Acupuncture shown to lower blood pressure
Hypertension is a significant part of our daily work in primary care and much effort and time is devoted to achieving optimal blood pressure targets. The tighter the targets become, the more likely it is that patients will end up on multiple antihypertensive drugs, and the greater the likelihood of drug interactions and adverse effects.
There has been discussion in the past over the role of acupuncture in reducing systemic blood pressure, but to date small, randomised trials have found no significant blood pressure lowering effect with either traditional or standardised acupuncture.
A new study has found that traditional Chinese acupuncture can lower blood pressure in patients with hypertension.
The study enrolled 160 patients with uncomplicated arterial hypertension, of whom 133 completed treatment and follow-up. The mean age was 58 (+/-8) years and there was an equal distribution of men and women.
Participants were randomised single-blind to a six-week course of traditional Chinese acupuncture or sham acupuncture. Both treatments consisted of 22 sessions of 30 minutes' duration. Seventy-eight per cent of the study group were receiving antihypertensive medication, which remained unchanged.
The primary outcome was mean 24-hour ambulatory blood pressure levels, measured after the treatment course and at three and six months' follow-up.
The results showed a significant reduction in blood pressure in the patients treated with traditional Chinese acupuncture. Mean 24-hour ambulatory systolic and diastolic blood pressures in the acupuncture group decreased by 5.4 mmHg (95% CI = 3.2-7.6) and 3.0 mmHg (95% CI= 1.5-4.6) respectively.
There was no significant difference in systolic or diastolic blood pressure in the sham procedure group.
The blood pressure reductions seen in the Chinese acupuncture group had disappeared at three and six months post-treatment.
This trial, although relatively small, showed a definite effect of traditional acupuncture on both systolic and diastolic blood pressure. It is also noteworthy that the extent of these reductions was similar to that seen in drug trials with antihypertensive monotherapy or salt restriction.
The fact that acupuncture would need to be an ongoing treatment option would result in considerable time and cost investment. However, this may be an acceptable option for patients with mild hypertension who are not keen on pharmacotherapy and have an interest in complementary medicine.
Acupuncture appeared to be well tolerated, with only two patients from the study population dropping out because of pain at the needle site.
I suspect that most patients will still opt for the tablets, though.
Flachskampf FA, Gallasch J, Gefeller O et al. Randomized Trial of Acupuncture to Lower Blood Pressure. Circulation 2007;155:3121-3129Reviewer
Dr Peter Savill
GPSI Cardiology, Southampton