Research: WANG and COLLEAGUES,

Listed in Issue 221

Abstract

WANG and COLLEAGUES, Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical  Sciences, Beijing 100053, China reviewed the published literature to assess the evidence of acupuncture for hypertension.

Background

To systematically assess the current clinical evidence of acupuncture for hypertension.

Methodology

The PubMed, EMBASE, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wan-fang Data in the Cochrane Library were searched until January, 2013. All the randomized controlled trials (RCTs) based on acupuncture compared with western medicine, sham acupuncture or lifestyle intervention in patients with hypertension were included. RCTs were included as well as combined acupuncture with western medicine compared with western medicine. In addition, RCTs based on acupuncture compared with sham acupuncture combined with western medicine in patients with essential hypertension were included. No language restriction was used. Review Manager 5.1 software was used for data analysis. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards.

Results

35 randomized trials (involving 2539 patients) were included. The methodological quality of the included trials was evaluated as generally low. Two trials reported the effect of acupuncture compared with sham acupuncture in combinations of western medicine. Acupuncture significantly reduced SBP (-7.47 mmHg, 95% CI - 10.43 to -4.5, P<0.00001) and DBP (-4.22 mmHg, 95% CI - 6.26 to -2.18, P<0.0001) and no heterogeneity between studies was detected. However, other studies had substantial heterogeneity due to the quality of them was poor, and their sample sizes were not satisfactory as an equivalence study. Five trials described the adverse effects.

Conclusion

While there are some evidences that suggest potential effectiveness of acupuncture for hypertension, the results were limited by the methodological flaws of the studies. Therefore, further thorough investigation, large-scale, proper study designed, randomized trials of acupuncture for hypertension will be required to justify the effects reported here.

References

Wang J, Xiong X and Liu W. Acupuncture for essential hypertension. Int J Cardiol.;169(5): 317-26. doi: 10.1016/j.ijcard.2013.09.001. Epub Sep 6 2013. Nov 20 2013.

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