The aim of the present study was to compare the effects of acupuncture treatment on arterial blood pressure (BP) and heart rate (HR) in patients with mild hypertension with high sympathetic tone with those of normotensive patients and to examine the effects on cardiac sympathetic nerve activity (CSNA) and vagal activity using heart rate variability (HRV) analysis.
Design:
Eight male patients with prehypertension or stage I hypertension and eight normotensive age-matched patients were included in this study. All patients had their systolic BP (SBP), diastolic BP (DBP), HR, and HRV measured. In addition, the ratio of low-frequency (LF) to high-frequency (HF) HRV and the power of the HF of the HRV were recorded. The study was conducted at Kansai University of Health Sciences in Japan.
Interventions:
Each patient underwent a single, 15-min-long acupuncture session. Acupuncture was applied to PC6, LI4, ST36, LR3 on both sides, and GV20.
Results:
SBP and HR decreased significantly in the hypertensive group during and after acupuncture compared with the baseline SBP and HR (p < 0.05). LF/HF was significantly reduced during acupuncture (p < 0.05), and HF was significantly increased after acupuncture in the hypertensive group (p < 0.05). However, there were no significant changes in LF/HF or HF in the control group.
Conclusions:
Acupuncture may reduce the BP and HR in patients with mild hypertension. An HRV analysis suggests that acupuncture may suppress the enhanced basal CSNA activity and increase the vagal nerve activity in patients with mild hypertension.
KearmeyPM, WheltonM, ReynoldsK, et al.Global burden of hypertension: Analysis of worldwide data. Lancet, 2005; 365:217–223.
2.
ChobanianAV, BakrisGL, BlackHR, et al.Seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension, 2003; 42:1206–1252.
3.
MensahGA. The global burden of hypertension: Good news and bad news. Cardiol Clin, 2002; 20:181–185.
4.
ShawE, AndersonJG, MaloneyM, et al.Factors associated with noncompliance of patients taking antihypertensive medications. Hosp Pharm, 1995; 30:201–203, 206–207.
5.
WoodMJ, StewartRL, MerryH, et al.Use of complementary and alternative medical therapies in patients with cardiovascular disease. Am Heart J, 2003; 145:806–812.
6.
FlachskampfFA, GallaschJ, GefellerO, et al.Randomized trial of acupuncture to lower blood pressure. Circulation, 2007; 115:3121–3129.
7.
YinC, SeoB, ParkHJ, et al.Acupuncture, a promising adjunctive therapy for essential hypertension: A double-blind, randomized, controlled trial. Neurol Res, 2007; 29:98–103.
8.
LiuY, ParkJE, ShinKM, et al.Acupuncture lowers blood pressure in mild hypertension patients: A randomized, controlled, assessor-blinded pilot trial. Complement Ther Med, 2015; 23:658–665.
9.
OhsawaH, OkadaK, NishijoK, SatoY. Neural mechanism of depressor responses of arterial pressure elicited by acupuncture-like stimulation to a hindlimb in anesthetized rats. J Auton Nerv Syst, 1995; 51:27–35.
10.
UchidaS, ShimuraM, OhsawaH, SuzukiH. Neural mechanism of bradycardiac responses elicited by acupuncture-like stimulation to a hind limb in anesthetized rats. J Physiol Sci, 2007; 57:377–382.
11.
YaoT, AnderssonS, ThorenP. Long-lasting cardiovascular depressor responses to somatic stimulation in spontaneously hypertensive rats. Acta Physiol Scand, 1981; 111:109–111.
12.
YaoT, AnderssonS, ThorenP. Long-lasting cardiovascular depression induced by acupuncture-like stimulation of the sciatic nerve in unanaesthetized spontaneously hypertensive rats. Brain Res, 1982; 240:77–85.
13.
ThorenP, RickstenSE. Recordings of renal and splanchnic sympathetic nervous activity in normotensive and spontaneously hypertensive rats. Clin Sci, 1979; 57:197–199.
14.
SatoA, SatoY, ShimamuraK, SuzukiH. An increase in the sympathoadrenal medullary function in stroke-prone spontaneously hypertensive rats under anesthetized and resting condition. Neurocsi Lett, 1986; 72:309–314.
15.
PomeranzB, MaculayRJ, CaudillMA, et al.Assessment of autonomic function in humans by heart rate spectral analysis. Am J Physiol, 1985; 248:151–153.
16.
PaganiM, LombardiF, GuzzettiS, et al.Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog. Circ Res, 1986; 59:178–193.
17.
HayanoJ, SakakibaraY, YamadaA, et al.Accuracy of assessment of cardiac vagal tone by heart rate variability in normal subjects. Am J Cardiol, 1991; 67:199–204.
18.
GuzzettiS, PiccalugaE, CasatiR, et al.Sympathetic predominance in essential hypertension: A study employing spectral analysis of heart rate variability. J Hypertens, 1988; 6:711–717.
19.
TakaloR, KorhonenI, TurjanmaaV, et al.Short-term variability of blood pressure and heart rate in borderline and mildly hypertensive subjects. Hypertension, 1994; 23:18–24.
20.
NishijoK, MoriH, YoshikawaK, YazawaK. Decreased heart rate by acupuncture stimulation in humans via facilitation of cardiac vagal activity and suppression of cardiac sympathetic nerve. Neurosci Lett, 1997; 227:165–168.
21.
HakerE, EgekvistH, BjerringP. Effects of sensory stimulation (acupuncture) on sympathetic and parasympathetic activities in healthy subjects. J Auton Nerv Syst, 2000; 79:52–59.
22.
WangJD, KuoTB, YangCC. An alternative method to enhance vagal activities and suppress sympathetic activities in humans. Auton Neurosci, 2002; 100:90–95.
23.
WangJ, XiongX, LiuW. Acupuncture for essential hypertension. Int J Cardiol, 2013; 169:317–326.
24.
ZhaoXF, HuHT, LiJS. Is acupuncture effective for hypertension? A systematic review and meta-analysis. PLoS One, 2015; 10:e0127019.
25.
UchidaS, KagitaniF, HottaH. Mechanism of the reflex inhibition of heart rate elicited by acupuncture-like stimulation in anesthetized rats. Auton Neurosci, 2008; 143:12–19.
26.
KimuraK, IshidaK, TakahashiN, et al.Effects of acupuncture at the ST-36 point on muscle sympathetic nerve activity and blood pressure in normal adults. Auton Neurosci, 2017; 208:131–136.
27.
GrassiG, ColomboM, SeravalleG, et al.Dissociation between muscle and skin sympathetic nerve activity in essential hypertension, obesity, and congestive heart failure. Hypertension, 1998; 31:64–67.
28.
WatanabeN, HottaH. Heart rate changes in response to mechanical pressure stimulation of skeletal muscles are mediated by cardiac sympathetic nerve activity. Front Neurosci, 2017; 10:614.
29.
ImaiK, KitakojiH. Comparison of transient heart rate reduction associated with acupuncture stimulation in supine and sitting subjects. Acupunct Med, 2003; 21:133–137.
30.
UchidaS, KagitaniF, WatanabeN, HottaH. Sympatho-inhibitory response of the heart as a result of short-term acupuncture-like stimulation of the rat hindlimb is not augmented when sympathetic tone is high as a result of hypercapnia. J Physiol Sci, 2010; 60:221–225.
31.
ChangCH, HuangJL, TingCT, et al.Atropine-induced HRV alteration is not amended by electroacupuncture on Zusanli. Am J Chin Med, 2005; 33:307–314.
32.
HuangST, ChenGY, LoHM, et al.Increase in the vagal modulation by acupuncture at neiguan points in the healthy subjects. Am J Chin Med, 2005; 33:157–164.
33.
LiZ, WangC, MakAF, ChowDH. Effects of acupuncture on heart rate variability in normal subjects under fatigue and non-fatigue state. Eur J Appl Physiol, 2005; 94:633–640.
34.
OuyangH, YinJ, WangZ, et al.Electroacupuncture accelerates gastric emptying in association with changes in vagal activity. Am J Physiol Gastrointest Liver Physiol, 2002; 282:390–396.
35.
ImaiK, ArigaH, ChenC, et al.Effects of electroacupuncture on gastric motility and heart rate variability in conscious rats. Auton Neurosci, 2008; 138:91–98.
36.
NakaharaH, KawadaT, UedaSY, et al.Acupoint dependence of depressor and bradycardic responses elicited by manual acupuncture stimulation in humans. J Physiol Sci, 2019; 69:1077–1084.
37.
SparrowK, GolianuB. Does acupuncture reduce stress over time? A clinical heart rate variability study in hypertensive patients. Med Acupunct, 2014; 2:286–294.
