Research shows that ant-hypertensive medications are highly effective at managing hypertension. Indeed, they result in average reductions in blood pressure of 13.6mmHg (systolic, for single medications) to 17.3mmHg (systolic, for combination medications) (Bronsert et al., 2013). Nevertheless, hypertension remains a significant problem in the UK – indeed, Public Health England (2017) estimates that 12.5 million people in the UK, more than 1 in every 4 adults, have hypertension. The costs of medications to manage hypertension in the UK may be in excess of ￡1 billion per annum (NICE, 2011). For these reasons, alternative approaches to managing hypertension are important to consider. Acupuncture is one such approach.
1.2 Acupuncture
Acupuncture is a Traditional Chinese Medicine (TCM) therapy which has been practiced in China for more than 2500 years (Chang, 2012). It is based on the belief that essential energy, or qi, travels throughout the human body on pathways, or meridians (Chang et al., 2012; Kawakita & Okada, 2014). Turbulence or blockages in the flow of qi along the meridians results in the symptoms of a disorder (Kawakita & Okada, 2014) – for example: hypertension. Acupuncture involves placing fine metal needles at pre-determined points along a meridian, with the aim of rebalancing the qi, and subsequently relieving the symptoms of the disorder and restoring the person to a state of wellbeing (Kawakita & Okada, 2014). In relation to hypertension, it is believed that acupuncture helps to control the body’s processes for blood pressure regulation – including the RAAS – though its mechanism of action is still largely unclear (Li et al., 2019).
It is important to note that there is a recent Cochrane systematic review on the effects of acupuncture on hypertension (Yang et al., 2018). The Cochrane Collaboration is recognised to produce systematic reviews which are methodologically sound, and so provide high-quality evidence to inform clinical practice (LoBiondo-Wood & Haber, 2014). However, there are a number of limitations with Yang et al.’s (2018) review. In particular, the review considered the effects of acupuncture alone and in combination with other interventions, and it compared acupuncture with sham acupuncture, no treatment and anti-hypertensive medications (Yang et al., 2018). Because so many variables were considered, Yang et al. (2018) were unable to develop a firm conclusion about whether acupuncture was effective at reducing blood pressure in people with hypertension. This is a limitation this systematic review aims to address.
1.3 Aim of the Review
The aim of this systematic review is to retrieve, critically analyse and synthesise the existing research literature to determine the effects of acupuncture on hypertension. The studies selected for inclusion in this review will be carefully considered to avoid the methodological limitations of the existing Cochrane systematic review on the topic, noted above. The findings of the review will be used to inform evidence-based recommendations on the use of acupuncture for hypertension in clinical practice, and also recommendations for future research on the topic.
2.0 Methods
To gather evidence to inform practice in relation to the use of acupuncture to manage hypertension, a systematic review was undertaken. As with all other types of literature reviews, the purpose of a systematic review is to retrieve, critically appraise, synthesise and summarise the current, quality published research on a topic of interest (Macnee & McCabe, 2008). This is done with the aim of developing evidence to inform clinical practice in relation to the topic.
Systematic reviews form the basis of evidence-based practice (Macnee & McCabe,
