Acupuncture and moxibustion therapy have been long established in practice, and recorded in ancient books, as effective methods for managing hypertension. Multiple studies have demonstrated that this is achieved by stimulation of the nervous system through needle manipulation, which downregulates key hormones involved in hypertension such as plasma endothelin, catecholamine, and adrenaline.

Based on literature reviews, the TCM approach to hypertension management is closely associated with ailments in the TCM-specific organ systems, and treatment varies with the approach targeting these different systems depending on the cause of disease. Research has shown 3 main approaches to acupuncture management of Hypertension.

• Liver Meridian System approach: In TCM, “the liver governs emotions, regulates laxity, and stores blood.” The liver has certain influences on blood circulation in conjunction to changes in emotions. Being in a state of high pressure or stress can affect the liver’s ability to regulate qi, leading to liver qi stagnation, which can accumulate and transform into liver heat. This excess heat causes imbalance in the flow of qi and blood in the body, resulting in excessive upward flow of qi and blood due to the upward characteristics of heat and fire. This often manifests as dizziness, headache, and irritability. Liv 3 Taichong (太冲) is often utilized to prevent this and regulate qi flow within the body.
• From the perspective of Human Anatomy: Another common TCM practice is using human anatomy to guide selection of acupuncture points, with majority of the selected points located on muscles near the neck region, such as on the sternocleidomastoid muscle, trapezius, and levator scapulae. An example is ST 9 Renying (人迎) which has been described in TCM classical text “Huangdi Neijing – Lingshu” (皇帝内经 – 灵枢) to be useful in treating headaches, dizziness, shortness of breath and chest pain, which are symptoms of acute hypertension. The nerves in this area include the carotid sinus, sympathetic nerves, parasympathetic nerves (specifically the vagus nerve), and pressure receptors, which are closely related to the regulation of blood pressure.

• Addressing phlegm and blood stasis: Most modern dietary habits tend to include a significant portion of greasy and sweet foods, along with a tendency to overeat. This weakens the spleen and stomach, in turn causing these organ systems to be unable to absorb and distribute nutrients and water efficiently. As fluid metabolism is disrupted, it accumulates into dampness, eventually forming phlegm. This phlegm can obstruct blood vessels which then lead to blood stasis. Narrowed blood vessels also trigger the body’s reflexes to strengthen blood vessel contraction to facilitate blood circulation, resulting in hypertension. Available research indicates that LI 11 Quchi (曲池) and ST 40 Fenglong (丰隆) acupoints have significant therapeutic effects on hypertension. LI 11 is a point where Qi and blood accumulates, and is chosen for its regulatory effect on qi and blood circulation. The selection of ST 40 is partly out of consideration of modern dietary habits as it is used to dispel phlegm as understood from the TCM perspective.

References

1. 卫彦, 孙忠人, 寇吉友, 等. 针刺人迎穴治疗高血压病120例临床观察.针灸临床杂志.2006(02):4-5.
2. 袁恺, 李万瑶, 熊俊, 等. 针刺颈穴对原发性高血压患者血压、血清一氧化氮及血浆内皮素-1的影响. 时珍国医国药. 2013,24(06):1528-1530.
3. 王舒馨, 刘健. 针刺治疗单纯舒张期高血压临床医案. 中华针灸电子杂志.2020,9(01):13-14.
4. 张朝晖, 周洁, 王强, 等. 针刺治疗原发性高血压病及其对血管内皮功能的影响. 中国针灸, 2004(08):24-25.
5. Bolívar JJ. Essential hypertension: an approach to its etiology and neurogenic pathophysiology. Int J Hypertens. 2013;2013:547809.
6. Stocker SD, Osborn JL, Carmichael SP. Forebrain osmotic regulation of the sympathetic nervous system. Clin Exp Pharmacol Physiol. 2008,35(5-6):695-700.
7. Chen QH, Toney GM. AT(1)-receptor blockade in the hypothalamic PVN reduces central hyperosmolality-induced renal sympathoexcitation. Am J Physiol Regul Integr Comp Physiol. 2001 Dec;281(6):R1844-53.

Click to download PowerPoint