Sticking it to High Blood Pressure With Acupuncture
Is there proof that it works?
There are many approaches to treating high blood pressure. Many people choose to use complementary and alternative medicine (CAM) as a treatment approach. More and more physicians are incorporating lifestyle changes and integrative medicine, combining CAM and conventional medicine where there is scientific evidence for safety and effectiveness. Acupuncture has been the subject of serious, on-going research, and the evidence is now coming in.
Acupuncture is among the oldest healing practices in the world. It is part of Traditional Chinese Medicine (TCM), based on the concept that disease results from disruption in the flow of qi and imbalance in the forces of yin and yang. Acupuncture seeks to remove blockages in the flow of qi and restore and maintain health through a variety of techniques, including the insertion of thin metal needles though the skin. Some practitioners also combined standard acupuncture with electric stimulation (electro-acupuncture), though this is not part of traditional practice.
However, high blood pressure cures are not part of traditional acupuncture. Blood pressure measurements are a modern diagnostic procedure, and hypertension is usually asymptomatic. TCM relies on analyzing disease symptoms, the tongue, pulse, and other observable body conditions. So much of the work around hypertension and acupuncture has been a collaborative effort betweenTCM practitioners and traditional medical doctors.
Evaluating Acupuncture as a High Blood Pressure Remedy
Numerous small case studies and research trials indicated that there was some benefit for acupuncture. In 2003, the World Health Organization (WHO) published the "Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials". Treatment of hypertension was recognized as effectively treated by acupuncture.
However, larger trials were mixed. In 2004, a University of Texas Southwest Medical Center study failed to find any long-term benefits. Eleven patients with normal to mild hypertension received electrical acupuncture over a four-week time period. There was a minor, temporary drop in blood pressure immediately after each treatment. However, there was no evidence of persistent, long term blood pressure reduction.
In 2006, the results of the first large clinical trial was released. The Stop Hypertension with the Acupuncture Research Program (SHARP) pilot trial enrolled 192 participants with untreated moderate to severe hypertension. The trial followed principles of TCM . After being weaned off of their medication, participants were randomly assigned to three treatments: individualized traditional Chinese acupuncture, standardized acupuncture at preselected points, or invasive sham acupuncture. Again, no benefit was detected.
However, studies continue on long-term treatment results. In 2007, the Susan Samueli Center for Integrative Medicine at the University of California, Irvine released findings that showed acupuncture can help normalize blood pressure. The Center found that acupuncture has a slow onset and prolonged effect. In their study, they combined acupuncture with low levels of electrical stimulation. These treatments lowered elevations in blood pressure by as much as 40 percent.
A recent article for the American Journal of Hypertension (2009) evaluated eleven acupuncture trials, including Chinese and German results. The authors reviewed and analyzed numerous scientific studies published over the past few years. Overall results were mixed. One study supported the slow onset of change, with no reduction at four weeks but significant reductions at eight weeks. Some studies imply no change when acupuncture is combined with drug therapy, other studies show a measurable improvement. One study even suggested acupuncture acts to stimulate nitric acid production in the body, acting in a similar fashion as foods known to reduce blood pressure such as chocolate.
Should you consider acupuncture a potential high blood pressure remedy?
While the reviews on acupuncture are mixed, anyone who has been treated for hypertension will know that regular drug treatments can have mixed results as well. Several prescription medicines once prescribed regularly have been found to have serious side effects. Despite new (and expensive) treatment options, the older diuretics have continued to be the main treatment drug for high blood pressure. There is no blood pressure cure. But acupuncture remains a possible - and for many patients a viable - part of their complementary treatment regime.
Finding an Acupuncture Practitioner For Hypertension
If you want to try acupuncture as a blood pressure remedy, you may not know where to start. First, you need to consider your own comfort level with complementary medicine. Then, since is may be a deciding factor, what kind of insurance coverage you have or if treatment is covered. In most countries, acupuncturist are licensed and regulated as an allied health field. In the US, acupuncturists must meet education and licensing standards determined at the state level. When not delivered properly, acupuncture can cause serious adverse effects. All acupuncturists should use a new set of disposable needles taken from a sealed package for each patient. Treatment sites should be swabbed with alcohol or another disinfectant before inserting needles.
In many states, physicians can practice acupuncture with no required formal training course in acupuncture. In some states, chiropractors may also practice acupuncture with little or no formal training. For non-physician acupuncturists, there are minimum training and practice requirements in most locations. Generally, this is at least 1905 hours of training and a certification exam. In 1995, the WHO developed a series of statements and guidelines on acupuncture related to basic training, safety in clinical practice, indications and contraindications. Most state licensing and regulatory requirements meet or exceed these standards. However, there are no practice acts for acupuncture in Alabama, Kansas, Mississippi, North Dakota, Oklahoma, South Dakota, or Wyoming.
- Physician-Acupuncturist. Physicians may be board-certified by the American Board of Medical Acupuncture (ABME). MDs and DOs that complete the required training may be certified by this medical specialty board. These physicians often combine Western medical technology and pharmaceuticals with acupuncture.
- Physician Member of the American Academy of Medical Acupuncture (AAMA). AAMA members are practicing physicians with verified minimum experience and education in acupuncture. These physicians also may combine Western and Eastern approaches to treatment.
- Chiropractor certified in acupuncture. Licensed chiropractors may test for certification and earn the Chiropractic Acupuncture Diplomate designation after completing a 300-hour training program. The American Association of Acupuncture & Oriental Medicine (AAAOM) maintains a position that the 300-hour program is insufficient and that this certification should not be recognized.
- Licensed Acupuncturist. In the US, acupuncturists should be graduates of a school accredited by Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM), met all state licensing requirements, and passed the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) exam.
If approached realistically, and with clear expectations and discussion with the practitioner, you may find acupuncture helps deflate you hypertension.