Evaluating the Impact of Pharmacopuncture on Blood Pressure: Arterial and Autonomic Predictors of Treatment Responsiveness

Abstract

Objective Pharmacopuncture (PA), combining herbal medicine and acupuncture, is used for various conditions, but evidence concerning its use in hypertension remains limited. This retrospective observational study examined blood pressure (BP), pulse wave velocity (PWV), and heart rate variability (HRV) during PA treatment and explored baseline physiological characteristics associated with subsequent BP changes. Methods We analyzed 105 patients receiving PA for hypertension (1,912 visit records) without a control group. Changes in systolic and diastolic BP (SBP, DBP), PWV, and HRV were assessed. Multiple linear regression, linear mixed-effects models, and multivariate Cox proportional-hazards models evaluated associations with clinical change, longitudinal BP trajectories, and visits to target BP thresholds (SBP < 130 mmHg, DBP < 90 mmHg). Exploratory K-means clustering was based on baseline PWV and HRV. Results PA treatment was associated with observed changes in SBP (−23.7 mmHg), DBP (−14.8 mmHg), PWV (−0.8 m/s), and HRV (+6.8 ms; all p < 0.001). Concurrent antihypertensive medication status was not significantly associated with BP changes in the reported models. Male sex was associated with earlier SBP target attainment on the visit scale and a greater observed SBP reduction ( p = 0.043 and p = 0.029, respectively). The lower-baseline-HRV cluster showed a greater observed SBP reduction than the higher-baseline-HRV cluster (ΔSBP: −28.6 vs. −14.6 mmHg, p = 0.018). No serious adverse events were documented during the observation period. Conclusion PA treatment was associated with reductions in BP and PWV and an increase in HRV during the observation period, regardless of pharmacological management. Baseline HRV may represent a potential prognostic marker for differential BP changes, but prospective external validation is required.