The effect of auricular therapy on blood pressure: A systematic review and meta-analysis.
JiaLiang Gao, Guang Chen, HaoQiang He and 4 others
PMID 31583887WHAT IT FOUND
Adding ear acupressure to blood pressure medicines lowered systolic readings by 5.06 mm Hg and diastolic readings by 5.30 mm Hg more than medicines alone after trials with larger starting pressures were excluded, but other ear therapy comparisons were inconsistent.
Key findings
01In the pooled trials, the change in systolic blood pressure from baseline to after treatment was 5.06 mm Hg lower in the ear acupressure plus drug group than in the drug-only group after four outlier trials were excluded, and the change in diastolic blood pressure was 5.30 mm Hg lower.
02Across 44 randomized trials involving 5022 participants, only 25 trials were similar enough to combine, and comparisons of auricular acupressure with antihypertensive drugs were not consistent.
03Trials of bloodletting in the auricle reported local adverse events, including hematoma and swelling, and two trials comparing it with antihypertensive drugs found no difference in efficacy rate.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 17 of 44 trials reported how the random sequence was generated, no trial reported allocation concealment, only three mentioned blinding, and only four mentioned dropouts. No trial provided a pre-trial sample size estimation. Only 25 of 44 trials were combined by meta-analysis; the rest were described separately because the comparisons or data were not consistent enough. The main blood pressure result depended on excluding four trials with larger baseline blood pressure values. Heterogeneity was high in several comparisons, and data could not be pooled in some ear acupressure versus drug trials. The review could not assess long-term effectiveness, cardiovascular outcomes, or effects by age, disease duration, target auricles, or treatment course. Bloodletting is a traumatic intervention and reported local adverse events, including hematoma and swelling. The included trials varied in ear points and intervention duration, from 20 minutes to 12 weeks.
Declared interests
The authors declared no conflict of interest. The research was funded by the Innovative Funding for PhD candidates at China Academy of Chinese Medical Sciences.
The easy way to misread this
Do not conclude that ear therapy alone controls hypertension. The clearest pooled benefit was for ear acupressure added to antihypertensive drugs, and bloodletting had local adverse events.