Abstract
The outcome of acupuncture on hypertension treatment is inconclusive. This study aims to evaluate the influence of acupuncture on hypertension, based on findings from mechanistic studies over the course of decades particularly those conducted at the University of California, Irvine. Low-current and low-frequency electroacupuncture (EA) at P5–6 (overlying the median nerve) and S36–37 (overlying the deep peroneal nerve) reduced high blood pressure in a subset of patients (~70 %) with mild-to-moderate hypertension, in a slow-onset (4–8 weeks) but long-lasting (1–2 months) manner. EA inhibited cardiovascular sympathoexcitatory neurons through activation of neurons in the arcuate nucleus of the hypothalamus, the ventrolateral periaqueductal gray in the midbrain and the nucleus raphe pallidus in the medulla, through inhibiting the activity of premotor sympathetic neurons in the rostral ventrolateral medulla (rVLM). Several neurotransmitters such as glutamate, acetylcholine, opioids, GABA, nociceptin, serotonin and endocannabinoids were involved in this EA-induced hypotensive response. The long-lasting inhibition of hypertension induced by EA was related to opioids and GABA in the rVLM, neural circuitry between the arcuate and ventrolateral periaqueductal gray, and prolongation of the increase in preproenkephalin mRNA levels and enkephalin levels in the rVLM and arcuate. Moreover, the long-lasting inhibition of sympathetic activity by EA was confirmed in EA-treated hypertensive patients with decreased levels of norepinephrine, renin and aldosterone.
Highlights
Hypertension is the most common chronic disorder, affecting approximately one billion individuals worldwide [1]
We examined the effectiveness of activating different acupuncture points on reflex-induced increases in blood pressure (BP) by performing stimulation of visceral nerves in cats [33]
We have shown that EA at P5–6, H5–7, or S36–37 with low current (2 mA) and frequency (2 Hz) for 30 min inhibited the reflex increase in BP for 30–40 min
Summary
Hypertension is the most common chronic disorder, affecting approximately one billion individuals worldwide [1]. One-third of the US adult population is hypertensive, and the lifetime risk of developing hypertension approaches 90 % [2]. There are many antihypertensive medications, but these have adverse side effects. Drug therapy indiscriminately blocks many receptors that lead to a multiplicity of side effects [3, 4]. There is growing interest in alternative medical treatments such as acupuncture, which may complement, and offer a potential alternative to, pharmacological therapy [5]. Despite the increasing worldwide interest in acupuncture [6, 7], many Western physicians are reluctant to recommend acupuncture, owing to its controversial mechanism
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