External counterpulsation stimulation combined with acupuncture for vascular endothelial function in patients with hypertension: A randomized pilot trial

ABSTRACT

Objective

Endothelial function may improve with enhanced external counterpulsation (EECP) or acupuncture. This study aimed to evaluate the feasibility of acupoint stimulation combined with EECP (acupoint-EECP) for endothelial cell function in patients with essential hypertension.

Methods

Thirty essential hypertensive patients were, randomly divided into two groups, with 15 patients in the acupoint-EECP group, and 15 patients in the control group, of which 3 cases were lost by week 6. Both groups were treated with continued medicine. The participants in the acupoint-EECP group received acupoint stimulation combined with EECP therapy, 45 min for each time, 5 times weekly for 6 weeks for a total of 22.5 hours. The selected acupoints are Zusanli (ST36), Fenglong (ST40) and Sanyinjiao (SP6). The curative effects of the two groups were compared.

Results

The acupoint-EECP group (n=15) showed significant improvement in endothelial function [nitric oxide (NO) ，endothelin-1 (ET-1) and carotid-femoral pulse wave velocity (cf-PWV), respectively] values compared to the control group (n=12). Multiple imputation (n = 20 imputations) was performed to account for potential bias due to missing data. In stratified analyses, SBP and DBP values decreased when the baseline SBP was ≥120 mmHg and DBP was ≥80 mmHg.

Conclusions

These findings suggest the feasibility of acupoint-EECP in improving endothelial function and treating hypertension. (The Chinese clinical trial registration number is ChiCTR2100053795.)

KEYWORDS:

• Blood pressure
• endothelin
• external counterpulsation
• acupressure
• nonpharmaceutical therapy

Acknowledgment(s)

We thank the patients and staff of Ruian Hospital Division of Cardiovascular Rehabilitation Department for their valuable contributions to the study.

Author contributions

Wang L and Guan XF designed the project and are responsible for the overall content, contributed to revise the manuscript. Lin ML, Wang XN and Ye BB carried out all the experiments. Lin ML and Jin Y prepared the manuscript. Zhang J is responsible for blood pressure measurement. Lin SM, Xu YY, Zhou JG, Liu SP, and Zhou SW are responsible for recruitment and registration. All authors have seen and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10641963.2023.2181355

Additional information

Funding

This work was supported by the Chinese Association of Integrative Medicine-Hutchison Research Fund (grant number HMP2005002P).