1/2 | Dr. Hunlong Yan, professor and dean of the School of Traditional Chinese Medicine at China Medical University, is the lead author of a study showing that acupuncture may reduce stroke risk in patients with rheumatoid arthritis.Photo provided by: China Medical University
NEW YORK, Feb. 13 (UPI) — Rheumatoid arthritis patients are at increased risk of stroke, but new research shows acupuncture may reduce that risk.
The study was conducted by Taiwan’s China Medical University and published Tuesday in the open access journal BMJ Open.
This effect appears to be independent of gender, age, drug use, or other pre-existing conditions, and the researchers found that acupuncture reduced levels of pro-inflammatory proteins called cytokines that are associated with cardiovascular disease. It suggests that it may be possible.
The main cause of death in patients with rheumatoid arthritis is cardiovascular disease. And they were more likely to have a stroke than the general population, the study’s researchers noted.
Acupuncture has been used to control pain and reduce inflammation, but researchers sought to find out whether acupuncture could reduce the risk of ischemic stroke. This type of stroke is caused by a blood clot in the brain and is accompanied by systemic inflammation.
“Acupuncture is known as a complementary approach to improve pain. Even in Taiwan, many patients visit Chinese herbal clinics for acupuncture treatment,” said lead author of the study and director of National Taiwan University said Dr. Hung Long Yen, professor and dean. Department of Traditional Chinese Medicine at China Medical University told UPI in an email.
“Our previous study showed that 10.9% of the general Taiwanese population used acupuncture,” Yen said.
“Among patients with rheumatoid arthritis, 23.6% had received acupuncture. It would be interesting to know whether acupuncture has long-term effects in these patients, not just short-term effects on pain. That’s it.”
Potential long-term effects
Yen added that this study reveals a possible long-term effect of acupuncture on stroke prevention. He said it should be considered as a standard treatment for rheumatoid arthritis because it is not as expensive as immunosuppressants or biologics.
The researchers relied on national medical records from the Catastrophic Disease Registry database for 47,809 adults newly diagnosed with rheumatoid arthritis between 1997 and 2010.
Yen said these numbers represent 99% of Taiwan’s total population of 23 million and have a long-term follow-up period. “The power of ‘big data’ and ‘real-world evidence’ has allowed us to determine the effectiveness of acupuncture,” he said.
The final analysis included 23,226 patients with complete data, of whom 12,266 received acupuncture treatment after diagnosis until the end of December 2010.
Of these patients, 11,613 were matched to non-acupuncture patients on age, gender, comorbidities, drug use and disease-modifying therapies, and year of diagnosis.
Women between the ages of 40 and 59 and participants with high blood pressure made up the majority of both groups.
Mainly manual acupuncture
Most of the acupuncture group (87%) were treated with manual acupuncture (87%). 3% received electroacupuncture. In this treatment, electrodes were attached to the needles to generate low electrical pulses. 10% received both types.
An average of 1,065 days passed between rheumatoid arthritis diagnosis and first acupuncture treatment, and the average number of sessions was approximately 10.
During the monitoring period up to the end of 2011, 946 patients suffered ischemic stroke. Risk increased with age and with number of comorbidities.
For example, people with high blood pressure were more than twice as likely to have a stroke than people with normal blood pressure, and people with diabetes were 58% more likely to have a stroke.
However, there were significantly fewer cases of ischemic stroke in the acupuncture group: 341 versus 605, corresponding to a 43% lower risk. And this was independent of age, gender, drug use, and comorbidities.
The authors acknowledged that because this was an observational study, firm conclusions about cause and effect cannot be drawn. Moreover, it was only possible to estimate the severity of the disease from the drugs the patient took.
There was also a lack of information about potentially influencing factors, such as height, weight, laboratory tests, and physical activity levels, and not all patients had the same acupuncture points.
Lifestyle factors
“Addressing cardiovascular risk in these patients requires not only proper medication management but also measures such as diet and exercise,” said Dr. Chiti Parikh, executive director of the Integrative Health and Wellbeing Program at Weill Cornell Medicine. It is important to consider other lifestyle factors.” And NewYork-Presbyterian Church was not involved in the study.
However, Parikh said acupuncture is safe and can offer more options for rheumatoid arthritis patients, especially those who experience stiffness and joint pain on a daily basis but cannot tolerate certain medications. he added.
“By reducing inflammation, acupuncture can alleviate these symptoms and improve quality of life and athletic performance,” she said.
“Rheumatoid arthritis is a systemic inflammatory condition,” said Jacob Wolf, a naturopathic physician and certified acupuncturist at Conner Hall Health University Hospital in Cleveland.
He added: “Although the main focus of symptoms is often in the joints, there is an underlying inflammatory process that can also affect the cardiovascular system.”
Dr. John Magaldi, chief of rheumatology at Hartford HealthCare’s Bone and Joint Institute in Hartford, Conn., recommends that patients receive acupuncture treatment given the minimal risks it poses. He said it would not prevent him from doing so, but said he could not claim that acupuncture reduces the risk. Risk of ischemic stroke.
medicine is effective
This type of stroke is more associated with high blood pressure and high cholesterol than with inflammation. Drugs for these conditions have “significantly reduced heart disease and stroke,” Magaldi said.
“The link between stroke and rheumatoid arthritis is not only plausible, but likely,” said Dr. Shaiba Ansari Ali, a rheumatologist at Northwestern Medicine Delnor Hospital in Geneva, Illinois. .
Using acupuncture as an adjunct to standard treatment for rheumatoid arthritis can calm an overactive immune system, but to avoid permanent damage and long-term complications, the underlying disease must be treated. remains important, noted Dr. Ansari Ali.
“Acupuncture is a practice that has been used for thousands of years and is a safe, non-invasive treatment for improving some diseases,” said Dr. Gary Soffer, an integrative medicine specialist at Yale Medicine in New Haven, Connecticut. We offer a low-cost alternative.”
“Despite being practiced for thousands of years, there is little research and limited understanding of how it actually works,” Soffer says. “That’s why a study of this scale has so many of us in the integrative medicine community so excited.”
