Acupuncture attenuates hypertension-induced myocardial hypertrophy: role of the SIRT1/NF-κ B/MAPK signaling axis in the hypothalamic paraventricular nucleus

Background Chronic hypertension is a major risk factor for cardiovascular complications and can induce pathological myocardial hypertrophy. The hypothalamic paraventricular nucleus (PVN) is a key autonomic regulatory center involved in hypertension through sympathetic overactivation, neuroinflammation, and central renin–angiotensin system dysregulation. Although acupuncture exerts protective effects against hypertension-related target organ damage, its central mechanisms remain unclear. This study investigated whether acupuncture was associated with the attenuation of hypertension-induced myocardial hypertrophy in spontaneously hypertensive rats (SHRs) and whether these effects may involve modulation of the sirtuin 1 (SIRT1)/nuclear factor-κB (NF-κB)/mitogen-activated protein kinase (MAPK) signaling axis in the PVN. Methods Twenty-seven SHRs were randomly assigned to Model, Acupuncture, and Losartan groups ( n = 9 per group), while nine Wistar-Kyoto (WKY) rats served as Controls. Rats received acupuncture at Taichong (LR3), Baihui (GV20), and Sanyinjiao (SP6) or losartan treatment for 12 weeks. Blood pressure, plasma norepinephrine (NE), cardiac function, myocardial remodeling, fibrosis, and PVN-related molecular changes were assessed. Results Acupuncture reduced systolic and diastolic blood pressure and decreased plasma NE levels in SHRs. In the PVN, acupuncture increased SIRT1 expression and inhibited NF-κB p65 expression and MAPK phosphorylation. Moreover, acupuncture suppressed central renin–angiotensin system activation, neuroinflammation, and neurotransmitter imbalance by regulating ACE, AT1R, pro-inflammatory cytokines, GABA, and Glu levels. Echocardiographic and histological analyses demonstrated that acupuncture alleviated myocardial hypertrophy, improved cardiac function, and reduced fibrosis and structural remodeling. Conclusion Acupuncture was associated with the attenuation of hypertension-induced myocardial hypertrophy in SHRs, possibly involving modulation of the PVN SIRT1/NF-κB/MAPK signaling axis. These effects may involve suppression of neuroinflammation and sympathetic overactivation, regulation of the central renin–angiotensin system, and restoration of PVN neurotransmitter balance, providing new insights into the central neural mechanisms underlying acupuncture-mediated cardioprotection in hypertension.