An Apple among Oranges in hypertension research

red apple fruit and orange sunkist fruit ** Note: Slight blurriness, best at smaller sizesHere is a typical and nice positive study regarding acupuncture. It came from a team in Germany and was published in the highly regarded American journal “Circulation”.   They treated 160 patients who had moderate essential hypertension 3 to 5 times per week for 6 weeks using traditional oriental acupuncture points or sham (“placebo”) acupuncture, without patients knowing which treatment they were receiving. Their blood pressures were monitored over the course of treatments and then over the next 6 months after the treatments ended. For the acupuncture group and not the sham group, the blood pressures were significantly lowered to a degree similar to the result from drug trials for ACE inhibitors, one of the most common and potent drugs used for hypertension. The antihypertensive effect of acupuncture however did not last longer than the treatment period. Blood pressure levels of patients undergoing active acupuncture treatment returned to pre-treatment levels within 12 weeks after termination of treatment, so they did not have a lasting effect (just like drugs). The authors concluded that acupuncture effectively lowered systolic and diastolic blood pressures and offers a drug alternative for patients with mild or moderate hypertension. Unlike antihypertensive medications that can have very significant side effects, acupuncture had minimal, if any, side effects. However, acupuncture worked only during the treatment period and would require a substantially greater commitment of time and money from the patients compared to drug therapy.

Alina Tousseeva RAc

Alina Tousseeva RAc

Gord Grant - Acupuncturist

Gord Grant PhD, RAc

The problem with the interpretation of this type of research is that it examines acupuncture as if it were a drug! This bias is replete throughout most acupuncture research and other scientific investigations into complementary healthcare. The outcomes of blood pressure reduction can be similar with both, but one simply costs more and takes more time (measurable components), and the other has more side effects (less quantifiable to compare). So it becomes simplified into one question: which do you want – more cost/time vs more side effects? This comparison represents a fundamental thinking error in the medical system today; it misses the very important difference between the acupuncture mechanism and the essence of a holistic and complementary practice compared to a drug-based solution to a symptom in a medical-based context.

In this research study, they just put the needles in and walked away – it was all about the effect of the needles in and of themselves just like a drug. You see the doctor once or twice for very briefly for him or her to discover a symptom and prescribe a medication, and you may be monitored to re-evaluate the effectiveness of the drug once or twice a year over the rest of your life. At a holistic acupuncture clinic like ours, we take time to get to know you, your medical history, your diet and lifestyle, and encourage you monitoring your blood pressure to develop awareness and confidence in what makes it change over time. If you are motivated to do and change things that may impact your blood pressure, we become accountability partners. We may see you weekly or more in the beginning, as we help you in making your plans and goals toward addressing your health beyond your blood pressure symptom. Perhaps there are injuries preventing you from getting exercise, or sleep and stress issues that make you exhausted and need more thorough investigation medically. We take time to explain what things mean, and we support the changes you decide to make as they evolve with you, including becoming more aware and informed about your diet and exercise in a non-prescriptive way. We may refer you to other complementary professionals like nutritionists, exercise therapists, or counsellors who could support you in this time of transition, beyond the disease management focus already received. At our clinic we implemented community acupuncture specifically for those who need routine, frequent and affordable treatments.   In essence, we do what is necessary and take the time to help people who are ready to make turning points in their lives.

Let’s further compare acupuncture to a medication from a mechanism point of view to understand why they should not be compared equivalently. Acupuncture works by stimulating natural regulatory mechanisms, helping your body do better what it already does in its own built-in systems. Research shows it affects blood pressure likely through its impact on the autonomic nervous system. Like Beta blocking drugs used for hypertension, acupuncture effects are more than just on blood pressure. But unlike medications, the other global effects it has on the body are not considered negative “side effects”, but rather represent the positive and indirect way it works overall. Accumulating research shows acupuncture works indirectly on many issues relating to the autonomic nervous system — fight or flight responses. It reduces emotional stress and helps you relax, helps you digest your food better, improves fertility, and helps you get a better sleep to have a clear and calm mind to lessen depression, all fundamental for your health and in the process for you to make better decisions in lifestyle changes. The very least of what acupuncture treatments do, at least with a caring and committed therapist, is just lower blood pressure for a few days at a time – but this became the whole focus and outcome of the research trial. Yes, acupuncture treatments importantly have an impact on blood pressure, but more, this positive impact should also performed and perceived by both practitioner and patient within the context of a committed mindset to explore and change diet and lifestyle in sustainable ways. Hypertension in the medical world fosters mindset toward a simpler and externally derived solution, an objective measure of success, which more often than not misses the main point.

Everyone would benefit from changing the way we understand, diagnose, interpret, and treat singular symptoms like hypertension. We could all benefit from developing a collaborative approach between the medical and complementary health communities with each client toward a focus on overall health promotion. If healthcare resources are focused mainly toward diagnosing and treating a symptom like hypertension with drugs, at least initially, long before the cardiovascular disease has arrived, we have missed a more fundamental and important lesson.

As with most social global trends – the environment, agriculture, economy and population — we see too the medical system moving unsustainably toward consumption of technology and short-term drug fixes, crippled under information overload with body scans and genetic profiling; herein lies both the challenge and the opportunity for us all.