Abstract
Hypertension affects approximately 1 billion individuals worldwide. Pharmacological therapy has not been perfected and often is associated with adverse side effects. Acupuncture is used as an adjunctive treatment for a number of cardiovascular diseases like hypertension. It has long been established that the two major contributors to systemic hypertension are the intrarenal renin-angiotensin system and chronic activation of the sympathetic nervous system. Recent evidence indicates that in some models of cardiovascular disease, blockade of AT1 receptors in the rostral ventrolateral medulla (rVLM) reduces sympathetic nerve activity and blood pressure, suggesting that overactivity of the angiotensin system in this nucleus may play a role in the maintenance of hypertension. Our experimental studies have shown that electroacupuncture stimulation activates neurons in the arcuate nucleus, ventrolateral gray, and nucleus raphe to inhibit the neural activity in the rVLM in a model of visceral reflex stimulation-induced hypertension. This paper will discuss current knowledge of the effects of acupuncture on central nervous system and how they contribute to regulation of acupuncture on the endocrine system to provide a perspective on the future of treatment of hypertension with this ancient technique.
Highlights
Hypertension affects approximately 1 billion individuals worldwide [1]
Microinjection of kainic acid (KA) into the arcuate blocks the inhibitory influence of EA on the reflex hypertension. These results suggest that excitatory projections from the arcuate nucleus to the ventrolateral periaqueductal gray (vlPAG) appear to be essential to the inhibitory influence of EA on the reflex increase in blood pressure (BP) induced by splanchnic nerve (SN) and gallbladder afferent stimulation
Since opioid or nociceptinlike immunoreactivity is present in the spinal sympathetic nuclei [49, 50], we have considered the possibility that EA influences the neurotransmission between the brain stem and the IML [51]
Summary
Hypertension is the most common chronic disorder in the United States, affecting 29% of the adult population [1]. The prevalence of this disorder increases with age; for normotensive middle-aged adults in the US, the lifetime risk of developing hypertension approaches 90% [2]. An important hypothesis in the pathogenesis of essential hypertension involves an interaction between high dietary sodium intake and defects in renal sodium excretion, which can be influenced by sympathetic neural activity and the renin-angiotensin-aldosterone system [3]. Manual acupuncture and its potent alternative, electroacupuncture (EA), have been used in Asia to treat a number of cardiovascular diseases including hypertension. Evidence-Based Complementary and Alternative Medicine current knowledge of the effects of acupuncture on central nervous system and how they contribute to regulation by acupuncture of the endocrine system to provide a perspective on the future of treatment of hypertension with this ancient technique
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