Insufficient oxygen supply to heart muscle cells is called ischaemic heart disease. This condition is potentially life threatening, and may lead to myocardial infraction. Due to the life style and diet domineering in developed countries, including Poland, the rate of ischaemic disease cases has systematically been rising, more and more often afflicting young people and women. Because of complex aetiology, inevitably connected with patients lifestyle.

This is why many people search for alternative or complementary methods of treatment.

The efficiency of acupuncture in treatment of ischaemic heart disease manifesting as angina pectoris was proven beyond any doubt. Lately, in December 2012, the meta-analysis was published in which 16 randomized controlled clinical trials were included(source)1 In conclusions, authors state that acupuncture applied as a method complementing pharmacotherapy is distinctively more efficient that the drugs themselves both in alleviating the symptoms of angina pectoris, and improving the objective indices such as ECG recording.  Moreover, acupuncture as an independent method of treatment of angina pectoris, also reveals distinctively greater effectiveness than medications, however the relief is experienced slightly later, which may indicate that acupuncture should not be applied in the treatment of acute myocardial infraction.

The last statement contradicts the proved outcomes of acupuncture effect in the course of acute infraction. During research, the results of which were published in the late 80-ties, it was revealed that acupuncture improves microcirculation and functions of left hearth ventricle during myocardial infraction(source)2,(source)3

STRENGTH OF EVIDENCE
Power of arguments

„Acupuncture is more effective than pharmacology in reducing symptoms of angina pectoris” 
However the relief is felt a bit later than in case of using drugs

“Acupuncture added to pharmacotherapy is significantly better than pharmacotherapy alone in reducing the symptoms of angina pectoris and improving objective parameters like ECG”

Mechanisms

Angina pectoris results from myocardial ischaemia. Therapeutic action of acupuncture in treatment of angina pectoris involves mainly the decrease of ischaemia. Acupuncture shows the comprehensive impact on human body, so this effect takes place using different mechanisms.

Studies on animal models show that acupuncture slows down the heart beating(source)4 This activity is connected with the decrease of arterial pressure and lowered afterload of left heart ventricle(source)5 What is more, acupuncture causes blood redistribution in coronary vessels(source)6, secretion of β-endorphins in myocardium(source)7, dilatation of coronary vessels and increased collateral circulation in coronary system(source)8

Acupuncture reduces heart muscle ischaemia:

  • slows down the heartbeat
  • reduces blood pressure and lowers the afterload of left ventricle
  • improves coronary circulation (dilates the vessels and improves collateral circulation)
  • increases secretion of β–endorphins in the heart
BIBLIOGRAPHY

1 Chen J, Ren Y, Tang Y, Li Z, Liang F. „Acupuncture therapy for angina pectoris: a systematic review” J Tradit Chin Med. 2012 Dec;32(4):494-501

2 Zhu BJ, Bi L, Liang SY, Pang L, Wang SL, Liu JF, Jiang AP, Li CJ, Ye ZJ, Yang: „Effect of acupuncture on left ventricular function, microcirculation, blood rheology and cyclic nucleotides in patients with acute myocardial infarction”. J Tradit Chin Med 1989; 9:63-68.

3 Li CJ, Bi LG, Zhu BJ, Qi MZ, Zhao CX, Xu YF, Yao ZL, Lu ZS, Sun SM, Dong H, et al: „Effects of acupuncture on left ventricular function, microcirculation, cAMP and cGMP of acute myocardial infarction patients”. J Tradit Chin Med 1986; 6:157-161.

4 Uchida S, Kagitani F, Hotta H. „Neural mechanisms of reflex inhibition of heart rate elicited by acupuncture-like stimulation in anesthetized rats”. Auton Neurosci. 2010 Oct 28;157(1-2):18-23

5 Tsung O. Cheng (2013). „Acupuncture in Cardiology”, w „Acupuncture in Modern Medicine”, Dr. Lucy L Chen (Ed.), ISBN: 978-953-51-1020-0, InTech, DOI: 10.5772/55252. Available from: http://www.intechopen.com/books/acupuncture-in-modern-medicine/acupuncture-in-cardiology

6 Mannheimer C, Eliasson T, Augustinsson L-E, Blomstrand C, Emanuelsson H, Larsson S, Norrsell H, Hjalmarsson A: „Electrical stimulation versus coronary artery bypass surgery in severe angina pectoris. The ESBY study.” Circulation 1998; 97:1157-1163.

7 Kurono Y, Egawa M, Yano T, Shimoo K: „The effect of acupuncture on the coronary arteries as evaluated by coronary angiography: a preliminary report”. Am J Chin Med 2002; 30:387-396

8 Tsung O. Cheng (2013). „Acupuncture in Cardiology”, w „Acupuncture in Modern Medicine”, Dr. Lucy L Chen (Ed.), ISBN: 978-953-51-1020-0, InTech, DOI: 10.5772/55252. Available from: http://www.intechopen.com/books/acupuncture-in-modern-medicine/acupuncture-in-cardiology

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