03. March 2016 · Comments Off · Categories: Acupuncture, Blood Pressure

Acupuncture is effective as an adjunctive therapy to medication for treating hypertension, a Chinese systematic review concludes. Twenty-three RCTs involving 1788 patients were included. Compared with sham acupuncture plus medication, meta-analysis revealed that acupuncture as an adjunct to medication was more effective for reducing blood pressure than medication alone. Acupuncture alone showed no significant effect on blood pressure after intervention.
Is Acupuncture Effective for Hypertension? A Systematic Review and Meta-Analysis. PLoS One. 2015 Jul 24;10(7):e0127019.

07. January 2016 · Comments Off · Categories: Acupuncture, Blood Pressure

A group of American researchers have found that electro-acupuncture (EA) has a significant and long-lasting blood pressure–lowering effect in hypertensive patients with chronically elevated blood pressure (BP). Sixty-five patients with mild to moderate hypertension not receiving medication were randomly assigned to one of two acupuncture interventions. They were treated once weekly for eight weeks with 30-minutes of EA at either a set of active treatment acupoints (Jianshi P-5 – Neiguan P-6, plus Zusanli ST-36 – Shangjuxu ST-37) or a set of control acupoints (Pianli L.I.-6 – Wenliu L.I.-7, plus Guangming GB-37- Xuanzhong GB-39). Patients were assessed with 24-hour ambulatory blood pressure monitoring. After eight weeks of treatment, 70% of patients in the treatment group were found to have achieved a significant decrease in peak and average systolic and diastolic BP – an average of 6 to 8 mmHg for systolic blood pressure and 4 mmHg for diastolic blood pressure. These improvements persisted for a month and a half. In the treatment group plasma levels of noradrenalin (which constricts blood vessels and increases blood pressure and blood glucose levels) – which were initially elevated – were shown to have decreased by 41%. Plasma levels of renin (an enzyme produced in the kidneys that helps control blood pressure) also fell by 67%, while levels of aldosterone (a hormone that regulates electrolytes) declined by 22%. No consequential blood pressure changes were found in the group who received electro-acupuncture at the control acupoints. Although the blood pressure reductions in the active treatment group were relatively small, they were clinically meaningful, and the authors not that the technique could be especially useful in treating systolic hypertension in patients over 60. Since EA was demonstrated to decrease both peak and average systolic blood pressure over 24 hours, the researchers concluded that it may help decrease the risk for stroke, peripheral artery disease, heart failure and myocardial infarction in hypertensive patients.
Long-Lasting Reduction of Blood Pressure by Electroacupuncture in Patients with Hypertension: Randomized Controlled Trial. Medical Acupuncture, 2015 Aug 18; 27(4): 253.

12. November 2015 · Comments Off · Categories: Blood Pressure

A brief walk in the forest can elicit physiological and psychological relaxation effects in hypertensive middle-aged individuals, according to Japanese researchers. In a pilot study, twenty hypertensive participants were instructed to walk predetermined courses in forest and urban environments (as control). Course length, walking speed and energy expenditure were equal between the forest and urban environments. Heart rate variability (HRV) and heart rate were used to quantify physiological responses. The high-frequency component of HRV (which reflects cardiac parasympathetic modulation) was found to be significantly higher, and heart rate significantly lower, when participants walked in the forest compared with the urban environment. Questionnaire results indicated that, compared with the urban environment, walking in the forest increased ‘comfortable’, ‘relaxed’, ‘natural’ and ‘vigorous’ feelings and decreased ‘tension-anxiety’, ‘depression’, ‘anxiety-hostility’, ‘fatigue’ and ‘confusion’.

Effect of forest walking on autonomic nervous system activity in middle-aged hypertensive individuals: a pilot study. Int J Environ Res Public Health. 2015 Mar 2;12(3):2687-99.

 

Tai chi (TC) has beneficial effects on blood pressure (BP) and levels of gaseous cellular signaling molecules in the blood of patients with essential hypertension (EH). In a Chinese study, 24 EH patients were assigned to a tai chi exercise group (HTC), while another 16 formed the control hypertension group (HP) who received no intervention. Sixteen healthy volunteers matched for age and gender were recruited as controls (NP). The HTC group performed TC for 60 minutes per day, six days per week for 12 weeks. By week 12, systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) had decreased significantly in the HTC group. Over the same time period in the HTC group, levels of blood lipids were found to have improved significantly, while plasma levels of the vasoactive gaseous signalling molecules nitric oxide (NO), carbon monoxide (CO) and hydrogen sulfide (H2S) had increased. Correlations were observed between changes in SBP and MAP and changes in NO, CO and H2S. No changes were observed in the HP and NP groups. (Effects of Tai Chi exercise on blood pressure and plasma levels of nitric oxide, carbon monoxide and hydrogen sulfide in real-world patients with essential hypertension. Clin Exp Hypertens. 2014 Feb 3. [Epub ahead of print]). http: / / www.ncbi.nlm.nih.gov / pubmed / 24490621

American authors who have spent the last two decades investigating the neural mechanisms underlying the ability of acupuncture to regulate blood pressure have summarised their work in a review paper. Their findings suggest that acupuncture has point-specific effects that can cause prolonged cardiovascular changes that far outlast the duration of needle stimulation. They note that stimulation of acupuncture points activates somatic afferent nerves, and -depending on the underlying situation (high or low blood pressure) – this results in the modification of autonomic nervous system outflow by reducing activity in brain stem nuclei that participate in the primary blood pressure response. The authors conclude that acupuncture has the potential to regulate cardiovascular function in patients with diseases such as hypertension. (Acupuncture regulation of blood pressure: two decades of research. Int Rev Neurobiol. 2013;111:257-71).

A daily dose of cinnamon may improve blood pressure and blood sugar levels in people with type-2 diabetes, according to UK-based research. Fifty-eight people with type-2 diabetes were randomly assigned to receive a daily supplement containing 2g of cinnamon or placebo for 12 weeks. At the end of the study, the results indicated that the cinnamon supplement was associated with a significant decrease in both systolic and diastolic blood pressure. The results also showed a significant reduction in levels of glycated haemoglobin (a long-term measure of blood sugar levels) over the 12 weeks in the cinnamon group, compared with an increase in the placebo group. (Glycated haemoglobin and blood pressure-lowering effect of cinnamon in multi-ethnic Type2 diabetic patients in the UK: a randomized, placebo-controlled, double-blind clinical trial. Diabet Med. 2010 Oct;27(10):1159-67).

A systematic review of the literature on the effect of tai chi exercise on blood pressure (BP) suggests that it may reduce BP and serve as a practical, non-pharmacological adjunct to conventional hypertension management. Of the 26 studies that met the inclusion criteria, 22 (85%) reported reductions in BP with tai chi (3-32 mm Hg systolic and 2-18 mm Hg diastolic BP reductions). (The effect of tai chi exercise on blood pressure: a systematic review. Prey Cardiol. 2008 Spring;11(2):82-9).

A rigorous, randomised, single-blind, Western trial comparing acupuncture with sham needling suggests that acupuncture may decrease blood pressure in hypertensive patients by a similar amount to that achieved using pharmaceutical therapy. The German study randomised 160 outpatients (mean age 58) with uncomplicated, mild to moderate hypertension to six weeks of acupuncture performed by Chinese medicine practitioners (trained in China), or to a sham procedure. Those on hypertensive medication continued taking it. Patients were assigned to one of four patterns of hypertension, based on TCM diagnosis. Those in both trial arms underwent 22 30-minute treatment sessions over a six-week period. During each session, three acupuncture points were needled bilaterally for 20 minutes.  In the active treatment group, the points were chosen according to TCM diagnosis. Sham treatment consisted of needling points without relevance for lowering blood pressure, according to traditional concepts. Twenty-four hour ambulatory systolic and diastolic blood pressures were significantly reduced from baseline in the acupuncture-treated patients (by 5.4 mmHg and 3.0 mmHg, respectively).  No significant decrease was seen in the sham-treated patients. The extent of blood pressure reduction observed was comparable to that seen with ACE-inhibitor monotherapy or aggressive lifestyle changes.  However, blood pressure returned to pretreatment levels within 12 weeks of treatment cessation, leading investigators to conclude that ongoing acupuncture treatments would be required to maintain the beneficial effects.  (Randomized trial of acupuncture to lower blood pressure.  Circulation. 2007 Jun 19;115(24):3121-9).