The efficacy of integrative medicine in the treatment of essential hypertension: a meta-analysis

Abstract

Objective: We aim to evaluate the efficacy of integrating Chinese and modern medicine in the management of essential hypertension. Methods: Five electronic databases were systematically searched for eligible randomised clinical trials from 2002 to 2022, according to PRISMA-P terminologies. Quality assessment for the included studies was assessed using the criteria from Cochrane Risk of Bias guidelines. Meta-analysis was conducted in the Review Manager 5.4.1 software. The apriori-association algorithm was used to characterise prescription regularities and elucidate the core herbal network for essential hypertension. Results: Our search yielded a total of 32 studies comprising 2926 patients. Meta-analysis revealed the integrative intervention group presents higher overall efficacy than that of the conventional treatment group [RR=1.15,95%CI(1.10,1.20),p<0.00001]. The intervention group experienced better therapeutic outcomes in terms of endpoint blood pressures and TCM syndrome scores as well. We also characterised the core herbal network for hypertension to be Achyranthes bidentata, Gastrodia elata, Uncaria rhynchophylla, and Eucommia ulmoides. Conclusion: We suggest that integrative medicine might be effective in lowering blood pressure and alleviating symptoms for patients with essential hypertension. Nonetheless, the evidence remains weak due to unclear methodological quality of the included studies. Well-designed and long-term clinical trials are required to further warrant its use.

Keywords – Chinese medicine; Essential hypertension; Integrative medicine; Meta-analysis; Core prescription analysis.