Is Acupuncture an Effective Adjunct to Antihypertensive Medication in the Treatment of Primary Hypertension?
By Ildikó Horváth
2013 Abstract Objective:
This study conducted a systematic review on randomised controlled trials investigating acupuncture combined with antihypertensive medication in the treatment of primary hypertension. The aims are to specify the role of acupuncture in the treatment of hypertension and find the optimal frequency and number of acupuncture treatments, to analyse the outcomes linked to the intervention characteristics and to evaluate the included studies using CONSORT and STRICTA guidelines.
Hypertension is the world’s leading risk factor for mortality. In Hungary health care expenses are growing for antihypertensive medication even though it is only effective in 45% of the cases. If acupuncture were found to be an effective intervention for hypertension the findings of this study may help to reduce costs and help the effectiveness of antihypertensive medication. Methods: The study conducted a systematic literature review using a narrative synthesis on randomised controlled trials to examine acupuncture treatments combined with antihypertensive medication versus medication as a monotherapy or sham acupuncture plus antihypertensive medication. English and Chinese papers were searched. The search included texts published from date of inception till December 2011 found in MEDLINE, EMBASE, AMED, CINAHL and CNKI databases.
13 RCTs were included. 11 studies found significant differences between acupuncture and the control groups favouring acupuncture, 1 found no significant changes. In those 3 trials where the control arms were a form of sham acupuncture plus antihypertensive medication there were no significant changes in the control groups, but blood pressure decreased significantly in the treatment groups in 2 trials.
There is limited evidence that acupuncture is effective as an adjunct to antihypertensive medication in the treatment of primary hypertension. According to CONSORT and STRICTA guidelines 1 trial was rated high quality, 5 good quality and 6 low quality. In future more rigorous trials should be conducted and better reporting should be performed to collect more evidence about the mechanism, characteristics and effectiveness of acupuncture.