Acupuncture in Traditional Chinese Medicine: A Complementary Approach for Cardiovascular Health

This comprehensive narrative review examines the role of Traditional Chinese Medicine acupuncture as a complementary approach for cardiovascular disease. Cardiovascular diseases represent the leading cause of global mortality, responsible for 17.9 million deaths annually. In this context, acupuncture emerges as a promising therapy that may complement conventional medical treatment. The study explores the theoretical foundations of Traditional Chinese Medicine, particularly the concepts of Qi and blood, and how their imbalances may contribute to cardiovascular disease.

Emotional factors such as stress and anxiety can interrupt the flow of Qi, impairing blood circulation and increasing cardiovascular risk. The review emphasizes that diet, lifestyle, and emotional factors play crucial roles in cardiovascular health from the TCM perspective. The mechanisms by which acupuncture exerts therapeutic effects on the cardiovascular system are multifactorial and include modulation of the autonomic nervous system, anti-inflammatory effects, improvement in endothelial function, reduction of oxidative stress, and modulation of neurotransmitters. Acupuncture demonstrates the ability to reduce sympathetic nervous system activity while increasing parasympathetic activity, resulting in a decrease in heart rate and blood pressure.

The acupuncture points most commonly used for cardiovascular health include Neiguan (PC-6), located on the inner forearm and commonly used for cardiac symptoms such as chest pain and palpitations; Zusanli (ST-36), located below the knee and effective in improving circulation; Taichong (LR-3), between the toes, useful for improving blood flow; and Hegu (LI-4), between the thumb and index finger, associated with the reduction of blood pressure. The analysis of clinical evidence reveals encouraging results across several cardiovascular conditions. For hypertension, a meta-analysis of 23 randomized clinical trials with 1,788 patients indicated that acupuncture as adjuvant therapy may be more effective in reducing systolic and diastolic blood pressure than sham acupuncture combined with medication. In the treatment of coronary artery disease, a 2019 meta-analysis involving 24 studies and 1,916 patients demonstrated that those who received adjuvant acupuncture had a significantly higher efficacy rate compared with standard treatment alone.

For arrhythmias, studies have shown that acupuncture is safe and effective in relieving symptoms of atrial fibrillation and in reducing the recurrence rate after procedures such as radiofrequency ablation. A meta-analysis revealed that acupuncture significantly improved conversion rates in patients with atrial fibrillation. In cases of heart failure, although the evidence is limited, studies suggest benefits such as reduced ICU length of stay, improvement in hemodynamic parameters, and increased exercise capacity and quality of life. The limitations identified include methodological variations across studies, the need for standardization of applications for specific conditions, and inadequate reporting of adverse events in some studies.

The review concludes that acupuncture represents a promising complementary approach for the management of cardiovascular diseases, demonstrating the ability to effectively reduce blood pressure, decrease coronary artery events, mitigate arrhythmias, and improve cardiac function when used in conjunction with conventional medication. Future research is needed to establish standardized protocols and to validate its integration into cardiovascular clinical care.