There are two main types of hypertension: primary and secondary. Primary hypertension doesn’t have a single cause. It typically relates to risk factors such as genetics, age, and lifestyle. Secondary hypertension happens because of an underlying cause, such as certain health conditions and medications. Between 5% and 10% of people withhigh blood pressure have secondary hypertension.

Acupuncture and primary hypertension

Acupuncture may help you manage primary hypertension, especially if it helps minimize the impact of risk factors such as age and stress. One 2021 study involved 122 women who had gone through menopause. Half of the women received 4 weeks of acupuncture every 6 months for 2 years, while the other half didn’t receive any treatment. According to the results, acupuncture appeared to significantly lower both systolic and diastolic blood pressure for the women who received acupuncture. Chronic stress can also increase your chances of developing primary hypertension — and according to 2014 research, acupuncture could help lower your stress levels over time.

Acupuncture and secondary hypertension

Acupuncture may not help manage secondary hypertension directly. A 2019  of 44 people with obstructive sleep apnea — a condition that can cause secondary hypertension —found that acupuncture seemed to have no effect on the participants’ blood pressure. Still, acupuncture may help relieve symptoms of conditions that can cause secondary hypertension, including:

• thyroid conditions
• type 2 diabetes
• kidney disease
• pregnancy

One 2018 study included 22 pregnant women with preeclampsia, a condition that involves high blood pressure. Half the women received up to 10 acupuncture sessions over 2 weeks, while the other half received treatment as usual. Adding acupuncture to the usual treatments for preeclampsia lowered both systolic and diastolic blood pressure more than the usual treatments alone. By the end of the study, participants who received acupuncture experienced significantly more improvement in their blood pressure than those who received treatment as usual. A 2019 case study even found acupuncture helped one woman keep her pregnancy after receiving a preeclampsia diagnosis at 27 weeks. After 5 weeks of acupuncture and acupressure, she gave birth at week 34 to a baby with Apgar scores of 8 and 9 — in other words, a healthy newborn.

According to TCM practitioners, acupuncture helps balance your body’s qi, or vital energy. Acupoints are the specific points where qi can flow from your organs to the surface of your body. Meridians, or pathways, connect these external points to your internal organs. When an acupuncturist stimulates combinations of specific acupoints in the right way, it’s thought to balance your qi and help regulate different bodily functions, including your blood pressure. Scientific evidence has yet to find an explanation for exactly how acupuncture works, but stimulating certain points on your body may act on your body’s central nervous system, influencing blood flow as well as the way your body produces key hormones. When it comes to hypertension, acupuncture may help regulate your blood pressure by acting on the hormones involved in the renin-angiotensin-aldosterone system (RAAS). This system keeps up a level blood pressure and balances your fluids and electrolytes. In particular, acupuncture may change how the hormones and enzymes in your RAAS show up in your blood and stimulate receptors in your body that regulate blood pressure. Acupuncture could also act on your limbic system to increase your levels of the neurotransmitter dopamine, which plays a key role in your brain’s reward system. Research from 20201 suggests dopamine may lower oxidative stress — an excess of free radicals — and help keep your blood pressure balanced. Research also highlights acupuncture’s relaxing effects on the walls of your arteries and veins, which may help lower your blood pressure.

What about acupressure?

Acupressure, a related approach, involves stimulating acupoints by applying fingertip pressure rather than needles. You can also try acupressure yourself once you learn the right points to stimulate. Research exploring acupressure’s effectiveness for hypertension does suggest it may help regulate blood pressure alongside traditional treatments:

• A small 2016 study found pressure on the taichong point helped lower blood pressure. While the results only lasted for 30 minutes, the study authors suggest you could use this strategy at home to help keep up low blood pressure.
• A small 2019 study suggests acupressure lowers your blood pressure by stimulating blood circulation and relaxation. While the study didn’t identify which points participants used, it did suggest acupressure could help older adults lower their blood pressure at home.
• A 2020 review found that auricular acupressure, or acupressure on certain points on your ear, could offer a non-invasive way to lower your blood pressure yourself, especially as a boost to other treatments.

How to try it

The taichong point is one of the most common acupoints for hypertension. To stimulate it through acupressure:

• Find the space between your big toe and the toe next to it.
• Using a finger, feel for the groove between the bones, or metatarsals, that extend in the direction of your ankle.
• Move your finger down that groove an inch or two until you hit a stopping point — that’s the taichong point.

Does it actually work?

Many smaller studies suggest acupuncture can help improve hypertension:

• A small 2015 study found 33 participants treated with acupuncture had lower systolic and diastolic blood pressure after 8 weeks of treatment.
• A 2018 review found that acupuncture treatments helped lower blood pressure for anywhere from 1 to 24 hours.
• A 2019 review found that acupuncture combined with Western medicine approaches could help improve hypertension more effectively than Western medicine alone.

Even so, experts call into question the quality and rigor of many of these studies. Acupuncture may certainly help lower blood pressure for many people. Yet, as most research points out, these results often don’t last for long. You’d likely need sessions weekly, if not more frequently, to make acupuncture a long-term approach to lowering your blood pressure. Future high-quality research may offer more support for acupuncture’s ability to improve hypertension.

Safety and side effects

When performed by a board certified acupuncturist, acupuncture is generally safe for most people, with little risk of side effects. Side effects aren’t common, but you could notice:

• bruising or bleeding
• pain where the needle is inserted
• nausea
• dizziness
• tiredness

Issues can arise if your practitioner doesn’t use sterile, single-use needles. But for trained and licensed acupuncturists, this is standard practice. Improperly performed acupuncture could lead to infection or, in rare cases, serious side effects such as central nervous system injuries or punctured organs. You’ll want to ask a healthcare professional before trying acupuncture if you have a bleeding disorder such as hemophilia or a metal allergy.

While its effectiveness for lowering blood pressure in the long-term remains up for debate, smaller studies suggest acupuncture could temporarily help improve high blood pressure. You can safely use acupuncture alongside most blood pressure medications, and this combo could do more to lower your blood pressure than medication alone. If needles aren’t your thing, at-home acupressure could also have a temporary, but noticeable, positive impact on hypertension.