Dr.Steve’s BOTTOM LINE: In order to find out if acupuncture, or any other treatment, works for high blood pressure a randomized clinical trial needs to be done. This means, comparing one treatment to another (i.e. in this case real vs. sham acupuncture) where the treatment is randomly selected (i.e. a flip of the coin to determine which treatment you get). Fortunately, there have been some. Unfortunately, not many and of variable quality. Simply publishing a “report” that something “works” is not highly scientific and can lead to the wrong answer…..often. So, when taken as a group what do these randomized trials say about acupuncture for treatment of high blood pressure?

This is a published report of all randomized trials out there, analyzed and grouped as a meta-analysis. This means, the scientific strength of each study was examined and then the statistical numbers were all compared as a group rather than having the interested reader look at all of these studies individually. This way you don’t have to pull your hair out trying to figure out which one(s) to believe.

The bottom line is that when the higher quality studies looked at defining the reason for high blood pressure, and essential hypertension (the most common type) was looked at separately from other types of blood pressure elevation, acupuncture clearly helped reduce blood pressure (both systolic and diastolic). Of note, patient groups receiving sham (fake) acupuncture and real acupuncture both were also on medications. Unfortunately, out of the group of some 20 studies, only three were of high quality and helped get to this conclusion. More studies are definitely needed, but this is a step in the right direction to determine how much acupuncture really helps.

Acupuncture for essential hypertension.

Altern Ther Health Med. 2010 Mar-Apr;16(2):18-29

Authors: Kim LW, Zhu J

OBJECTIVE: To assess the efficacy of acupuncture for treatment of essential hypertension and the efficacy of acupuncture using prescription adhering to the principles of “syndrome differentiation.” DATA SOURCES: Medline, Embase, Cochrane Central Register, and China National Knowledge Infrastructure (September 2008). STUDY SELECTION: Randomized, controlled trials comparing acupuncture with sham acupuncture, antihypertensive drugs, Chinese herbal medicine, or exercise in essential hypertension. DATA EXTRACTION: Two reviewers independently assessed trials for inclusion, extracted data, assessed methodological quality, and extracted outcome data on blood pressure. DATA SYNTHESIS: Treatment effects were summarized as mean differences with 95% confidence intervals. Twenty trials were included: three trials were relatively rigorous while others were methodologically suboptimal. Acupuncture arms achieved significant effect modification on blood pressure compared with control arms (19 comparisons: systolic blood pressure [SBP]: mean difference -4.23 mmHg, 95% confidence intervals -6.47 to -1.99; diastolic blood pressure [DBP]: -2.53, -3.99 to -1.08), with significant heterogeneity. In high-quality trials, blood pressure was significantly lower in treatments of acupuncture plus antihypertensive drug arms than in sham-acupuncture plus hypertensive drug arms (two comparisons: SBP: -5.72 mmHg, -8.77 to -2.68; DBP: -2.80, -5.07 to -0.54), with no significant heterogeneity. As for trials using prescription adhering to the principles of syndrome differentiation, we found a significant blood pressure reduction with acupuncture arms in comparison with control arms (11 comparisons: SBP: -6.46 mmHg, -8.04 to -4.87; DBP: -3.07, -4.17 to -1.96) with no significant heterogeneity. In contrast, in trials not using prescription adhering to the principles of syndrome differentiation, we found no significant reduction in blood pressure with acupuncture arms in comparison with control arms (eight comparisons: SBP: -1.55 mmHg, -5.39 to 2.29; DBP: -2.12, -4.97 to 0.73) with significant heterogeneity. CONCLUSIONS: Because of the paucity of rigorous trials and the mixed results, these findings result in limited conclusions. More rigorously designed and powered studies are needed.

PMID: 20232615 [PubMed - in process]