Blood Pressure Lowering Effect of Electro‐Acupuncture in Middle‐aged and Elderly Patients with Mild to Moderate Hypertension: Does Inflammation Play a Role

Our previous findings have shown that Electroacupuncture (EA) at P5-6 and ST36-37 for 8 weeks reduces Blood Pressure (BP) in patients with mild to moderate hypertension (HTN) through sympathetic inhibition. Responsiveness to EA (defined as ≥-6mmHg in peak or average systolic BP) was 80% in patients younger than 50 years, 71% in males older that 50 years, and 44% in females older than 50 years. It is well known that inflammation is increased in aging and may play a critical role in age related conditions like HTN. In this study, we formulated a targeted treatment strategy reducing inflammation and sympathetic activity named immuno-sympathoinhibitory EA treatment that includes acupoints targeting both immune and sympathetic (P5-6, ST36-37, and SP6-7) systems to address the low-grade chronic inflammation in older hypertensive patients. High sensitivity C-reactive protein (hs-CRP), a marker of systemic chronic low-grade inflammation was assessed. We hypothesized that immuno-sympathoinhibition by EA treatment decreases BP and hs-CRP in middle-aged and elderly patients with HTN. Participants were not on antihypertensive medications and randomly allocated to either sympathoinhibitory (n=12) or immuno-sympathoinhibitory (n=9) EA treatment. After completion of the 8-week course of treatment, the BP lowering responsiveness to the immuno-sympathoinhibitory EA was 88% (P=0.016) and to the sympathoinhibitory EA was 58% (P=0.042). The hs-CRP likely could be reduced by immuno-sympathoinhibitory EA treatment (decreased by 6.7 %, pre-EA vs post-EA P=0.08, n=5) while hs-CRP did not decrease in patients treated with sympathoinhibitory EA (increased by 0.9 %, pre-EA vs post-EA P=0.42, n=15). Therefore, combining EA targeted at the immune and sympathetic systems may be important in lowering BP and chronic low-grade inflammation and improving responsiveness to EA treatment in middle-aged and elderly hypertensive patients.