroke recurrence.…”

Laser-Acupuncture in Nursing Care for Hypertensive Individuals in Primary Care: Case Report

“…Estudos mostram que esse mecanismo homeostático advindo da AP em associação ao tratamento medicamentoso encontra relações com o equilí-brio da atividade do sistema renina-angiotensina-aldosterona, com melhor liberação plasmática de catecolaminas e neurotransmissores como a noradrenalina, serotonina e endorfina. [11][12][13][14] No entanto, a experiência clínica ora relatada pautou-se somente no comportamento da PA das mulheres hipertensas acompanhadas, a partir da aferição da PAS e PAD pré e pós--intervenção com LA. Infere-se que a dosagem sérica das mencionadas substâncias pode confirmar a hipótese suprarreferida.…”

Acupuncture for Blood Pressure Control in Stroke Patients: Case Reports

“…The blood pressure-lowering magnitude of the last visit versus the first visit in cases 2 and 3 was 20/10 and 30/10 mm Hg, after 47 and 46 sessions of acupuncture treatment, respectively. Systematic review of the literature showed a blood pressure change of 7.47/4.22 mm Hg induced by acupuncture plus antihypertensive medications [3]. The difference might be ex-plained by different participants and acupuncture treatment courses.…”

“…Secondary stroke prevention is positively correlated with the magnitude of decreased blood pressure values [2]. Acupuncture plus antihypertensive medication has been shown to concurrently treat essential hypertension [3], but the blood pressure-lowering effect of acupuncture alone remains controversial.…”