To systematically evaluate the efficacy of pure acupuncture in the treatment of essential hypertension.

Databases including China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, VIP Chinese Journal Service Platform, Chinese Biomedical Literature Database (SinoMed), PubMed, Cochrane Library, Embase, and Web of Science were searched for randomized controlled trials (RCTs) on pure acupuncture for essential hypertension, from database establishment to February 29th of 2024. After data extraction and bias risk assessment of the included studies, Meta-analysis was performed using RevMan 5.4 software.

A total of 19 RCTs involving 1738 patients were included. The Meta-analysis results showed that: compared with Western medicine, acupuncture was superior in improving the effective rate of blood pressure reduction ［RR=1.10, 95%CI (1.01, 1.20), P=0.03］, reducing patients' systolic blood pressure ［MD=-5.55, 95%CI (-9.85, -1.25), P=0.01］ and diastolic blood pressure ［MD=-5.27, 95%CI (-8.74, -1.80), P=0.003］； compared with sham acupuncture, acupuncture was superior in reducing patients' diastolic blood pressure ［MD=-2.11, 95%CI (-3.95, -0.26), P=0.03］, but there was no statistically significant difference in reducing systolic blood pressure between acupuncture and sham acupuncture ［MD=-3.52, 95%CI (-10.57, 3.54), P=0.33］; the incidence of adverse reactions in the acupuncture group was lower than that in the control group ［RR=0.19, 95%CI (0.08, 0.42), P<0.001］.

Pure acupuncture can effectively reduce patients' systolic and diastolic blood pressure, improve the effective rate of blood pressure reduction, with fewer adverse reactions. However, limited by the quantity and quality of included studies, the above conclusions need to be verified by more researches.