Hypertension Research 2

A 2017 acupuncture blood pressure study found acupuncture effective for treating hypertension in middle-aged adults. An international research team concluded that acupuncture improved both brachial and central aortic blood pressure in hypertensive middle-aged adults.[1]

This groundbreaking study was a collaboration between researchers from Larkin Community Hospital (Miami, Florida), Marymount University (Arlington, Virginia), Nosov Magnitogorsk State Technical University (Russia), and Moscow Financial and Law University (Russia).

Resting Aortic Hemodynamics

The investigators referenced prior studies finding acupuncture effective for the treatment of hypertension.[2,3] However, this investigation was the first to measure acupuncture’s effects on resting aortic hemodynamics and stiffness.

In this acupuncture blood pressure study, the researchers noted, “We found that eight weeks of acupuncture therapy resulted in beneficial reductions of aortic hemodynamics and arterial stiffness. Our results indicate that acupuncture improves resting aortic vascular function in hypertensive middle-aged individuals.” [4]

Pulse Wave Reflexion

Acupuncture’s effectiveness in improving pulse wave reflection (Alx) confirmed earlier findings by Satoh et al. in their investigation of the effects of acupuncture point GV20 (Baihui). The international team measured Alx “as the difference between the late and early systolic peak relative to aortic pulse pressure.” [6]

The findings of both Alx studies confirmed acupuncture’s effectiveness in downregulating Alx, resulting in decreased aortic stiffness. This finding is significant because a 10% increase in Alx increases pathological cardiovascular event risks by 31.8%.[7]

Acupuncture Blood Pressure Study Conclusions

As a result, the researchers in this acupuncture blood pressure study concluded that acupuncture’s ability to downregulate Alx indicates that it reduces cardiovascular risks. Eight weeks of acupuncture lowered aortic systolic blood pressure by 10 mm Hg on average. Furthermore, acupuncture lowered brachial systolic blood pressure by 10 mm Hg and diastolic blood pressure by 6 mm Hg.

Hypertension Study Protocol

With a randomized, controlled, and parallel experimental design, investigators used a strict acupuncture point prescription for all patients. Practitioners manually stimulated needles to elicit a deqi response (achy feeling at the point). Participants received three treatments a week for eight weeks, with each treatment lasting 20 minutes.

Points administered in the acupuncture blood pressure study included:
ST36 (Zusanli)
ST37 (Shangjuxu)
PC5 (Jianshi)
PC6 (Neiguan)
LV3 (Taichong)
SP4 (Gongsun)
LI11 (Quchi)

Aortic Pressure Vs. Peripheral Pressure

Investigators agreed with Mayo Clinic’s findings that “aortic pressure is a better predictor of cardiovascular outcome than peripheral pressure.” [12] In addition, pressure amplification creates a discrepancy between aortic and brachial blood pressure readings, making aortic pressure a superior measurement.

Additional Studies Supporting Acupuncture

The research team cited previous studies exploring possible mechanisms responsible for acupuncture’s antihypertensive therapeutic actions. In one study, acupuncture exerted a homeostatic regulatory effect on “plasma nitric oxide (NO) levels, a potent vasodilator.” [15–16]

Another study concluded that acupuncture regulated plasma levels of potent vasoconstrictors (endothelin-1, angiotensin II).[17–18] Investigators cited additional research finding acupuncture effective in controlling sympathetic nervous system outflows, mainly when applied with electroacupuncture to acupoints PC5–PC6 and ST36–ST37.[19–21]

Conclusions

The findings of this acupuncture blood pressure study demonstrate acupuncture’s importance as a treatment option for hypertension. Researchers emphasized the need to educate medical professionals about the benefits of acupuncture in treating hypertension and the importance of increasing referrals to licensed acupuncturists.

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References

1. Terenteva, Nina, Oksana Chernykh, Marcos A. Sanchez-Gonzalez, and Alexei Wong. “Acupuncture therapy improves vascular hemodynamics and stiffness in middle-aged hypertensive individuals.” Complementary Therapies in Clinical Practice (2017).
2. D.Z. Li, Y. Zhou, Y.N. Yang, Y.T. Ma, X.M. Li, J. Yu, Y. Zhao, H. Zhai, L. Lao, Acupuncture for essential hypertension: a meta-analysis of randomized sham-controlled clinical trials, Evidence-Based Complement. Altern. Med. 2014 (2014).
3. J. Wang, X. Xiong, W. Liu, Acupuncture for essential hypertension, Int. J. Cardiol. 169 (2013) 317e326.
4. Terenteva, Nina, Oksana Chernykh, Marcos A. Sanchez-Gonzalez, and Alexei Wong. “Acupuncture therapy improves vascular hemodynamics and stiffness in middle-aged hypertensive individuals.” Complementary Therapies in Clinical Practice (2017), pg. 16.
5. H. Satoh, Acute effects of acupuncture treatment with bai hui (GV20) on human arterial stiffness and wave reflection, J. Acupunct. Meridian Stud. 2 (2009) 130e134.
6. Terenteva, Nina, Oksana Chernykh, Marcos A. Sanchez-Gonzalez, and Alexei Wong. “Acupuncture therapy improves vascular hemodynamics and stiffness in middle-aged hypertensive individuals.” Complementary Therapies in Clinical Practice (2017), pg. 17.
7. Ibid.
8. Y. Liu, J.-E. Park, K.-M. Shin, M. Lee, H.J. Jung, A.-R. Kim, S.-Y. Jung, H.R. Yoo, K.O. Sang, S.-M. Choi, Acupuncture lowers blood pressure in mild hypertension patients: a randomized, controlled, assessor-blinded pilot trial, Complement. Ther. Med. 23 (2015) 658e665.
9. C. Yin, B. Seo, H.-J. Park, M. Cho, W. Jung, R. Choue, C. Kim, H.-K. Park, H. Lee, H. Koh, Acupuncture, a promising adjunctive therapy for essential hypertension: a double-blind, randomized, controlled trial, Neurol. Res. 29 (Suppl 1) (2007) S98eS103.
10. P. Li, S.C. Tjen-A-Looi, L. Cheng, D. Liu, J. Painovich, S. Vinjamury, J.C. Longhurst, Long-lasting reduction of blood pressure by electroacupuncture in patients with hypertension: randomized controlled trial, Med. Acupunct. 27 (2015) 253e266.
11. Nelson, Matthew R., Jan Stepanek, Michael Cevette, Michael Covalciuc, R. Todd Hurst, and A. Jamil Tajik. “Noninvasive measurement of central vascular pressures with arterial tonometry: clinical revival of the pulse pressure waveform.” In Mayo Clinic Proceedings, vol. 85, no. 5, pp. 460-472. Elsevier, 2010.
12. Ibid.
13. Ibid.
14. Ibid.
15. D.D. Kim, A.M. Pica, R.G. Dur an, W.N. Dura n, Acupuncture reduces experimental renovascular hypertension through mechanisms involving nitric oxide synthases, Microcirculation 13 (2006) 577e585.
16. H.S. Hwang, Y.S. Kim, Y.H. Ryu, J.E. Lee, Y.S. Lee, E.J. Yang, S.M. Choi, Electro- acupuncture delays hypertension development through enhancing NO/NOS activity in spontaneously hypertensive rats, Evidence-Based Complement. Altern. Med. 2011 (2011) 1e7.
17. Z. Huo, D. Li, J. Guo, S. Li, N. Ding, Z. Li, Effect of electroacupuncture stimulation on expression of angiotensinogen, angiotensin II type 1 receptor, endothelin-1, and endothelin a receptor mRNA in spontaneously hypertensive rat aorta, Chin. J. Integr. Med. 22 (2016) 778e782.
18. P. Pan, X. Zhang, H. Qian, W. Shi, J. Wang, Y. Bo, W. Li, Effects of electroacupuncture on endothelium-derived endothelin-1 and endothelial nitric oxide synthase of rats with hypoxia-induced pulmonary hypertension, Exp. Biol. Med. (Maywood) 235 (2010) 642e648.
19. D.Y. Zhang, A.S. Anderson, The sympathetic nervous system and heart failure, Cardiol. Clin. 32 (2014) 33e45.
20. S. Uchida, F. Kagitani, H. Hotta, Neural mechanisms of reflex inhibition of heart rate elicited by acupuncture-like stimulation in anesthetized rats, Auton. Neurosci. Basic Clin. 157 (2008) 18e23.
21. S.C. Tjen-A-Looi, P. Li, J.C. Longhurst, Prolonged inhibition of rostral ventral lateral medullary premotor sympathetic neurons by electroacupuncture in cats, Auton. Neurosci. Basic Clin. 106 (2003) 119e131.