ACUPUNCTURE FOR HYPERTENSION

INTRODUCTION:

·       Acupuncture is one of the most widely practiced forms of nonpharmacological treatments.

·       It is the important part of traditional Chinese medicine.

·       It is a Chinese therapy by inserting needles to the acu-points on the body surface along meridians to treat a wide range of diseases.

·       It could be used on patients who want to avoid drug therapy or as an alternate option to reduce dosages of antihypertensive agents.

NATUROPATHIC INTERVENTION:

AIM:

·                       To reduce the Blood Pressure

·                       To reduce the dosage of medications

·                       To improve the Quality of life

·                       To prevent the complications

INFLUENCE OF ACUPUNCTURE ON RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM(RAAS):       

Acupuncture

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Can regulate BP homeostasis, vascular injury, & repair responses

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 by decreasing the activity of renin

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By decreasing the levels of angiotensin converting enzyme and angiotensin receptors (AT1R & AT2R)

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& decreasing the plasma content of angiotensin II & aldosterone

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It can significantly decrease the mRNA expression of angiotensinogen

EFFECT OF ACUPUNCTURE ON OXIDATIVE STRESS:

LIVER 3:

Acupuncture on liver 3 (Tai Chong)

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May increase the antioxidant enzymes (Superoxide dismutase, Glutamate dehydrogenase 1, Glutathione-s- transferase) in the medulla & improve oxidative stress

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It reduces the formation of ROS by regulating the oxidation/antioxidant enzyme system

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Increased superoxide dismutase (SOD) promotes the enhanced antioxidant function

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& relaxing the vascular smooth muscle

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which results in reducing BP

INFLUENCE OF ACUPUNCTURE ON VASCULAR ENDOTHELIAL FUNCTION:

STOMACH-36

Acupuncture on st-36

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Can lower BP by reducing endothelin A receptor (ETAR) & ET-1 production

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A Research study reported that there is an expression of endothelial nitric oxide synthase (eNOS)

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& production of Nitric Oxide (NO) Were enhanced by electroacupuncture on Stomach-36 (Zusanli)

It can lower BP

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By restoring the equilibrium of endothelium-dependent relaxing factor (EDRF) & endothelial cell-dependent contractility factor (EDCF)

EFFECT OF ACUPUNCTURE ON INFLAMMATORY FACTORS:

Acupuncture effect was mediated by the reduction of inflammatory factors (TNF-alpha, interlekin-6, & CRP-C reactive protein)

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All the evidence suggests that acupuncture can reduce inflammatory factors

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Which may affect the RAAS system & endothelial function

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Resulting in reduction of BP

INFLUENCE OF ACUPUNCTURE ON NEUROENDOCRINE:

• Hypothalamus is one of the anti-hypertensive targets

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It has been reported that paraventricular nucleus & arcuate nucleus in the hypothalamus

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Can regulate cardiovascular function

• The ventrolateral Periaqueductal Gray (vlPAG) & Rostral ventrolateral medulla in medulla oblongata (rVLM)

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Also play an important role in the regulation of cardiovascular function

rVLM plays a key role in the regulation of BP

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Inhibition of neuronal function in rVLM

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Results in drastic reduction of BP

• Research found that “Acupuncture”

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Can inhibit rVLM premotor sympathetic cardiovascular neurons

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& can attenuate visceral sympathoexcitatory reflexes

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Through opioid mediated inhibition of aspartic acid & glutamic acid action in rVLM.

Central effects may also affect the endocrine system 

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Which leads to decreasing in the plasma levels of Aldosterone, Angiotensin II, and Norepinephrine  

                                                               ↓                                                                                                                                                                                                 Therefore, the mechanism of acupuncture’s beneficial effects is related to the sympathetic outflow & regulation of endocrine system                                                                                                                                                                                                                                        

 

INFLUENCE OF ACUPUNCTURE ON BRAIN FUNCTIONAL IMAGING:

• Needling on LIVER-3

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                   Can lower BP & improve symptoms

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By activating the anterior cingulate gyrus

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To regulate the parasympathetic

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& also improve the cognitive impairment caused by long-term hypertension

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By strengthening the connection of anterior cingulate gyrus with the function of other brain regions

•    Research study reported that using resting state fMRI                                                               

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Found that the limbic system, cerebellum, bilateral thalamus, & frontal lobes                                                                                                                                                            ↓                                      

May be targets in the brain

By needing liver-3 & kidney-3

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& thereby maintaining their original treatment in hypertensive patients

• Therefore, acupuncture can regulate the cortical level, hypothalamus, & brain stem

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Along with other brain complex networks

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To reduce the autonomic nervous response & regulating the cardiovascular system

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Thus, resulting in an antihypertensive effect

MOST COMMON POINTS:

Liver-3

Stomach-36

Pericardium-6

Pericardium-5

Large Intestine-11

Governing vessel-20

EAR  ACUPUNCTURE

SIX EAR ACUPUNCTURE POINTS:

·       Ear apex point

·       Endocrine point

·       Shen men point

·       Superior triangular fossa point

·       Heart point and

·       Groove of the posterior surface point

MOXIBUSTION 

It uses the heat generated by burning herbal preparations containing Artemisia vulgaris to stimulate acupuncture point.

MOXA POINTS:

Governing vessel-20

Pericardium-6

Stomach-36

Kidney-1

Conceptional vessel-8

Gall bladder-39

CAUTION:

·       Don’t practice it by yourself.

·       Consult with a physician before you use a needle.

·       You can start giving slight pressure to acupoints instead of needling.

·       Only, Registered Medical Practitioners are allowed to use acupuncture needles on patients.