Quite a few people, especially those getting on a bit, tend to find themselves taking medication to reduce their blood pressure. But since these medications can sometimes have unwelcome side effects, (such as headaches, or a dry cough) any means of reducing blood pressure without recourse to the products of the pharmaceutical industry are to be welcomed (except, perhaps, by the pharmaceutical industry.) Can acupuncture be such a means?
Of course, since high blood pressure, aka hypertension, may often be caused by the seemingly all-pervading stresses and strains of modern living, and since acupuncture treatment is for most people a surprisingly relaxing experience, it can certainly help. But can acupuncture have a direct effect on blood pressure itself?
Most cases of high blood pressure are classified as essential hypertension, which means that there is no obvious reason as to why the blood pressure is high. It just is. (I suppose ‘essential hypertension’ sounds more impressive than ‘unexplained hypertension’, and the suggestion that no one actually knows why your blood pressure is high might send it even higher! No one likes uncertainty.) And the issue with hypertension, whether essential or otherwise, is that it is often asymptomatic. Raised blood pressure, the silent killer. You feel fine, and then suddenly you drop dead, or at least have a stroke or a heart attack.
This lack of symptoms is potentially problematical for traditional acupuncturists, at least if we want to treat the essential version, since we tend to rely on signs and symptoms to guide our traditionally framed diagnosis and consequent treatment. (Signs being things we can observe about the patient, such as their complexion or the way they walk; symptoms being what they tell us about their condtion.) Blood pressure is not part of that traditional framework. Traditional Chinese doctors noticed all sorts of things about their patients, from the colour of their tongue to the brightness, or otherwise, of their eyes, and they certainly paid a lot of attention to their pulse. But measuring blood pressure was not part of their world. Hypertension does not feature as a potential symptom of any traditional Chinese diagnostic category.
Of course there have been recent attempts to integrate blood pressure into the signs and symptoms traditional Chinese doctors and acupuncturists interpreted. How successful these attempts have been so far is perhaps a moot point, which may leave us with a bit of a quandary. How do we treat someone for their high blood pressure if there are no symptoms to go on (other than their high blood pressure.) How do we treat someone who is apparently in perfect health, blood pressure readings aside?
Fortunately, though, perfectly healthy people do not exist. At least, I have not met one yet Ask the right questions, in the right kind of way, and you soon find out that the perfectly healthy person does, actually, occasionally have a headache. Not very often, perhaps, really quite mild. Or, they do occasionally have a little trouble getting off to sleep. Or, perhaps, their hands and feet do tend to get cold quite easily. And then there is the pulse. Traditional acupuncturists like a bit of pulse taking, and sometimes the pulse can give a few little hints. Maybe it feels just a little too tight or tense. Maybe it feels a little on the thin side. Maybe, even, it is a bit ‘slippery’. (You can’t, though, tell anything about someone’s blood pressure from taking their pulse, as far as I know anyway.)
So, look hard enough at the perfectly healthy person and you will find some small, subtle, imbalance, some area of potential weakness, some hint that their Yin and Yang is not quite in perfect equilibrium, some suggestion that their Qi is not as abundant and free flowing throughout every organ system as it should be. (From this perspective, hypertension is not so much as silent killer as one who is really quite quiet.)
So we can make a diagnosis based on these little imperfections and hints, and treat accordingly.
For example: it may be that their occasional headache, cold extremities, and tense pulse lead us to believe that they are suffering from a little bit of Liver Qi Stagnation. So, we treat their Liver Qi Stagnation with acupuncture. And maybe their blood pressure comes down. If it doesn’t, maybe we have to look again, maybe even more carefully, listen even more attentively to the pulse. Maybe there is something underlying the Liver Qi Stagnation, Kidney Yin deficiency perhaps. Surely, somewhere inside, something is going on which results in the blood pressure being raised. As Einstein put it, God doesn’t play dice with the universe - meaning things don’t just happen at random. You don’t get abnormally high blood pressure just through bad luck. (Although there is an issue here about just what constitutes “abnormally high”. Is it the same for everybody? If my blood pressure has been on the low side all my life, and now it is ‘normal’, is that, for me, high?)
There is certainly evidence to support acupuncture as a treatment for hypertension. For instance, a recent Chinese trial using just a couple of acupuncture points on the foot and ankle, and utilising MRI scans of the brain during treatment found positive and long lasting effects on reducing blood pressure in patients with hypertension, along with activation of the parts of the brain involved in blood pressure regulation.1
This tends to support the idea that acupuncture is a moderating kind of treatment modality. If something (blood pressure, stress levels, muscle tension etc.), acupuncture helps reduce it; if something (blood pressure, energy levels, mood etc.) is too low, it helps raise it In western medical parlance, it promotes homeostasis.
So to go back to the original question as to whether acupuncture can treat hypertension, I think we can answer that it can, but not necessarily directly. That is to say, it can treat the underlying disharmonies in a patient’s body-mind which are behind the raised blood pressure, whether these disharmonies are Liver Qi Stagnation, Kidney Yin deficiency, or something else. It can promote homeostasis. It can help restore a patient to how nature intended them, so to speak.
1. Acupuncture at LR3 and KI3 shows a control effect on essential hypertension and targeted action on cerebral regions related to blood pressure regulation: a resting state functional magnetic resonance imaging study Zhang et al 2020 Acupuncture in Medicine 39,1
Here is some of the latest news on acupuncture and related things, perhaps with a few of my thoughts thrown in for good measure.