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, retrieved 18 July 2019, from

Zhang, Y, Liu, XG, Dong, XY, Liu, Y & Xu, JY (2012), Clinical research of acupuncture adding psychotherapy in treating essential hypertension, Journal of Chengdu University of Traditional Chinese Medicine, vol. 35, no. 4, pp. 16-18.

Zhao, H, Li, D, Li, Y, Yang, Y, Liu, Y, Li, J & Mao, J (2019), Efficacy and safety of acupuncture for hypertension: An overview of systematic reviews, Complementary Therapies in Clinical Practice, vol. 34, no. 1, pp. 185-194.

Zheng, H, Li, J, Li, Y, Zhai, L, Wu, X, Chen, J, Li, X, Huang, YL, Chang, XR, Liu, M, Cui, J, Wang, RH, Du, X, Shi, J,Guo, TP & Liang, FR (2018), Acupuncture for patients with mild hypertension: A randomised controlled trial, Journal of Clinical Hypertension, vol. 21, no. 1, pp. 412-420.

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. 

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 2: Keywords

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
(n = 0)

Records identified through database searching
(n = 102)

Identification

Records after duplicates removed
(n =102)

Screening

Records excluded
(n = 87)

Records screened
(n = 102)

Full-text articles assessed for eligibility
(n = 15)

Eligibility

Studies included in literature review
(n = 6)

Included

Full-text articles excluded, with reasons
(n = 9)

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; d