Complementary Alternative Cardiovascular Medicine

Chapter 11 / Acupuncture and CVD 181
in 16 spontaneous hypertensive rats (p < 0.001). The magnitude of the
depressor response correlated significantly to the initial blood pressure
(r = 0.75; p < 0.001). The response was reversed by iv naloxone, as well
as by chloralose-urethane anesthesia. No significant change in blood
pressure was observed in the normotensive group (49). However, the
depressor response could not be reproduced in a different group of hypertensive
rats, in which the hypertension was not associated with sympathetic
hyperactivity (50).
Level B Randomized Trials. In 50 patients with essential hypertension,
the effect of acupuncture was compared to the effect of rest in a
crossover design with a 30-min observation period. A significant decrease
was demonstrated for both treatments, and the one for acupuncture was
associated with a decrease in plasma rennin activity. No between-group
comparison was made, and there was no random allocation between the
treatments (51).
APOPLEXY
Evidence Level A Randomized Clinical Trials. A review based on
nine randomized trials, with a total sample size of 538 patients concluded
that there is not sufficient evidence to indicate that acupuncture
is effective in stroke rehabilitation (52).
CARDIOVASCULAR EFFECTS IN HEALTHY HUMANS
Evidence Level A Scientific Studies. In a randomized crossover
design, the effect of electroacupuncture on acupoint LI4 (Hegu) and
LI10 (Shousanli) (2 Hz for 20 min) was compared to that of a placebo
pill, with respect to myocardial work capacity (expressed as pressurerate-product)
and skin blood flow in 23 healthy subjects. The study
demonstrated that acupuncture increased initial low values of maximum
pressure-rate-product and decreased initial high values, whereas intermediate
values were not affected (r = 0.70, p < 0.0002) (53,54).
NAUSEA
Clinical Trials Evaluating the Clinical Effect
of Acupuncture in Noncardiovascular Disease
Evidence Level A Randomized Trials. Although not directly
related to an evaluation of the cardiovascular effects of acupuncture, three
studies of the antiemetic effect of acupuncture and acupressure deserve
attention, because the acupuncture points used are commonly used in
acupuncture and acupressure treatment of ischemic heart disease. These
studies demonstrate an effect of stimulation of sensory nerves of the skin
and symptoms related to the inner organs, in this case nausea (55–58).