Abstract
Objective The aim of this study was to summarize and evaluate the efficacy of acupuncture in hypertension animal study. Methods Studies were searched from six databases, including Medline, Embase, Chinese National Knowledge Infrastructure, Wanfang Data, VIP information database, and Chinese Biomedical Literature Database. Study quality of each included study was evaluated according to the Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines, and the risk of bias was evaluated by the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) tool. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were selected as outcomes. Meta-analyses were performed using Stata 12.0 software. The effect size was calculated by combining SBP/DBP/MAP data with the random effects model, respectively. Results 67 studies containing 1522 animals were included. According to the ARRIVE guideline, 8 items were assessed as poor and 4 items were assessed as excellent. According to the SYRCLE tool, all studies were judged as having high risk of bias. Compared with the hypertension group, the pooled results showed significant antihypertension effects of acupuncture for SBP, DBP, and MAP. Similarly, compared with the sham-acupuncture group, the pooled results showed significant antihypertension effects of acupuncture for SBP, DBP, and MAP. Conclusion Although pooled data suggested that the acupuncture group was superior to the hypertension group or sham-acupuncture group for SBP/DBP/MAP, the presentation of poor methodological quality, high risk of bias, and heterogeneity deserves cautious interpretation of the results.
Highlights
Hypertension is a major modifiable risk factor for cardiovascular and cerebral vascular disease [1, 2], affecting about 1.39 billion people worldwide [3]. e main treatment modality for hypertension is pharmacological treatment
Studies were included if all of the following standards were met: sustaining high blood pressure (HBP) animal model, baseline systolic blood pressure (SBP) ≥ 140 mmHg, diastolic blood pressure (DBP) ≥ 90 mmHg [9, 10]; at least one of the following was used as outcome measures: Systolic blood pressure (SBP), DBP, and mean arterial pressure (MAP); and SBP/DBP/ MAP was compared with those of hypertension animals receiving sham-acupuncture or no treatment
After screening titles and abstracts of remaining 2018 records, 1914 records were excluded for one or more of the following reasons: (1) not research studies of hypertension or hypertension combined with other conditions, (2) unsustainable hypertension, e.g., the HBP was caused by cold or electric stress, (3) not animal study, (4) not an acupuncture study or acupuncture combined with other therapy, (5) review articles, and (6) other language
Summary
Hypertension is a major modifiable risk factor for cardiovascular and cerebral vascular disease [1, 2], affecting about 1.39 billion people worldwide [3]. e main treatment modality for hypertension is pharmacological treatment. Because of its relative safety, acupuncture has led to a growing interest among nonpharmacological complementary therapies, in the treatment of hypertension. It has been shown potential in lowering BP, the effects were not proven sustaining [4]. A systematic review of preclinical animal studies contributes to translational medicine and potentially brings about more precise medical care decisions [7]. Us, the aim of present review is to synthesize and appraise pooling results of acupuncture’s antihypertensive effects in animal models, quantitively assess influencing factors of acupuncture’s efficacy, explore future study direction, provide clues for clinical studies, and assess potential publication bias and its influence Systematic review of preclinical evidence could inform the design and contribute to success of future clinical studies, indicate the necessity of further research, reduce unnecessary study replication, and implement the principle of “replacement, refinement, and reduction of animals” in animal research [8]. us, the aim of present review is to synthesize and appraise pooling results of acupuncture’s antihypertensive effects in animal models, quantitively assess influencing factors of acupuncture’s efficacy, explore future study direction, provide clues for clinical studies, and assess potential publication bias and its influence
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