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The effect of acupuncture on 24-hour ambulatory blood pressure and circadian rhythm in patients with essential hypertension: a systematic review and meta-analysis of randomised controlled trials.

Blood pressure·December 2026·Huawei Gao, Zhihong Li, Wenxiang Zhan et al.
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Key Finding

Acupuncture combined with Western medication significantly reduced 24-hour ambulatory blood pressure readings and improved circadian rhythm patterns compared to medication alone in patients with essential hypertension.

What This Means For You

Researchers conducted a comprehensive review to determine whether acupuncture can help manage high blood pressure, specifically looking at 24-hour blood pressure readings and daily rhythm patterns. They analyzed 13 clinical trials involving 1,080 patients with essential hypertension (high blood pressure without an identifiable cause).

The study found that acupuncture combined with standard blood pressure medication worked significantly better than medication alone. Patients receiving both treatments showed improvements across multiple measures: their average blood pressure over 24 hours decreased for both systolic (upper number) and diastolic (lower number) readings. Additionally, acupuncture helped reduce blood pressure variability—meaning blood pressure remained more stable throughout the day rather than spiking unpredictably. The treatment also improved blood pressure load (the percentage of time blood pressure stays elevated) and helped restore healthier circadian rhythm patterns, which is important since blood pressure should naturally dip during sleep.

These results suggest that acupuncture may be a valuable addition to conventional hypertension treatment. The combination approach appears more effective than medication alone for managing not just average blood pressure numbers, but also the fluctuations and daily patterns that can impact cardiovascular health. This is particularly important because blood pressure variability and disrupted circadian rhythms are independent risk factors for heart disease and stroke.

For patients considering acupuncture for hypertension management, this research provides encouraging evidence, though it should complement—not replace—prescribed medications and lifestyle modifications. If you're interested in trying acupuncture for blood pressure management, seek treatment from a licensed acupuncturist who can coordinate care with your primary physician.

Clinical Notes for Practitioners

This systematic review and meta-analysis evaluated acupuncture's effect on 24-hour ambulatory blood pressure monitoring (ABPM) parameters in essential hypertension patients. Researchers analyzed 13 RCTs involving 1,080 patients from nine databases through May 2025. Meta-analysis using RevMan 5.4.1 demonstrated that acupuncture combined with Western medication significantly reduced 24-hour average SBP (MD = -3.57 mmHg, 95% CI: -5.04 to -2.10, p < 0.001) and DBP (MD = -3.61 mmHg, 95% CI: -5.12 to -2.10, p < 0.001) compared to medication alone. Additional improvements included reduced BP variability (SBP: MD = -1.15, p < 0.001; DBP: MD = -0.96, p < 0.001), decreased BP load (SBP: MD = -3.47, p = 0.003; DBP: MD = -2.20, p = 0.02), and improved circadian rhythm restoration. Clinical takeaway: Acupuncture as adjunctive therapy demonstrates statistically significant benefits across multiple ABPM parameters, suggesting value in comprehensive hypertension management protocols beyond casual BP reduction.

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