Zheng, Y, Zhang, J, Wang, Y, Wang, Y, Lan, Y, Qu, S, Tang, C & Huang, Y (2016), Acupuncture decreases blood pressure related to hypothalamus functional connectivity with frontal lobe, cerebellum, and insula: A study of instantaneous and short-term acupuncture treatment in essential hypertension, Evidence-Based Complementary and Alternative Medicine (online), retrieved 19 July 2019, from Appendix 1: PICO Population Intervention Comparator Outcome Adults: (a) with current hypertension, or (b) with a clear history of previous hypertension now controlled with anti-hypertensive medications. Needle acupuncture of any type. Not laser acupuncture, moxibustion on acupoints or hot cupping on acupoints. Sham acupuncture. (Acupuncture needles are inserted at acupoints not related to hypertension). Change in systolic and/or diastolic blood pressure. Appendix 2: Keywords Population Intervention Comparator/s Outcome adult* hypertens* (including hypertension, hypertensive) acupuncture randomi*ed (including randomised, randomized) RCT sham hypertens*(including hypertension, hypertensive) BP “blood pressure” Appendix 3: Inclusion and Exclusion Criteria Inclusion Criteria Exclusion Criteria Randomised controlled trial (RCT) Any other primary or secondary study Published in, or translated into, English Published in any other language Published 2005 to 2019 (15 years) Published 2004 or earlier Published in a peer-reviewed journal Not published in a peer-reviewed journal Conducted with humans Conducted with animals (e.g. rats) Full-text available Only an abstract, citation, conference poster or thesis available Tested the effects of acupuncture on hypertension, in (a) an intervention group receiving acupuncture, and (b) a control group receiving sham acupuncture Tested any other outcome in any other combination of intervention and control groups Appendix 4: Results from Database Searches Database Number of Results Final Selections CINAHL 28 3 British Nursing Index 5 1 MEDLINE/PUBMED 42 4 EMBASE 15 1 Web of Science 12 1 TOTAL (Excluding Duplicates) 102 6 Appendix 5: PRISMA Diagram of Search Results Additional records identified through other sources Records identified through database searching Identification Records after duplicates removed Screening Records excluded Records screened Full-text articles assessed for eligibility Eligibility Studies included in literature review Included Full-text articles excluded, with reasons N=4: not a randomised controlled trial N=3: a trial which did not include a sham acupuncture group N=1: not published in a peer-reviewed journal N=1: not available in English in full-text Appendix 6: Overview of Selected Studies Reference Location Number of Patients Hypertension Diagnostic Criteria Type/s of Hypertension Anti-Hypertensive Medication/s Finding/s Macklin et al., 2006 USA 192 total BP 140/90 mmHg to 179/109 mmHg once weaned from anti-hypertensive medications Hypertension only No Mean decrease in BP for active versus sham acupuncture: systolic BP: -3.56 versus -3.84 mm Hg, respectively; 95% CI for the difference: -4.0 to 4.6 mm Hg; P=0.90; diastolic BP: -4.32 versus -2.81 mm Hg, 95% CI for the difference: -3.6 to 0.6 mm Hg (p=0.16). Active acupuncture is no more effective than sham acupuncture for reducing systolic or diastolic BP. Flachskampf et al., 2007 Germany 160 total BP ≥140/90 mmHg or “a history of hypertension with current use of anti-hypertensive medications” (p.3122) Hypertension only Yes, if unchanged for previous 2 months Mean decrease in BP for active versus sham acupuncture: systolic BP: 6.4 mmHg (95% CI, 3.5 to 9.2); diastolic BP: 3.7 mmHg (95% CI, 1.6 to 5.8) (p<0.001). At 3 months and 6 months post-intervention, mean systolic and diastolic blood pressures had returned to pre-treatment levels. Active acupuncture is more effective than sham acupuncture for reducing systolic o
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