Young-Eun Kim

Effects of acupuncture in postmenopausal women with prehypertension or stage 1 hypertension: study protocol for a prospective, comparative, interventional cohort study

Background Hypertension is a major cause of cardiovascular disease and associated mortality, and postmenopausal women are at a high risk of hypertension. We aim to investigate the hypotensive effect and safety of acupuncture, focusing on postmenopausal women with prehypertension and stage 1 hypertension. In addition, we aim to investigate whether the effect of acupuncture treatment differed, depending on Sasang Constitution and cold–heat pattern. Methods This study is designed as an intervention cohort study. Two hundred postmenopausal women aged <65 years with prehypertension or stage 1 hypertension living in Daejeon city in Korea will be recruited, and randomly assigned to either an acupuncture or no-treatment control group. The intervention will consist of four sessions; one session will include acupuncture performed 10 times for 4 weeks. There will be a 20-week observation period after each session, and the total study duration will be 96 weeks. Acupuncture will be applied at the bilateral Fengchi (GB20), Quchi (LI11), Zusanli (ST36), and Sameumgyo (SP6) acupoints. The effect of acupuncture will be evaluated by comparing the change in systolic and diastolic blood pressure between the acupuncture and control groups every 4 weeks until the end of the study. Discussion To evaluate the success of blood pressure management, long-term observation is required, but no long-term studies have been conducted to evaluate the effect of acupuncture on blood pressure in postmenopausal women. To our knowledge, this study will be the first long-term study to investigate this issue for more than 6–8 weeks.

PS 11-07 Interactions between Antihypertensives and Herb: Review

Objective: Hypertension is common disease and many people are taking herbs and other plant-based dietary supplements to improve their health. The aim of this study was to assess the published clinical evidence on herb-drug interaction for the management of hypertension patients. Design and Method: We systematically searched papers through the MEDLINE, OASIS, CNKI, J-stage and CiNii until November 2014. Searching queries were made with 493 herbal plants, 72 herb formulas, 148 prescribed Kampo drugs and 81 antihypertensives. We reviewed the relevant studies and extracted information about herb-drug interactions, level of evidence, adverse events of herb-drug interaction studies, the intensity and the causality of the adverse reactions by using WHO-UMC adverse drug reaction causality assessment. Results: Total 141 papers were analyzed and 100 herb-drug pairs (34 antihypertensives, 49 botanical foods, 32 oriental herb drugs, 2 western herbs) were reported in those articles. 49 herbs increased antihypertensive effects, 13 herbs decreased antihypertensive effects. 23 herbs did not show any interactions, 3 herbs showed conflicting interaction results. 35 herb-drug interactions were reported with pharmacodynamics results, 19 herb-drug interactions were reported with randomized control trial results, 23 herb-drug interactions were reported with results of non-randomized control trial or case report. In 39 herb-drug pairs 28 kinds of adverse reactions were reported. Rhabdomyolysis, dyspnea, paralysis with electrolyte abnormality and dermatitis were reported as serious adverse effects enough to be hospitalized. According to WHO-UMC causality criteria, we could assess the reactions at 29 possible, 5 probable, 3 unlikely, 1 unclassifiable causality. Conclusions: Although many reports on antihypertensives-herb interactions were published, few studies have been conducted the laboratory analysis of suspect preparations. Present knowledge of herb-drug interactions is incomplete and adverse reaction may put individuals at risk. More research is still needed and health-care practitioners should be careful about using herb and hypertensive drugs.