Yin et al., 2007
South Korea
41 total
Systolic BP BP ≥120 mmHg or diastolic BP ≥89 mmHg
Essential hypertension and pre-hypertension
Yes, if prescribed prior to intervention and not changed during intervention
Mean decrease in BP for active acupuncture: 136.8/83.7 to 122.1/76.8 mmHg (p<0.01). Mean decrease in BP for sham acupuncture: no significant change.
Active acupuncture is more effective than sham acupuncture for reducing BP.
Kim et al., 2012
South Korea
33 total
Systolic BP 140-159 mmHg or diastolic BP 90-99 mmHg
Hypertension only
No
Average systolic and diastolic BP was not changed significantly except for nighttime diastolic BP (90.3±11.47 mm Hg to 87.8±9.16 mm Hg, p=0.041).
Active acupuncture may be more effective than sham acupuncture for reducing nighttime diastolic BP only.
Zheng et al., 2016
China
30 total
BP ≥140/90 mmHg
Essential hypertension only
Yes, if prescribed prior to intervention and not changed during intervention
In the group receiving active acupuncture, there was a reduction in systolic BP (p=0.006). There was no reduction in the group receiving sham acupuncture.
Active acupuncture may be more effective than sham acupuncture for reducing systolic BP only.
Zheng et al., 2018
China
428 total
Systolic BP 140-159 mmHg or diastolic BP 90-99 mmHg
Essential hypertension only
No
Acupuncture was superior to sham acupuncture (3.3 mm Hg, 95% CI 0.2 to 6.3, adjusted p=0.035).
Active acupuncture is more effective than sham acupuncture for reducing BP.
Appendix 7: Data Extraction
Reference | Type of Acupuncture | Acupoint/s Accessed | Control Treatment/s | Intervention Period | Follow-up Period | Blinding |
Macklin et al., 2006 | Traditional Chinese acupuncture | At least 1 of 32 pre-identified acupoints (not specified), individualised to each patient | Sham acupuncture; needles inserted at acupoints not related to hypertension | Up to 12 sessions, 30 minutes per session, once or twice per week for 6 to 8 weeks | 10 weeks | No |
Flachskampf et al., 2007 | Traditional Chinese acupuncture | 3 of 21 pre-identified acupoints (specified), individualised to each patient | Sham acupuncture; needles inserted at acupoints not related to hypertension | 22 sessions in 6 weeks, 30 minutes per session | 6 months | No |
Yin et al., 2007 | Saam (modern Korean) acupuncture | Not specified, semi-individualised to each patient | Sham acupuncture; needles inserted at acupoints not related to hypertension | Up to 12 sessions, 30 minutes per session, for 8 weeks | 8 weeks | No |
Kim et al., 2012 | Traditional Korean acupuncture | 2 pre-identified acupoints (specified) | Sham acupuncture; not specified | 16 sessions, 20 minutes per session, twice per week for 8 weeks | 8 weeks (no follow-up beyond trial period) | No |
Zheng et al., 2016 | Traditional Chinese acupuncture | 1 pre-identified acupoint (specified) | Sham acupuncture; needles inserted at acupoints not related to hypertension | 10 acupuncture treatments over 2 weeks, 30 minutes per session | 12 months | No |
Zheng et al., 2018 | Traditional Chinese acupuncture | Multiple pre-identified acupoints (specified), not individualised to each patient | Sham acupuncture; needles inserted at acupoints not related to hypertension | 18 sessions over 6 weeks | 12 weeks | No |
Appendix 8: CASP Critical Appraisal
Macklin et al., 2006 | Flachskampf et al., 2007 | Yin et al., 2007 | Kim et al., 2012 | Zheng et al., 2016 | Zheng et al., 2018 | |
Did the trial address a clearly-focused issue? | Yes – the effect of acupuncture on hypertension | Yes – the effect of acupuncture on hypertension | Yes – the effect of acupuncture on hypertension | Yes – the effect of acupuncture on hypertension in relation to the circadian rhythm | Yes – the effect of acupuncture on hypertension in relation to brain electrical activity | Yes – the effect of acupuncture on hypertension |
Was the assignment of patients to treatments random-ised? | Yes – process of randomisation not specified | Yes – process of randomisation not specified | Yes – process of randomisa |
