Acupuncture-based interventions for blood pressure control and cardiovascular risk-related outcomes in adults with hypertension: a systematic review and meta-analysis of randomized controlled trials.

Blood pressure control remains difficult in many adults with hypertension, and safe non-pharmacological strategies that can support conventional care are clinically relevant. This systematic review and meta-analysis evaluated acupuncture-based interventions for blood pressure control and cardiovascular risk-related outcomes in adults with hypertension. Randomized studies were identified from major biomedical databases and trial registers from inception to 16 March 2026. The primary synthesis focused on penetrating acupuncture and electroacupuncture, while non-penetrating acupoint stimulation was examined in extended analyses. Risk of bias was assessed using RoB 2, and certainty of evidence was evaluated using GRADE. Sixteen study reports representing 15 independent randomized studies were included. For end-of-treatment office blood pressure, acupuncture-based interventions reduced systolic blood pressure (MD -6.63 mmHg, 95% CI: -11.41 to -1.84) but showed no clear effect on diastolic blood pressure (MD -0.07 mmHg, 95% CI: -9.54 to 9.39). Change-score analyses showed a significant reduction in office diastolic blood pressure (MD -3.97 mmHg, 95% CI: -7.26 to -0.68), while systolic change crossed the null. Ambulatory blood pressure evidence was sparse; 24-h ambulatory diastolic change favored acupuncture-based interventions. No confirmed acupuncture- or stimulation-related serious adverse event was clearly reported. Overall, acupuncture-based interventions may support blood pressure control, especially systolic office blood pressure and diastolic change outcomes.