The claims for acupuncture have any clinical usefulness are vastly overblown with evidence ranging from weak to nonexistent to dangerous. As Steven Novella at Science-Based Medicine once wrote, acupuncture is nothing more than “theatrical placebo.” On the long list of ridiculous claims for this pseudoscience is using acupuncture for hypertension treatment – and once again, real biomedical science shows it is worthless.
And now, it’s time to examine a systematic review that debunks the false claim that acupuncture for hypertension is useful.
What is acupuncture?
Most of the readers probably have heard of it, but let me take a few minutes of your time to explain it so that you can fully grasp the pseudoscience behind it.
Acupuncture is considered an alternative medicine, that is, a practice to treat a medical condition which is unproven, disproven, impossible to prove, or harmful. Acupuncture utilizes thin needles that are inserted into specific areas of the body, often called meridians. Fundamentally, it lacks biological plausibility to support any of its claimed effects.
It is a part of traditional Chinese medicine, which is not based on scientific evidence. As stated previously, acupuncture is simply a pseudoscience. In most Western countries, it is mainly used for pain relief, although there are numerous other claims.
Unless you rely upon cherry picking or confirmation bias, the conclusions of numerous clinical trials and systematic reviews of acupuncture are inconsistent – this suggests that the practice is not clinically effective. Usually, only anecdotes, which are not scientific data, and confirmation or observation biases seem to support its usefulness. But that’s not the basis of evidence- or science-based medicine.
There is a whole list of treatment claims made by acupuncture hawkers that have been thoroughly debunked by real science:
- It doesn’t work for menopausal hot flashes.
- It doesn’t work for pain.
- It doesn’t work for depression.
- It doesn’t work for knee pain.
- It doesn’t work for lower back pain.
- It doesn’t work for infertility.
- It doesn’t work for asthma.
- It doesn’t work for lymphedema.
- Oh, let’s save you time – it doesn’t work for just about anything in medicine.
So why does acupuncture endure, despite the vast body of evidence that shows that it does absolutely nothing? Even those of you who dismiss almost every ignorant anti-science contention about vaccines, cancer treatments, GMOs, or anthropogenic climate change will state loudly that “but..but..but acupuncture worked for me.”
A lot of pseudosciences rely upon special pleading, telling us such nonsense that “Western medicine” and “mainstream science” just doesn’t understand acupuncture. Or rely upon post hoc fallacies, that try to “prove” that acupuncture did something while ignoring all of the circumstances which showed nothing happened. Or rely upon the power of the “placebo effect” which is vastly overrated and overstated in medicine.
All of this makes people comfortable with accepting acupuncture (and many other pseudo-medicines like chiropractic, homeopathy, and colon cleansing) as a viable treatment, even if it’s not really doing much.
Acupuncture for hypertension – a systematic review
In a powerful systematic review, published in a recent issue of the Cochrane Database of Systematic Reviews, researchers examined whether acupuncture had any effect on high blood pressure. Systematic reviews, which utilize systematic methods to collect secondary data, critically appraise research studies and synthesize studies, sit at the pinnacle of the hierarchy of published biomedical research. In evidence- and science-based medicine, a systematic review is the most important evidence supporting the clinical utility of any pharmaceutical, device or procedure (see Note 1).
This review examined 22 published trials, which included a total of 1744 patients. Here are the key results:
- 4 of 22 trials used a sham control, that is, a control that may seem like real needles, but isn’t – it almost impossible to blind the practitioner and patient to its use. These trials only found minimal, short-term effects (i.e., hours) in reducing blood pressure.
- Some of these trials attempted to compare acupuncture to angiotensin-converting enzyme (ACE) inhibitors, or to calcium antagonists – some results suggested short-term benefits, but the risk of bias was considered “very high.” Thus, the authors felt that acupuncture’s effects were outweighed by the risks of not using the medications that have shown robust effectiveness in treating hypertension.
- The remaining trials were considered to be of poor quality, and they also showed no evidence of long-term BP effect.
The reviewers found no evidence that acupuncture actually lowers blood pressure. For the few studies that showed a short-term effect, the reviewers stated that the results were uncertain and contained significant bias. They stated that acupuncture was an ineffective treatment for hypertension which left patients at continued risk for strokes, heart attacks, and other cardiovascular events.
- Despite the power of systematic reviews, it doesn’t mean that they a free pass from critical analysis. The old adage of “garbage in, garbage out” is very applicable to these types of studies. If the researchers ignore the quality of bad studies included in the review, then the review is worthless. Systematic reviews should actually examine every study included to weed out bias, poor study design, and bad statistical analyses.
- Ernst E. Acupuncture: what does the most reliable evidence tell us? J Pain Symptom Manage. 2009 Apr;37(4):709-14. doi: 10.1016/j.jpainsymman.2008.04.009. Epub 2008 Sep 11. Review. PubMed PMID: 18789644.
- Standaert CJ, Friedly J, Erwin MW, Lee MJ, Rechtine G, Henrikson NB, Norvell DC. Comparative effectiveness of exercise, acupuncture, and spinal manipulation for low back pain. Spine (Phila Pa 1976). 2011 Oct 1;36(21 Suppl):S120-30. doi: 10.1097/BRS.0b013e31822ef878. Review. PubMed PMID: 21952184.
- Yang J, Chen J, Yang M, Yu S, Ying L, Liu GJ, Ren YL, Wright JM, Liang FR. Acupuncture for hypertension. Cochrane Database of Systematic Reviews 2018, Issue 11. Art. No.: CD008821.DOI: 10.1002/14651858.CD008821.pub2.