Acupuncture as Adjuvant Therapy for Hypertension in the Elderly: A Network Meta-Analysis

Abstract

Objective: The purpose of this study was to evaluate the effectiveness and safety of acupuncture as adjuvant therapy for hypertension in elderly patients.

Methods: We conducted a systematic review and network meta-analysis to assess the effects of acupuncture as adjuvant therapy for hypertension in the elderly. Databases searched included the Cochrane Library, PubMed, Embase, Web of Science, and the China National Knowledge Infrastructure database from their inception to March 1, 2025. The primary outcome was the mean change in blood pressure, while the secondary outcome was safety, evaluated by the incidence of adverse reactions.

Results: A total of 24 studies (3044 participants) were included. For systolic blood pressure (SBP), acupuncture combined with calcium antagonists demonstrated significantly greater efficacy compared to calcium antagonists alone, auricular acupressure plus calcium antagonists, auricular acupressure alone, acupuncture plus ACE inhibitors, auricular acupressure plus ACE inhibitors, ACE inhibitors alone, acupuncture alone, electroacupuncture, and angiotensin II (mean difference [MD]: 10.71; 17.86; 13.48; 16.47; 19.84; 25.8; 28.25; 36.34; and 27.23, respectively). For diastolic blood pressure (DBP), acupuncture combined with calcium antagonists was significantly more effective than auricular acupressure alone, calcium antagonists alone, electroacupuncture, acupuncture alone, angiotensin II, acupuncture plus ACE inhibitors (MD: 26.32; 17.48; 32.43; 29.56; 22.66; 29.18; 31.75; 24.27; and 25.61, respectively). Based on ranking probabilities, acupuncture combined with calcium antagonists may be the most effective and safe treatment for hypertension in the elderly.

Conclusions: Current evidence suggests that acupuncture as adjuvant therapy could be effective and safe for elderly patients with hypertension, with the combination of acupuncture and calcium antagonists potentially being the optimal choice. However, due to potential biases, results should be interpreted cautiously.

Keywords: Acupuncture; Complementary therapies; Hypertension.