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Title 1: The Effects of Acupuncture on Hypertension
Hypertension is a common problem in the UK; indeed, Public Health England (2017) estimates that 12.5 million people in the UK, more than 1 in every 4 adults, have hypertension. Hypertension is problematic because it places the cardiovascular system under chronic excessive strain (Bradley, 2015), and it thereby increases a person’s risk of developing cardiovascular disease. For a person with moderate hypertension, the risk of cardiovascular-related mortality is 1.31 times greater than for a person without hypertension (Wu et al., 2015).
Treating hypertension is a priority identified in UK clinical guidelines (NICE, 2011). The NICE (2011) guidelines recommend that all people in the UK diagnosed with hypertension are prescribed a suitable anti-hypertensive medication/s. However, the costs of these medications are excessive, perhaps upwards of £1 billion per annum (NICE, 2011). Alternative approaches to managing hypertension are important to consider. Acupuncture is one such approach.
Flachskampf, FA, Gallasch, J, Gefeller, O, Gan, J, Mao, J, Pfahlberg, AB, Wortmann, A, Klinghammer, L, Pflederer, W & Daniel, WG (2007), Randomised trial of acupuncture to lower blood pressure, Circulation, vol. 115, no. 24, pp. 3121-3129.
Kim, HM, Cho, SY, Park, SU, Sohn, IS, Jung, WS, Moon, SK, Park, JM, Ko, CN & Cho, KH (2012), Can acupuncture affect the circadian rhythm of blood pressure? A randomised, double-blind, controlled trial, Journal of Alternative and Complementary Medicine, vol. 18, no. 10, pp. 918-923.
Yin, CS, Seo, BY, Park, HJ, Cho, M, Jung, WS, Choue, R, Kim, C, Park, HK, Lee, H & Koh, H (2007), Acupuncture, a promising adjunctive therapy for essential hypertension: A double-blind, randomised, controlled trial, Neurological Research, vol. 29, no. S1, pp. 98-103.
Zheng, H, Li, J, Li, Y, Zhai, L, Wu, X, Chen, J, Li, X, Huang, YL, Chang, XR, Liu, M, Cui, J, Wang, RH, Du, X, Shi, J,Guo, TP & Liang, FR (2018), Acupuncture for patients with mild hypertension: A randomised controlled trial, Journal of Clinical Hypertension, vol. 21, no. 1, pp. 412-420.
Bradley, EG (2015), Nursing Management: Hypertension, in Brown, D, Edwards, H, Seaton, L & Buckley, T (Eds.), Lewis’ Medical-Surgical Nursing: Assessment and Management of Clinical Problems (4th Edn.), Sydney: Mosby-Elsevier, pp.716-734.
National Institute for Health and Care Excellence (NICE) (2011), Hypertension in Adults: Diagnosis and Management, retrieved 21 July 2019, from <https://www.nice.org.uk/guidance/cg127/resources/hypertension-in-adults-diagnosis-and-management-pdf-35109454941637>
Public Health England (2017), Health Matters: Combating High Blood Pressure, retrieved 21 July 2019, from <https://www.gov.uk/government/publications/health-matters-combating-high-blood-pressure/health-matters-combating-high-blood-pressure>
Wu, CY, Hu, HY, Chou, YJ, Huang, N, Chou, YC & Li, CP (2015), High blood pressure and all-cause cardiovascular disease mortalities in community-dwelling older adults, Medicine (online), retrieved 21 July 2019, from <https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/26632749/>
Title 2: The Effects of Acupuncture on Menopausal Hot Flashes
Menopause is the natural process where a woman’s ovarian function progressively ceases (Santoro et al., 2015). It occurs because the aging ovaries become less responsive to pituitary control (Stephenson, 2017) As a result, the ovaries produce less oestrogen (Stephenson, 2017).
Around 74.0% of women experience one or more symptoms of reduced circulating oestrogen levels during menopause (Palacios et al., 2010). One of the most common of these symptoms is ‘hot flashes’, or episodes of flushing, sweating and overheating (Stephenson, 2017). The experience of hot flashes can be extremely uncomfortable for women (Kadakia et al., 2012). Oestrogen-based hormonal therapies are prescribed to manage hot flashes, but these are not always effective and are not without risks (Sassarini & Anderson, 2017). Alternative approaches to managing hot flashes are important to consider. Acupuncture is one such approach.
Avis, NE, Coeytaux, RR, Isom, S, Prevette, K & Morgan, T (2016), Acupuncture in menopause (AIM) study: A pragmatic, randomised controlled trial, Menopause, vol. 23, no. 6, pp.626-637.
Kim, KH, Kang, KW, Kim, DI, Kim, HJ, Yoon, HM, Lee, JM, Jeong, JC, Lee, MS, Jung, HJ & Choi, SM (2010), Effects of acupuncture on hot flashes in perimenopausal and postmenopausal women: A multicenter randomised clinical trial, Menopause, vol. 17, no. 2, pp.269-280.
Painovich, JM, Shufelt, CL, Azziz, R, Yang, Y, Goodarzi, MO, Braunstein, GD, Karlan, BY, Stewart, PM & Merz, CN (2012), A pilot randomised, single blind, placebo-controlled trial of traditional acupuncture for vasomotor symptoms and mechanistic pathways of menopause, Menopause, vol. 19, no. 1, pp.54-61.
Venzke, L, Calvet, JF & Gilbertson, B (2010), A randomised rial of acupuncture for vasomotor symptoms in post-menopausal women, Complementary Therapies in Medicine, vol. 18, no. 2, pp.59-66.
Kakadia, KC, Loprinzi, CL & Barton, DL (2012), Hot flashes: The ongoing search for effective interventions’ Menopause (online), accessed 21 July 2019, from <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3386611/>
Palacios, S, Henderson, VW, Siseles, N, Tan, D & Villaseca, P (2010), Age of menopause and impact of climacteric symptoms by geographical region, Climacteric, vol. 13, no. 5, pp.419-428.
Santoro, N, Epperson, CN & Matthews, SB (2015), Menopausal symptoms and their management, Endocrinology and Metabolic Clinics of North America, vol. 44, no. 3, pp. 497-515.
Sassarini, J & Anderson, RA (2017), New pathways in the treatment of menopausal hot flushes, The Lancet, vol. 389, no. 10081, pp. 1775-1777.
Stephenson, CN (2017), The Acupuncturist’s Guide to Conventional Medicine (2nd Edn.), Philadelphia: Singing Dragon, p.461-500.
Title 3: The Effects of Acupuncture on Induction of Labour
Induction of labour – that is, facilitating the onset of the physiological labour process – is now a “routine” part of obstetric care (Kehl et al., 2015: p.283). In the UK, 32.6% of women who give birth in a hospital have labour induced (National Health Service [NHS] Digital, 2018). Induction is required for a variety of reasons, including because labour is overdue and/or there are issues with the wellbeing of the mother/fetus which require expedited delivery (Sinkey et al., 2018).
Labour can be induced in a variety of ways, including via amniotomy, cervical balloon catheter and the administration of artificial hormones (Mozurkewich et al., 2011). However, these are not always effective at facilitating the onset of labour, and many are associated with significant negative side-effects such as uterine hyperstimulation (Mozurkewich et al., 2011). Alternative approaches to inducing labour are important to consider. Acupuncture is one such approach.
Gaudet, LM, Dyzak, R, Aung, SKH & Smith, GN (2008), Effectiveness of acupuncture for the initiation of labour at term: A pilot randomised controlled trial, Journal of Obstetrics and Gynaecology Canada, vol. 30, no. 12, pp. 1118-1123.
Modlock, J, Nielsen, BB & Uldbjerg, N (2010), Acupuncture for the induction of labour: A double-blind randomised controlled study, British Journal of Obstetrics and Gynaecology (online), retrieved 21 July 2019, from <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2955967/>
Smith, C, Crowther, C, Collins, C & Coule, M (2008), Acupuncture to induce labour: A randomised controlled trial, Obstetrics and Gynaecology, vol. 112, no. 5, pp. 1067-1074.
Torkzahrani, S, Mahmoudikohani, F, Saatchi, K, Sefidkar, R & Banaei, M (2019), The effect of acupressure on the initiation of labour: A randomised controlled trial, Women and Birth (online), retrieved 21 July 2019, from <https://www.ncbi.nlm.nih.gov/pubmed/27444642>
Kehl, S, Weiss, C, Dammer, U, Raabe, E, Burghaus, S, Heimrich, J, Hackl, J, Winkler, M, Beckmann, MW & Faschingbauer, F (2015), Induction of labour: Change of method and its effectiveness, Geburtshilfe und Frauenheilkunde, vol. 75, no. 3, pp. 238-243.
Mozurkewich, EL, Chilimgras, JL, Berman, DR, Perni, UC, Romero, VC, King, CJ & Keeton, KL (2011), Methods of induction of labour: A systematic review, BMC Pregnancy and Childbirth (online), retrieved 21 July 2019, from <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3224350/>
NHS Digital (2018), NHS Maternity Statistics, England 2017-18, retrieved 21 July 2019, from <https://digital.nhs.uk/data-and-information/publications/statistical/nhs-maternity-statistics/2017-18>
Sinkey, RG, Lacevic, R, Relic, T, Hozo, I, Gibson, KS, Odibo, AO, Djulbegovic, B & Lockwood, CJ (2018), Elective induction of labour at 39 weeks among nulliparious women: The impact on maternal and neonatal risk, PLoS One (online), retrieved 21 July 2019, from <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5918610/>
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