External counterpulsation stimulation combined with acupuncture for vascular endothelial function in patients with hypertension: A randomized pilot trial

Objective Endothelial function may improve with enhanced external counterpulsation (EECP) or acupuncture. This study aimed to evaluate the feasibility of acupoint stimulation combined with EECP (acupoint-EECP) for endothelial cell function in patients with essential hypertension. Methods Thirty essential hypertensive patients were, randomly divided into two groups, with 15 patients in the acupoint-EECP group, and 15 patients in the control group, of which 3 cases were lost by week 6. Both groups were treated with continued medicine. The participants in the acupoint-EECP group received acupoint stimulation combined with EECP therapy, 45 min for each time, 5 times weekly for 6 weeks for a total of 22.5 hours. The selected acupoints are Zusanli (ST36), Fenglong (ST40) and Sanyinjiao (SP6). The curative effects of the two groups were compared. Results The acupoint-EECP group (n=15) showed significant improvement in endothelial function [nitric oxide (NO) ?endothelin-1 (ET-1) and carotid-femoral pulse wave velocity (cf-PWV), respectively] values compared to the control group (n=12). Multiple imputation (n = 20 imputations) was performed to account for potential bias due to missing data. In stratified analyses, SBP and DBP values decreased when the baseline SBP was >= 120 mmHg and DBP was >= 80 mmHg. Conclusions These findings suggest the feasibility of acupoint-EECP in improving endothelial function and treating hypertension. (The Chinese clinical trial registration number is ChiCTR2100053795.)