2020 Evidence-Based Complementary and Alternative Medicine

This study showed that the intervention time was concentrated at 4–8 weeks, mainly through Chinese herbal medicine for the prevention and treatment of elderly hypertension and the complications.

We systematically retrieved and summarised clinical studies on traditional Chinese medicine (TCM) for the prevention and treatment of essential hypertension (EH) using the evidence map. We aimed to explore the evidence distribution, identify gaps in evidence, and inform on future research priorities. Clinical studies, systematic reviews, guidelines, and pathway studies related to TCM for the prevention and treatment of EH, published between January 2000 and December 2019, were included from databases CNKI, WanFang Data, VIP, PubMed, Embase, and Web of Science. The distribution of evidence was analysed using text descriptions, tables, and graphs. A total of 9,403 articles were included, including 5,920 randomised controlled studies (RCTs), 16 guidelines, expert consensus and path studies, and 139 systematic reviews (SRs).

A total of 10 high-quality studies were retrieved, where qigong (20 RCTs), zhengan xifeng decoction (6 RCTs), Liuwei Dihuang pill (6 RCTs), and Chinese herbal medicine (24 RCTs) were considered to have evidence of potential positive effects. Xuefu zhuyu decoction (15 RCTs) was considered a positive effect; i.e., we are confident in estimating the research results.

Traditional Chinese Medicine for Essential Hypertension: A Clinical Evidence Map Zhang Y, Wang B, Ju C, Liu L, Zhu Y, Mei J, Liu Y, Xu F

2020 Frontiers in Pharmacology

Compared with conventional Western medicine alone, Chinese herbal medicine plus antihypertensive drugs might be effective in reducing blood pressure levels and improving vascular endothelial function in patients with hypertension.

In clinical practice, antihypertensive Western medicines have a clear curative effect, but all of them have certain side effects. They cannot be completely eliminated from clinical use, and it is impossible to avoid situations where some patients may not be willing to take Western drugs and may not fully meet the needs of clinical treatment for hypertension. Thus, in Asian countries, some hypertensive patients have turned to TCM treatment with fewer adverse effects (Xiong et al., 2013).

To comprehensively evaluate the function of the vascular endothelium, we included many blood indicators to ensure that the results are comprehensive. The evaluation of the vascular endothelial function has not been included as one of the important factors affecting the cardiovascular prognosis of patients in the latest hypertension treatment guidelines. Moreover, there are no drugs specifically for vascular endothelial injury. The analysis in this study may provide some evidence for further improvement of the treatment guidelines.

After quantitative synthesis, our review is the first to demonstrate that CPAD can lower BP and improve vascular endothelial function in patients with hypertension, suggesting that TCM as an adjuvant therapy could be used for hypertension treatment by alleviating symptoms and improving well-being.

The Effect of Chinese Herbal Medicine Combined With Western Medicine on Vascular Endothelial Function in Patients With Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Ren W, Wang M, Liao J, Li L, Yang D, Yao R, Huang L

2019 International Journal of Hypertension

Acupuncture as an adjunctive therapy has antihypertensive effect.

The mechanism of acupuncture for hypertension is related to RAAS, vascular endothelium, oxidative stress, the neuroendocrine system, and other factors; also, there is cross-talk between multiple systems and multiple targets. In addition, the functional images, genes, metabolism, etc. change with antihypertensive effect. Acupuncture can protect target organs in addition to reducing BP. Overall, based on the mechanism research acupuncture may be an effective intervention for management of hypertension.

The Mechanism of Acupuncture in Treating Essential Hypertension: A Narrative Review Juan Li ,1 Mingsheng Sun ,2 Jing Ye,2 Yuxi Li ,2 Rongjiang Jin ,1 Hui Zheng ,2 and Fanrong Liang 2

2015 PLOS One

There is evidence of efficacy of acupuncture as an adjunctive therapy to western medicine for treating hypertension.

Our review provided evidence of acupuncture as an adjunctive therapy to medication for treating hypertension, while the evidence for acupuncture alone lowing BP is insufficient. The safety of acupuncture is uncertain due to the inadequate reporting of it. However, the current evidence might not be sufficiently robust against methodological flaws and significant heterogeneity of the included RCTs. Larger high-quality trials are required.

Is Acupuncture Effective for Hypertension? A Systematic Review and Meta-Analysis Zhao XF, Hu HT, Li JS, Shang HC, Zheng HZ, Niu JF, et al

2014 Evidence-Based Complementary and Alternative Medicine

Acupuncture significantly lowers blood pressure in patients taking antihypertensive medications.

Results from this meta-analysis of randomized sham-controlled trials provide evidence that acupuncture helped (lowered) BP in patients taking antihypertensive medications. Our results did not provide support that acupuncture alone significantly lowers BP in patients with hypertension. Larger RCTs with longer follow-up periods would help clarify the potential efficacy and safety of acupuncture for treating hypertension.

Acupuncture for Essential Hypertension: A Meta-Analysis of Randomized Sham-Controlled Clinical Trials Li DZ, Zhou Y, Yang YN, Ma YT, Li XM, Yu J, et al.