Acupuncture in Hypertension

Substantial interest in complementary and alternative medicine (CAM is the currently used acronym) continues, especially among patients with hypertension. A recently televised interview with Randall Zusman, MD, from Massachusetts General Hospital (About Health with Jeanne Blake, original air date May 25, 2001) which discussed acupuncture therapy in the treatment of elevated blood pressure kindled further consumer interest in the role of acupuncture in treating essential hypertension. Shortly thereafter, several patients and colleagues asked me for information about this issue. There is no dearth of published data on the effect of acupuncture on hypertension. A MED-LINE search of these two terms (“acupuncture and hypertension”) will return 133 results. There is just one problem: accessing the literature will be a lot easier if you can read and interpret Chinese characters or Russian script. Much of the acupuncture literature in hypertension is in non-English language publications. Restricting the search to English eliminates more than half of the citations, and limiting further to include only human studies cuts out more than two thirds of the original list. Acupuncture seems to decrease blood pressure in spontaneously hypertensive rats. In these rats an acupuncture-like electrical simulation reduces sympathetic neural activity and blood pressure. However, Western medicine tends to focus not just on results, but on testable mechanisms of effect. These data from our rodent relatives, a species from which much of what we know about mechanisms of human hypertension has been derived, are intriguing and are the basis for current clinical trial testing. One such study, using electro-acupuncture, is being conducted at the University of Texas Southwestern in Dallas, TX.1 This study will be a double-blind, randomized and prospective clinical trial, the very tool to defrost the icy scrutiny of a Western skeptic. Showing efficacy is a necessary first step, but I wonder if those who espouse acupuncture will go the distance and demonstrate a long-term benefit of this procedure on outcome, particularly the preservation of target organ function and life. After all, that is the ultimate goal of antihypertensive therapy.2