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Effects of Acupuncture on Arterial Hypertension and Endothelial Dysfunction: The AHEaD Trial
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Original Article

Effects of Acupuncture on Arterial Hypertension and Endothelial Dysfunction: The AHEaD Trial

Amanda Rodrigues Bitencourt et al. Ana Luiza Lima Sousa Paulo Cesar B. Veiga Jardim Alexandre Massao Yoshizumi … Mikaelle Costa Correia Priscila Valverde de Oliveira Vitorino Sandro Rogério Rodrigues Batista Weimar Kunz Sebba Barroso

Abstract

Background

Sympathetic overactivity, oxidative stress, and impaired nitric oxide (NO)-mediated vasodilation are key mechanisms involved in the pathogenesis of hypertension. Acupuncture may decrease blood pressure by modulating autonomic nervous system activity, increasing NO bioavailability, attenuating sympathoexcitatory responses, and promoting vasodilation.

Objective

To evaluate whether acupuncture decreases peripheral systolic blood pressure (pSBP), peripheral diastolic blood pressure (pDBP), central systolic blood pressure (cSBP), central diastolic blood pressure (cDBP), and pulse wave velocity (PWV), and improves flow-mediated dilation (FMD).

Methods

This prospective, single-blind, placebo-controlled, single-center randomized clinical trial included adults with prehypertension or stage 1 hypertension who were at low cardiovascular risk and were not receiving antihypertensive therapy. Participants were randomly assigned to an intervention group receiving manual acupuncture (n = 14) or a control group receiving nonpenetrating sham acupuncture (n = 16). Both groups underwent two 30-minute sessions per week for 12 weeks. The primary outcome was the between-group difference in pSBP measured at baseline (V1), after 12 weeks of treatment (V2), and at the 30-day end-study visit (V3). Statistical significance was defined as p < 0.05.

Results

Baseline characteristics were comparable between the groups. At V2, acupuncture decreased pSBP by 13.2 mmHg (p = 0.003) and increased FMD by 2.7% (p = 0.016). In the control group, pSBP decreased by 4.1 mmHg (p = 0.035), whereas FMD increased by 1.6% (p = 0.029). Compared with the control group, the intervention group demonstrated significantly greater improvements in pSBP (−9.1 mmHg, p = 0.006) and FMD (+3.0%, p = 0.037) at V2. These between-group differences remained significant at V3 (pSBP: −8.4 mmHg, p = 0.038; FMD: +2.9%, p = 0.028).

Conclusion

Acupuncture significantly improved endothelial function and decreased pSBP in adults with prehypertension or stage 1 hypertension who were not receiving antihypertensive therapy after 12 weeks of treatment.

  • Acupuncture
  • Hypertension
  • vascular endothelium
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Creative Commons Attribution (CC BY) Creative Commons license
17/08/2026 DOI: 10.36660/abc.20260462i Views 2
Figure 1
ABC
Research Letter

Acupuncture for Essential Hypertension and Endothelial Dysfunction: A Randomized Clinical Trial

Amanda Rodrigues Bitencourt et al. Ana Luiza Lima Sousa Priscila Valverde de Oliveira Vitorino Mikaelle Costa Correia … Alexandre Massao Yoshizumi Weimar Kunz Sebba Barroso

Introduction

Arterial hypertension (AH) is one of the main modifiable risk factors for cardiovascular diseases, as it causes increased arterial stiffness and endothelial dysfunction since early stages.

Sympathetic hyperactivity and activation of the renin-angiotensin-aldosterone system (RAAS) are among the major pathophysiological mechanisms of AH, in addition to an overproduction of reactive oxygen species (ROS) and imbalances in the nitric oxide (NO) availability. The increase in endothelial permeability in response to low NO synthesis explains the correlation of AH with atherosclerosis and makes the analysis of endothelial function a useful tool for clinical assessment.,,

[…]

  • Acupuncture
  • Endothelium
  • Hypertension
  • Prehypertension
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Creative Commons Attribution (CC BY) Creative Commons license
17/02/2025 DOI: 10.36660/abc.20240596i Views 1

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Bitencourt AR, Sousa ALL, Jardim PCBV, Yoshizumi AM, Correia MC, Vitorino PVO, Batista SRR, et al. Effects of Acupuncture on Arterial Hypertension and Endothelial Dysfunction: The AHEaD Trial. Arquivos Brasileiros de Cardiologia 2026;123(7):e20260462.

Electronic Document Format (ABNT)

Bitencourt, Amanda Rodrigues; Sousa, Ana Luiza Lima; Jardim, Paulo Cesar B. Veiga; Yoshizumi, Alexandre Massao; Correia, Mikaelle Costa; Vitorino, Priscila Valverde de Oliveira; Batista, Sandro Rogério Rodrigues; Barroso, Weimar Kunz Sebba. Effects of Acupuncture on Arterial Hypertension and Endothelial Dysfunction: The AHEaD Trial. Arquivos Brasileiros de Cardiologia, v. 123, n. 7, e20260462, Aug. 2026.

Electronic Document Format (APA)

Bitencourt, A. R., Sousa, A. L. L., Jardim, P. C. B. V., Yoshizumi, A. M., Correia, M. C., Vitorino, P. V. O., Batista, S. R. R., & Barroso, W. K. S. (2026). Effects of Acupuncture on Arterial Hypertension and Endothelial Dysfunction: The AHEaD Trial. Arquivos Brasileiros de Cardiologia, 123(7), e20260462.

Electronic Document Format (ISO)

Bitencourt, Amanda Rodrigues and Sousa, Ana Luiza Lima and Jardim, Paulo Cesar B. Veiga and Yoshizumi, Alexandre Massao and Correia, Mikaelle Costa and Vitorino, Priscila Valverde de Oliveira and Batista, Sandro Rogério Rodrigues and Barroso, Weimar Kunz Sebba. Effects of Acupuncture on Arterial Hypertension and Endothelial Dysfunction: The AHEaD Trial. Arquivos Brasileiros de Cardiologia [online]. 2026, vol. 123, n. 7, [cited 2026-10-14], e20260462. Available from: <https://journals.cardiol.br/en/article/effects-of-acupuncture-on-arterial-hypertension-and-endothelial-dysfunction-the-ahead-trial/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Bitencourt AR, Sousa ALL, Vitorino PVO, Correia MC, Yoshizumi AM, Barroso WKS. Acupuncture for Essential Hypertension and Endothelial Dysfunction: A Randomized Clinical Trial. Arquivos Brasileiros de Cardiologia 2025;122(1):e20240596.

Electronic Document Format (ABNT)

Bitencourt, Amanda Rodrigues; Sousa, Ana Luiza Lima; Vitorino, Priscila Valverde de Oliveira; Correia, Mikaelle Costa; Yoshizumi, Alexandre Massao; Barroso, Weimar Kunz Sebba. Acupuncture for Essential Hypertension and Endothelial Dysfunction: A Randomized Clinical Trial. Arquivos Brasileiros de Cardiologia, v. 122, n. 1, e20240596, Feb. 2025.

Electronic Document Format (APA)

Bitencourt, A. R., Sousa, A. L. L., Vitorino, P. V. O., Correia, M. C., Yoshizumi, A. M., & Barroso, W. K. S. (2025). Acupuncture for Essential Hypertension and Endothelial Dysfunction: A Randomized Clinical Trial. Arquivos Brasileiros de Cardiologia, 122(1), e20240596.

Electronic Document Format (ISO)

Bitencourt, Amanda Rodrigues and Sousa, Ana Luiza Lima and Vitorino, Priscila Valverde de Oliveira and Correia, Mikaelle Costa and Yoshizumi, Alexandre Massao and Barroso, Weimar Kunz Sebba. Acupuncture for Essential Hypertension and Endothelial Dysfunction: A Randomized Clinical Trial. Arquivos Brasileiros de Cardiologia [online]. 2025, vol. 122, n. 1, [cited 2026-10-14], e20240596. Available from: <https://journals.cardiol.br/en/article/acupuncture-for-essential-hypertension-and-endothelial-dysfunction-a-randomized-clinical-trial/>. ISSN 0066-782X

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