New Health Acupuncture Clinic
1407 York Road. Suite 305A. Lutherville.  MD  21093  
Tel : 443-310-5382  Fax: 667-206-2956   Emai: zbli2001@gmail.com
Acupuncture for Hypertension
  Hypertension is the most
frequent cardiovascular disease,
affecting roughly one third of the
adult population of America.  
Current pharmacologic
approaches to hypertension are
through affecting myocardial
contractility, chronotropy,
vascular tone, salt and water
retention. All of these
pharmaceuticals not only
2. Clinic trails for effect of acupuncture on hypertension
     To evaluate the efficacy and safety of acupuncture therapy for
patients with hypertension, a review analyzed 30 clinic trials
involved in 21007 patients with hypertension.  The pooled results
demonstrate that acupuncture plus anti-hypertensive drugs are
better than anti-hypertensive drugs alone at reducing systolic and
diastolic blood pressure. The same result was observed for
pooled data from experiments that compared acupuncture plus
medication to sham acupuncture plus medication at reducing
blood pressure. However, there is no difference between
acupuncture alone and antihypertensive drugs alone in the effect
on lowering blood pressure. This systematic review indicates that
acupuncture therapy is useful in treating hypertension.  
 To summarize the evidence on acupuncture for hypertension, a
review studied 8 databases involved 15 systematic reviews.  They
found that acupuncture combined with medication was better in
reducing both systolic blood pressure and diastolic blood
pressure, compared with medication alone.   Acupuncture was
more effective in reducing systolic blood pressure and diastolic
blood pressure, compared with sham acupuncture plus
medications. No serious adverse effects were reported.
  To determine the efficacy of acupuncture for hypertension, A
review studied 23 clinic trials involved 1788 patients with
hypertension.  2 trials of them revealed that acupuncture as an
adjunct to medication was more effective on reducing systolic and
diastolic blood pressure, compared with sham acupuncture plus
medication. 4 trials of them also showed acupuncture combined
with medication was superior to medication on efficacy. 17 clinic
trials involved in 1473 patients with hypertension showed that
acupuncture alone did not have significant effect on reducing
systolic and diastolic blood pressure compared with medication
alone.  No adverse events were reported in those clinic trails.
  Most clinic trials provided evidence that acupuncture is an
adjunctive therapy to medication for treating hypertension. At
present,  the evidence for acupuncture alone lowing blood pressure
is insufficient.
1.  Introduction
partially effect requiring treatment, but also are costly, fraught with
compliance problems, and accompanied by unwanted side effects.
Lifestyle changes such as weight loss, salt intake restriction, and
exercise are other approaches to help lowering high blood pressure,
but it is so difficult to achieve and even more difficult to maintain.           
    Acupuncture have been used for treat hypertension for many years.
During recent two-decade, rapidly increased medical researchers
have provided many scientific evidences that acupuncture is a better
support therapy for hypertension.  Acupuncture with medication
together can achieved a better therapeutic result for lowing blood
pressure to the patients with hypertension then using medication
alone.
Conclusion
3. Independent studies
      To understand how long effect of acupuncture on
lowering blood pressure maintains, a study
investigated 160 outpatients (age, 58±8 years; 78 men)
with uncomplicated arterial hypertension received a
6-week course of active acupuncture or sham
acupuncture. 78 % of them were receiving
antihypertensive medication. Primary outcome
parameters were mean 24-hour ambulatory blood
pressure levels after the treatment course and 3 and 6
months later. 140 patients finished the treatment
course. There was a significant (P<0.001) difference in
posttreatment blood pressures adjusted for baseline
values between the acupuncture group and sham
acupuncture group at the end of treatment. For the
primary outcome, the difference between treatment
groups amounted to 6.4 mm Hg and 3.7 mm Hg  for
24-hour systolic and diastolic blood pressures
respectively. In the acupuncture group, mean 24-hour
ambulatory systolic and diastolic blood pressures
decreased significantly after treatment by 5.4 mm Hg
and 3.0 mm Hg respectively. At 3 and 6 months, mean
systolic and diastolic blood pressures returned to
pretreatment levels in the active treatment group.  
    This figure showed the plots of the distribution of average 24-hour ambulatory
diastolic blood pressure in active and sham groups at baseline (left) and of the
changes vs baseline in both treatment groups during the study period (right).  
    A case report described using acupuncture treatments for a patient with
hypertension who could not tolerate the side effects of the antihypertensive
agents. The patient was 56-year-old man with initial blood pression of
160/100 mm Hg. He started taking levamlodipine 5 mg once daily in March
2011. His blood pressure remained the same, but he developed side effects
such as flushing and palpitations. He was switched to irbesartan 150 mg
once daily in July 2012. His blood pressure slightly reduced to 140/85 mm
Hg but he had side effects of diarrhoea, fatigue and decreased sexual
function.  The patient denied a family history of alcohol. The patient received a
total of 60 sessions of acupuncture treatment over 12 weeks (5–6 treatments
per week). Each acupuncture treatment session was 30 min.  During 12-
week treatment period, patient’s blood pressure decreased in the first 3
weeks, and slightly increased in weeks 4–7 and then gradually fell to a
satisfactory level of 130/80 mm Hg.  The antihypertensive drug side effects
such as diarrhea, fatigue and impotence completely disappeared. The
acupuncture was stopped at 12 weeks because he no longer had side
effects from the antihytertensive drugs and he decided to return to work. The
patient continued to monitor his blood pressure at home. The average blood
pressure was 125–135/75-85 mm Hg.   After 7 months, the patient’s blood
pressure rose to 160/95 mm Hg in the afternoon and he resumed taking
antihypertensive medicine.  This case report suggested that acupuncture is a
good choice therapy for the patient who cannot tolerate the side effects of
antihypertensive agents.   
    A nature research paper  explored the mechanisms of acupuncture
lowers blood pressure in hypertension by using rat animal model.   The rat’s
hypertension was induced by cold exposure (6 °C) for six weeks. Electrical
acupuncture was applied for 30 min twice weekly for five weeks while sham
was conducted with the same procedures except for no electrical
stimulation. Elevated blood pressure was reduced after six sessions of
electrical acupuncture and remained low 72 hrs after electrical acupuncture  
in 18 rats, but not in sham control rats (n = 12) and untreated rats (n = 6).      
The mRNA levels of preproenkephalin in the rostral ventrolateral medulla
(rVLM) was increased in acupuncture rats (n = 9) after treatment 72 hr,
compared to the sham control (n = 6), untreated rats (n = 6) and
normotensive control animals (n = 6). Block rVLM pathway by microinjection
of δ-opioid receptor antagonist ICI 174 and 864, into the rVLM partially
reversed electrical acupuncture’s effect on elevated blood pressure in
acupuncture treatment rats (n = 4).   The rostral ventrolateral medulla
(RVLM) is a major node of the brain network that generates Sympathetic
nerve activity, which is moderately elevated in essential hypertension.  
These data suggest that acupuncture reduce blood pressure by increasing
enkephalin in the rVLM.   
4. Mechanism of acupuncture for lowing blood pressure
5. References