TITLE:
Neuromodulation in treatment of hypertension by acupuncture: A neurophysiological prospective
AUTHORS:
Peyman Benharash, Wei Zhou
KEYWORDS:
Central Nervous System; Electroacupuncture; Neurotransmitter; Brain Stem
JOURNAL NAME:
Health,
Vol.5 No.4A,
April
23,
2013
ABSTRACT: Hypertension
is a major public health problem affecting over one billion individuals worldwide.
This disease is the result of complex interactions between genetic and life-style
factors and the central nervous system. Sympathetic
hyperactivity has been postulated to be present in most forms of hypertension.
Pharmaceutical therapy for hypertension has not been perfected, often requires a
multidrug regimen, and is associated with adverse side effects. Acupuncture, a
form of somatic afferent nerve stimulation has been used to treat a host of cardiovascular
diseases such as hypertension. It has long been established that the two major contributors
to systemic hypertension are the intrarenal reninangiotensin system and chronic
activation of the sympathetic nervous system. A number of important studies on the
baroreflex response and its response to acupuncture are discussed. The inhibitory effects of acupuncture on the rostral ventrolateral medulla (rVLM) reduces sympathetic nerve activity and
blood pressure suggesting overactivity of the angiotensin system in this nucleus
may play a role in the maintenance of hypertension. Our experimental studies have
shown that electroacupuncture stimulation activates neurons in the arcuate nucleus,
ventro-lateral gray, and nucleus raphe to inhibit the neural activity in the rVLM
in a model of visceral reflex stimulation-induced
hypertension. The significant role of
spinal cord opioids and nociceptin are also reviewed. Although clinical studies
of acupuncture to date have met some success, they are rarely scientifically robust
and do not feature randomization and long-term follow up. Based on a great deal
of basic scientific evidence,
large trials are desperately needed to study the effects of acupuncture on the hyperensive man.