DOI QR코드

DOI QR Code

Acupuncture for Prehypertension and Stage 1 Hypertension in Postmenopausal Women: A Randomized Controlled Pilot Trial

폐경 후 고혈압 전단계 및 1기 고혈압에 대한 침 치료 효과: 무작위 대조 예비연구

  • Kim, Jung-Eun (Clinical Research Division, Korea Institute of Oriental Medicine) ;
  • Choi, Sun-Mi (KM standards center, Korea Institute of Oriental Medicine) ;
  • Choi, Jin-Bong (College of Korean Medicine, Dongshin University) ;
  • Kim, Hyeong-Jun (College of Korean Medicine, Semyung University) ;
  • Kwon, Ojin (Clinical Research Division, Korea Institute of Oriental Medicine) ;
  • Kim, Jae-Hong (College of Korean Medicine, Dongshin University) ;
  • Park, Ji-Eun (Mibyeong Research Center, Korea Institute of Oriental Medicine)
  • 김정은 (한국한의학연구원 임상연구부) ;
  • 최선미 (한국한의학연구부 한의기술표준센터) ;
  • 최진봉 (동신대학교 한의과대학) ;
  • 김형준 (세명대학교 한의과대학) ;
  • 권오진 (한국한의학연구원 임상연구부) ;
  • 김재홍 (동신대학교 한의과대학) ;
  • 박지은 (한국한의학연구원 미병연구단)
  • Received : 2017.08.29
  • Accepted : 2017.09.09
  • Published : 2017.09.27

Abstract

Objectives : The aim of this study was to assess the effectiveness of acupuncture in treating prehypertension and stage 1 hypertension in postmenopausal women. Methods : The study was a multi-center, four-arm, non-blinded, randomized clinical trial. Sixty participants were randomly assigned to experimental or control groups. The experimental groups received 10 acupuncture sessions over 4 weeks(Group A, n=20) or 20 sessions over 8 weeks(Group B, n=20) along with usual care. The acupoints were GB20, LI11, ST36, and SP6, bilaterally. The acupuncture groups were followed-up for an additional 12 weeks after acupuncture treatment. The control groups received usual care for 16 weeks(Group C, n=10) or 20 weeks(Group D, n=10). The outcomes were blood pressure, blood pressure control rates, lipid profile, and high-sensitivity C-reactive protein(hs-CRP). Results : After 4 weeks, DBP in the acupuncture groups(A+B) showed no significant decrease compared to the control group(C+D). However, after 8 weeks of acupuncture treatment, group B showed a significant decrease in DBP after acupuncture treatment and follow-up period compared to control group. Although there was no difference between the acupuncture and control groups in SBP after acupuncture treatment, group B showed a significant decrease in SBP compared to control group after follow-up period. Lipid profiles and hs-CRP did not differ significantly between acupuncture and control groups. Conclusions : Acupuncture treatment for 8 weeks showed the effect on prehypertension and mild hypertension. To verify the effect of acupuncture on blood pressure, rigorous trials including more participants are required.

Keywords

Acknowledgement

Supported by : Korea Institute of Oriental Medicine

References

  1. Ministry of Health and Welfare. Prevalence of Chronic disease 2017 [cited 2017 August 16]; Available from: URL: http://www.index.go.kr/potal/main/EachDtlPageDetail.do?idx_cd=1438.
  2. James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014 ; 311(5) : 507-20. https://doi.org/10.1001/jama.2013.284427
  3. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003 ; 42(6) : 1206-52. https://doi.org/10.1161/01.HYP.0000107251.49515.c2
  4. Greenlund KJ, Croft JB, Mensah GA. Prevalence of heart disease and stroke risk factors in persons with prehypertension in the United States, 1999-2000. Arch Intern Med. 2004 ; 164(19) : 2113-8. https://doi.org/10.1001/archinte.164.19.2113
  5. Kim YM, Hong KS, Choi YH, Choi MG, Jeong JY, Lee JM, et al. Rates and related factors of progression to hypertension among prehypertensive local residents ageed 45 or over in Chuncheon city: Hallym aging study from a community-based cross-sectional study. Korean Circ J. 2008 ; 38(1) : 43-50. https://doi.org/10.4070/kcj.2008.38.1.43
  6. Kshirsagar AV, Carpenter M, Bang H, Wyatt SB, Colindres RE. Blood pressure usually considered normal is associated with an elevated risk of cardiovascular disease. Am J Med. 2006 ; 119(2) : 133-41. https://doi.org/10.1016/j.amjmed.2005.08.023
  7. Kim Y, Lee S. Prevalence and Risk Factors Associated with Prehypertension by Gender and Age in a Korean Population in the KNHANES 2010-2012. Iran J Public Health. 2015 ; 44(12) : 1594-602.
  8. Chun BY, Shin JY. The scientific evidence for the management of prehypertensives and high risk group. J Korean Med Assoc. 2011 ; 54(10) : 1013-9.
  9. Lima R, Wofford M, Reckelhoff JF. Hypertension in Postmenopausal Women. Curr Hypertens Rep. 2012 ; 14(3) : 254-60. https://doi.org/10.1007/s11906-012-0260-0
  10. Elliott WJ. What factors contribute to the inadequate control of elevated blood pressure? J Clin Hypertens (Greenwich). 2008 ; 10(1 Suppl 1) : 20-6.
  11. Shaw E, Anderson JG, Maloney M, Jay SJ, Fagan D. Factors associated with noncompliance of patients taking antihypertensive medications. Hosp Pharm. 1995 ; 30(3) : 201-3, 206-7.
  12. Liu Y, Park JE, Shin KM, Lee MH, Jung HJ, Kim AR, et al. Acupuncture lowers blood pressure in mild hypertension patients: a randomized, controlled, assessor-blinded pilot trial. Complement Ther Med. 2015 ; 23(5) : 658-65. https://doi.org/10.1016/j.ctim.2015.06.014
  13. Yin C, Seo B, Park HJ, Cho M, Jung W, Choue R, et al. Acupuncture, a promising adjunctive therapy for essential hypertension: a double-blind, randomized, controlled trial. Neurol Res. 2007 ; 29 Suppl : S98-103.
  14. Abdi H, Tayefi M, Moallem SR, Zhao B, Fayaz M, Ardabili HM, et al. Abdominal and auricular acupuncture reduces blood pressure in hypertensive patients. Complement Ther Med. 2017 ; 31 : 20-6. https://doi.org/10.1016/j.ctim.2017.01.003
  15. Macklin EA, Wayne PM, Kalish LA, Valaskatgis P, Thompson J, Pian-Smith MC, et al. Stop Hypertension with the Acupuncture Research Program (SHARP): results of a randomized, controlled clinical trial. Hypertension. 2006 ; 48(5) : 838-45. https://doi.org/10.1161/01.HYP.0000241090.28070.4c
  16. Zhao XF, Hu HT, Li JS, Shang HC, Zheng HZ, Niu JF, et al. Is Acupuncture Effective for Hypertension? A Systematic Review and Meta-Analysis. PLoS One. 2015 ; 10(7) : e0127019.
  17. Wang, J. Xiong X, Liu W. Acupuncture for essential hypertension. Int J Cardiol. 2013 ; 169(5) : 317-26. https://doi.org/10.1016/j.ijcard.2013.09.001
  18. Jung SY, Park JE, Kim JE, Kim AR, Choi SM, Review of acupuncture treatment for hypertension in clinical trials. J Korean Orient Med. 2012 ; 33(1) : 12-23.
  19. Lee H, Kim SY, Park J, Kim YJ, Lee H, Park HJ, Acupuncture for lowering blood pressure: systematic review and meta-analysis. Am J Hypertens. 2009 ; 22(1) : 122-8. https://doi.org/10.1038/ajh.2008.311
  20. Korean Acupuncture and Moxibustion Society. Acupuncture and Moxibustion. 2nd ed. Paju : Jipmoondang. 2008.
  21. Kim HG, Jung KG, Kim SM, Min YK, Kim CH, Y. HM. Literary review on the acupuncture and moxibustion therapy of hypertension. J Spine Joint Korean Med. 2006 ; 3(1) : 15-23.
  22. Seo SM, Baek SH, Jeon HK, Kang SM, Kim DS, Kim WS, et al. Correlations between the level of high-sensitivity C-reactive protein and cardiovascular risk factors in Korean adults with cardiovascular disease or diabetes mellitus: the CALLISTO study. J Atheroscler Thromb. 2013 ; 20(7) : 616-22. https://doi.org/10.5551/jat.16089
  23. Ryu SY, Lee YS, Park J, Kang MG, Kim KS. Relations of plasma high-sensitivity C-reactive protein to various cardiovascular risk factors. J Korean Med Sci. 2005 ; 20(3) : 379-83. https://doi.org/10.3346/jkms.2005.20.3.379
  24. Moon JS, Park KM, Choi SM. Study on the Development of a Questionnaire Software for Health Examination in Oriental Medicine. J Korea Institute Orient Med. 2007 ; 13(2) : 135-42.
  25. Kim JE, Choi JB, Kim HJ, Kang KW, Liu Y, Jung HJ, et al. Acupuncture for Prehypertension and Stage 1 Hypertension in Postmenopausal Women: Protocol for a Randomized Controlled Pilot Trial. Korean J Acupunct. 2014 ; 31(1) : 5-13. https://doi.org/10.14406/acu.2014.002
  26. National Institute of Food and Drug Safety Evaluation. Guideline on clinical trial of medical products in the treatment of hypertension. Korea Food & Drug Administration website. 2009 : 6.
  27. National Institute of Food and Drug Safety Evaluation. Clinical Trials Guidelines for Hypertension Treatment. Ministry of Food and Drug Safety website. 2015 : 27.
  28. Kalish LA, Buczynski B, Connell P, Gemmel A, Goertz C, Macklin EA, et al. Stop Hypertension with the Acupuncture Research Program (SHARP): clinical trial design and screening results. Control Clin Trials. 2004 ; 25(1) : 76-103.
  29. Egan BM, Li J, Wagner CS. Systolic Blood Pressure Intervention Trial (SPRINT) and Target Systolic Blood Pressure in Future Hypertension Guidelines. Hypertension. 2016 ; 68(2) : 318-23. https://doi.org/10.1161/HYPERTENSIONAHA.116.07575
  30. Pater C. Beyond the Evidence of the New Hypertension Guidelines. Blood pressure measurement - is it good enough for accurate diagnosis of hypertension? Time might be in, for a paradigm shift (I). Curr Control Trials Cardiovasc Med. 2005 ; 6(1) : 6. https://doi.org/10.1186/1468-6708-6-6
  31. Wang J, Xiong X, Liu W. Acupuncture for essential hypertension. Int J Cardiol. 2013 ; 169(5) : 317-26. https://doi.org/10.1016/j.ijcard.2013.09.001
  32. Lee H, Kim SY, Park J, Kim YJ, Lee H, Park HJ. Acupuncture for lowering blood pressure: systematic review and meta-analysis. Am J Hypertens. 2009 ; 22(1) : 122-8. https://doi.org/10.1038/ajh.2008.311
  33. Li DZ, Zhou Y, Ynag YN, Ma YT, Li XM, Yu J, et al. Acupuncture for essential hypertension: a meta-analysis of randomized sham-controlled clinical trials. Evid Based Complement Alternat Med. 2014 ; 279478.
  34. Choi HM, Kim HC, Kang DR. Sex differences in hypertension prevalence and control: Analysis of the 2010-2014 Korea National Health and Nutrition Examination Survey. Plos One. 2017 ; 12(5) : e0178334.
  35. O'Hagan TS, Wharton W, Kehoe PG. Interactions between estrogen and the renin angiotensin system - potential mechanisms for gender differences in Alzheimer's disease. Am J Neurodegener Dis. 2012 ; 1 : 266-79.
  36. Maas AH, Franke HR. Women's health in menopause with a focus on hypertension. Neth Heart J. 2009 ; 17 : 68-72. https://doi.org/10.1007/BF03086220
  37. Kim BS, Lim JH, Lee MH, Yun YJ. Reliability Study of the Pattern Identification Questionnaire Developed by Korean Institute of Oriental Medicine. J Society Korean Med Diagnostics. 2013 ; 17(1) : 29-44.
  38. Yang C, Kim Y, Kim C, Kim C, Song M. Pattern Analysis in Patients with Hypertension grades. Korean J. Oriental Physiology & Pathology. 2012 ; 26(6) : 934-9.
  39. Yang N, Han C. Study on Cold-Heat Pattern Identification in Hypertensive Patients with Antihypertensive Agents. Korean J. Orient. Int. Med. 2013 ; 34(3) : 267-77.