Abstract
This hypertension acupuncture case report describes a patient who could not tolerate the side effects of antihypertensive medications. The patient received regular acupuncture treatments for 12 weeks. During that time, his overall well-being improved, his blood pressure reduced, and he resolved the adverse effects of his previous antihypertensive drugs.
While acupuncture plus the drug appears to have a synergistic effect that weakens when discontinued, acupuncture plays a substantial role in managing hypertension, especially for patients who cannot tolerate the adverse effects of blood pressure medication.
Introduction
Investigators in this hypertension acupuncture case report determined that a patient with hypertension experienced reduced blood pressure with fewer adverse effects from the synergistic effect of antihypertensive medication combined with acupuncture. As a result, they concluded that acupuncture could be a viable alternative for patients who do not respond well to blood pressure medicine or who cannot tolerate its side effects.
Case Description
Doctors admitted a 56-year-old man (height 5′ 4″, weight 165 lbs.) to the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine in September 2012 with a diagnosis of hypertension and side effects from antihypertensive drugs. He was diagnosed with hypertension in 2007; his usual BP was 160/100 mm Hg.
He began taking a 5 mg calcium channel blocker daily in March 2011. However, his BP remained the same, and he reported side effects, including flushing and palpitations. He switched to 150 mg of irbesartan (antihypertensive) once a day in July 2012. However, his BP remained at 140/85 mm Hg. In addition, he reported side effects of diarrhea, fatigue, and decreased sexual function, among others.
His doctors ruled out a family history of alcoholism and cardiovascular disease; he did not consume significant amounts of salt and exercised daily.
Physical Examination and Investigation
A doctor’s exam revealed that the patient in this hypertension acupuncture case report had mild hypocalcemia (2.11 mmol/L) and reduced high-density cholesterol (0.88 mmol/L). A transcranial cerebral Doppler showed increased blood circulation in the right intracranial internal carotid artery and normal blood flow in other cerebral vessels. In addition, a carotid artery ultrasound indicated a plaque with a thickness of 2.0 mm in the left common carotid artery wall, accounting for 25% of the blood vessel. Furthermore, a cardiac color ultrasound revealed no findings in left ventricular hypertrophy.
Treatment and Outcome
Given the patient’s adverse effects from medication, he requested acupuncture in lieu of antihypertensives. As a result, he received regular acupuncture treatments over the next 12 weeks, from September 24th to December 24th, 2012. Each session lasted 30 minutes. Following this course of treatment, he no longer experienced adverse effects from the antihypertensive drugs and could return to work.
Practitioners utilized the following bilateral acupoints: LI4, LI11, ST36, and ST9. They applied tonifying or reducing manipulation of the needles to inspire jing qi through proper acupuncture techniques. Accordingly, they used tonifying manipulation to acupoints LI11, ST36, and ST9 and reducing manipulation to LI4. In addition, practitioners utilized points CV4, CV6, and SP6 to address the adverse drug reactions (diarrhea and fatigue).
The providers participating in this hypertension acupuncture case report had a minimum of 10 years of clinical experience. All needles were sterile and stainless steel. Practitioners elicited a “deqi” sensation at the site of the needle, which is associated with physiological changes and plays an essential role in the beneficial effects of acupuncture.
Acupuncture Point Selection
The patient received individualized acupuncture treatments for hypertension and adverse drug reactions such as diarrhea and fatigue. Frequently used antihypertensive acupuncture points, as described in systematic reviews, include LR3, LI11, GB20, ST36, and ST40.
In this case, the providers based their antihypertensive point selection on Traditional Chinese Medicine meridian theory. In traditional concepts, points located on the Yangming meridian, such as LI4, LI11, and ST36, reconcile qi and blood. The practitioners also selected ST9, a starting point of the Stomach and Gallbladder channels regulating qi and blood. Located next to the carotid artery, ST9 is the human body’s pressure sensor for regulating blood pressure. Based on TCM theory, practitioners selected CV4, CV6, and SP6 to address diarrhea and fatigue.
Blood Pressure Monitoring
Providers took the patient’s blood pressure (BP) during each visit using an automated BP monitor while seated and repeated after a 5-minute break. If the systolic or diastolic BP changed more than 5 mm Hg within the 5 minutes, they took a third measurement, recording the average values. In addition, the patient recorded daily and nightly blood pressure.
Acupuncture Results
After six weeks of acupuncture treatment, the patient in this hypertension acupuncture case report had a decreased BP load (percentage of readings >140 mm Hg (systolic) and >90 mm Hg (diastolic) recorded by the blood pressure monitor. Daytime systolic BP averages dropped from 85% to 12%, and diastolic from 95% to 32%. Nighttime systolic BP averages dropped from 100% to 50%, and diastolic from 100% to 80%.
With the lowering of BP (from 150/99 mm Hg to 128/85 mm Hg), the patient stopped taking antihypertensive medication on December 10th. After about 14 days, BP values rebounded to 146/95 mm Hg.
Hypertension Acupuncture Assessment
Acupuncture combined with medication has the most beneficial effect on treating hypertension. Specifically, acupuncture and the antihypertensive agent may have a synergistic effect. When the patient stopped taking the drug, his blood pressure began to rise again.
Investigators evaluated the immediate effects of acupuncture on hypertension by monitoring BP. Throughout the 12-week treatment period, BP decreased in the first three weeks, increased in weeks 4–7, and then gradually fell to a satisfactory level of 130/80 mm Hg. Most importantly, the antihypertensive drug adverse effects wholly disappeared.
From January to March 2013, the patient monitored his BP at home. The average SBP was 125–135 mm Hg, while the average DBP was 75–85 mm Hg. The highest reading was 140/95 mm Hg, but it was not common. What surprised the investigators was that his cardiac function tested on April 10th revealed a slight improvement, and transcranial cerebral Doppler showed a normal blood flow in the right intracranial internal carotid artery after 12 weeks of acupuncture treatment.
The patient monitored his BP at home after March. From April to June, the average BP was 140–145 mm Hg (systolic) and 80–90 mm Hg (diastolic). In July, his BP rose to 160/95 mm Hg in the afternoon, and he resumed taking antihypertensive medicine.
Discussion
Hypertension affects approximately one billion individuals worldwide, including 200 million people in China. In addition, high blood pressure is a significant risk factor for cardiac-cerebral vascular disease. Therefore, antihypertensive drugs have garnered much attention in modern medicine.
Calcium channel blockers are most frequently associated with adverse drug reactions, followed by diuretics, β-blockers, angiotensin receptor blockers, and ACE inhibitors. Typically, doctors address adverse drug reactions by adding a low dose of a second medication with a different mode of action, especially if the first drug does not sufficiently lower the BP. For example, edema is a common side effect of dihydropyridine calcium antagonists and is sometimes alleviated when combined with an ACE inhibitor.
Hypertension Acupuncture Case Report
In this hypertension acupuncture case report, the patient stopped his antihypertensive medication after ten weeks of acupuncture. However, two weeks later, his BP had a slight rebound elevation. Systematic reviews of acupuncture for hypertension showed that acupuncture only marginally reduced diastolic BP by 3 mm Hg. However, when administered with antihypertensive medication, acupuncture significantly reduced systolic BP by 8 mm Hg and diastolic BP by 4 mm Hg.
This case reveals that acupuncture is a viable alternative for hypertensive patients, especially those who cannot tolerate the adverse effects of medications.
Conclusion
This hypertension acupuncture case report suggests that acupuncture positively reduces BP, especially in combination with medication. Acupuncture also reduces the side effects of antihypertensive drugs. Furthermore, it provides an alternative for hypertensive patients who cannot tolerate the adverse effects of drugs.
Next Steps
At Raleigh Acupuncture, we’ve been helping patients with hypertension and prehypertension for nearly two decades. So if you are struggling with adverse side effects from your antihypertensive medications, or do not have the blood pressure control you want, give acupuncture a try.
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Additional Resources
First Hypertension Research Study.
Second Hypertension Research Study.
First Hypertension Case Study.
Reference
Zhang, L., Shen, P., & Wang, S. (2014). Acupuncture treatment for hypertension: a case study. Acupuncture in medicine: journal of the British Medical Acupuncture Society, 32(1), 73–76. https://doi.org/10.1136/acupmed-2013-010407
Focus Keyphrase: Hypertension Acupuncture Case Report
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