Stop Hypertension With the Acupuncture Research Program (SHARP)

Abstract

Abstract-Case studies and small trials suggest that acupuncture may effectively treat hypertension, but no large randomized trials have been reported. 3 Modalities of complementary and alternative medicine, including acupuncture, are being used by patients with increasing frequency, 4 but these therapies lack demonstrated efficacy and safety for treating cardiovascular disease and hypertension. 5 Acupuncture has been used in traditional Chinese medicine (TCM) to treat symptoms related to hypertension for Ͼ2500 years. 6 Today, acupuncture is commonly used to treat hypertension in China and the West. [7][8][9] The efficacy of acupuncture is well supported for treating postoperative dental pain 10 and nausea 11,12 with few reported adverse effects. 13 Acupuncture has been found effective for treating a number of other acute 14 -16 and chronic 17,18 conditions in a growing number of randomized trials, although opinion differs on the role of placebo effects. 19,20 Mechanistic studies have demonstrated effects of acupuncture on the activity and plasma concentrations of blood pressure modulators, including: renin, aldosterone, angiotensin II, norepinephrine, serotonin, enkephalins, and ␤-endorphins. [21][22][23][24][25][26][27][28][29] The efficacy of acupuncture for treating hypertension is suggested by a large number of published case series and uncontrolled trials. 22,23,25,30 -32 Three randomized trials 33-35 reported significant reductions in BP relative to randomly assigned control groups treated for 4 to 8 weeks, whereas 3 others did not report significant effects of acupuncture relative to control subjects. 36 -38 They were all relatively small trials (nϭ10 to 68), and all but Yin et al 35 were limited

Effects of electrical stimulation of acupuncture points on blood pressure

“…16 The mechanism of electrical acupuncture that reduces blood pressure is not well understood. 20 Studies seem to suggest a link of a blood pressure-lowering effect with syntheses of nitric oxide. 21,22 Kim et al 23 tested the hypothesis that acupuncture on stomach 36 point (ST-36) to reduce hypertension by activating nitric oxide synthase signaling mechanisms.…”

Safety, Efficacy, Regulations and Bioethics in Herbal Medicines Research and Practice

“…The lack of uniformity in medical systems across countries is the biggest challenge for standardization of herbal medicine research practice in inclusion and exclusion criteria. Several cases have been used in various countries while recruiting subjects for clinical trials involving herbal medicines (Table 1) [63][64][65].…”

Is acupuncture no more than a placebo? Extensive discussion required about possible bias

“…When the results of two studies about acupuncture on hypertension are compared (10,55), the data may demonstrate that the effects of active or verum acupuncture groups are different. Macklin et al (10) revealed that active acupuncture groups provided no greater benefit than sham acupuncture, while Flachskampf et al (55) reported a clear-cut effect on blood pressure in the active treatment group.…”

“…Macklin et al (10) revealed that active acupuncture groups provided no greater benefit than sham acupuncture, while Flachskampf et al (55) reported a clear-cut effect on blood pressure in the active treatment group. The setting of acupuncture administration was different in the two trials.…”

“…Furthermore, a previous study (8) indicated that there was no significant difference between verum (applied according to the principles of TCM) and sham acupuncture groups. Therefore, certain articles have implied that acupuncture is only a powerful placebo effect (9,10).…”