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A groundbreaking new study is testing whether an age-old therapy might help treat a modern-day ailment. Nine of ten Americans will eventually develop hypertension. And while drug therapies save lives by reducing pressure readings and preventing heart attacks and strokes, some people cannot--or will not--take prescription medicines.
Dr. Randall Zusman, lead researcher in the Stop Hypertension with Acupuncture Program (SHARP) told Medical Update he was "pretty committed" to drug therapy for blood pressure control when he enrolled the first patients in the clinical trial. Editor Patrick Perry interviewed Dr. Zusman to learn more about the ongoing study.
PP: Could you tell us about the SHARP study?
RZ: Our hypothesis is that acupuncture therapy will control the blood pressures of patients who have been taken off their medications, or who have never started it. To qualify, participants must have blood pressure values in excess of 140/90. We are comparing three different treatment regimens delivered as 12 treatments over a six-week period and then following the patients' blood pressures for one year We are first conducting a pilot trial of 180 patients. If the initial review of the data shows a statistical success, we will conduct a 900-patient trial which would conclude sometime in 2004 or 2005. People interested in participating in this trial may call 617-724-0407.
PP: How can acupuncture help control blood pressure?
RZ: Blood pressure is related to the resistance of blood flow in the blood vessels and the amount of blood being forced through those vessels. We believe that acupuncture reduces blood pressure by affecting the resistance component. Muscular cells of the blood vessel wall are induced in some way to relax as a result of the acupuncture process. It could be related to neurogenic factors: that is, an interaction between the central nervous system, the brain, the peripheral nervous system, and the vessel; or it could be related to a change in the hormonal balance, a decrease in those hormones that constrict the vessels and an increase in those hormones that dilate the vessels; or a combination of those possibilities. As yet, we really don't know.
PP: If the study yields positive results, could acupuncture offer an alternative for some individuals?
RZ: Acupuncture offers an alternative to drug therapy for those who are reluctant or unable to take medications. It also offers an alternative to initial therapy as an adjunct to nondrug therapies--weight loss, salt restriction, elimination of tobacco use, modest alcohol ingestion--we try to use in everybody.
We hope to hone in on who is most likely to respond. We are looking at the demographic characteristics of our patients. Age, gender, and race are the obvious ones, but we are also looking at how long they have been hypertensive, how high the blood pressure is, and whether there is a family history of high blood pressure to try to identify the patient population most likely to be responsive.
PP: Are you excited about preliminary observations?
RZ: Absolutely. I must say that I went into it with considerable skepticism, having had no experience with alternative medical techniques. But when I hurt my back last June, I had acupuncture treatments by one of our people. My personal response was striking. That convinced me of the potential for the treatment in various medical conditions.
People really need to understand that hypertension is the major risk factor for stroke and heart attack. Many patients will say that if they have a heart attack and die, it doesn't worry them--that is how they want to go. The problem is that people have strokes, don't die, and are significantly disabled. That is what they ought to be thinking about when contemplating whether to have their blood pressures controlled."
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