Table 6.
Results of evidence quality.
| Author, year | Outcomes | Intervention vs. comparison | Studies (participants) | Limitations | Inconsistency | Indirectness | Imprecision | Publication bias | Relative effect (∗95% CI) | Heterogeneity | Quality |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Liu et al., 2012 [26] | The effective rate of lowering blood pressure | Acupuncture vs. western medicine | 7 (612) | -1① | 0 | 0 | -1③ | 0 | OR = 0.93 (0.60, 1.45) | I 2 = 49% | L |
| Acupuncture+western medicine vs. western medicine | 3 (175) | -1① | 0 | 0 | -1③ | -1⑤ | OR = 2.95 (1.45, 6.01) | I 2 = 0% | VL | ||
| The effective rate of improving symptoms | Acupuncture vs. western medicine | 3 (180) | -1① | 0 | 0 | -1③ | -1⑤ | OR = 2.56 (1.22, 5.39) | I 2 = 0% | VL | |
| Acupuncture+ western medicine vs. western medicine | 1 (60) | -1① | 0 | 0 | -2③ | -1⑤ | OR = 9.33, (1.87, 46.68) | I 2 = 0% | VL | ||
|
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| Yu et al., 2013 [27] | The effective rate of lowering blood pressure | Acupuncture vs. western medicine | 14 (1164) | -1① | -1② | 0 | 0 | 0 | RR = 1.036, (0.946, 1.135) | I 2 = 64.7% | L |
| The efficacy of improving SBP | 10 (768) | -1① | -1② | 0 | 0 | 0 | SMD = −0.12 (-0.378, 0.129) | I 2 = 66.4% | L | ||
| The efficacy of improving DBP | 10 (768) | -1① | 0 | 0 | 0 | 0 | SMD = −0.051 (-0.195, 0.092) | I 2 = 44.9% | M | ||
|
| |||||||||||
| Zhang et al., 2013 [28] | The effect of reducing the magnitude of SBP | Acupuncture vs. western medicine | 8 (772) | -1① | -1② | 0 | -1③ | 0 | MD = 1.35 (0.11, 2.59) | I 2 = 90% | VL |
| Acupuncture+western medicine vs. western medicine | 2 (140) | -1① | 0 | 0 | -1③ | -1⑤ | MD = 8.30 (5.51, 11.09) | I 2 = 13% | VL | ||
| Acupuncture vs. sham acupuncture | 1 (160) | -1① | -1② | 0 | -1③ | -1⑤ | MD = 7.00 (4.67, 9.33) | Not applicable | VL | ||
| The effect of reducing the magnitude of DBP | Acupuncture vs. western medicine | 8 (772) | -1① | -1② | 0 | -1③ | 0 | MD = 0.52 (-1.43, 2.46) | I 2 = 78% | VL | |
| Acupuncture+western medicine vs. western medicine | 2 (140) | -1① | 0 | 0 | -1③ | -1⑤ | MD = 4.66 (2.88, 6.45) | I 2 = 0% | VL | ||
| Acupuncture vs. sham acupuncture | 1 (160) | -1① | -1② | 0 | -1③ | -1⑤ | MD = 3.0 (1.29, 4.71) | Not applicable | VL | ||
|
| |||||||||||
| Qian, 2013 [29] | The efficacy of improving 24 h SBP | Acupuncture vs. sham acupuncture | 1 | -1① | -1② | 0 | -1③ | -1⑤ | MD = −5.55 (-8.72, -1.28) | No information | VL |
| Acupuncture+traditional therapy(western medicine/lifestyle modification) vs. traditional therapy | 2 | -1① | -1② | 0 | -1③ | -1⑤ | MD = −7.51 (-10.37, -4.65) | No information | VL | ||
| The efficacy of improving 24 h DBP | Acupuncture vs. sham acupuncture | 1 | -1① | -1② | 0 | -1③ | -1⑤ | No statistical significance | No information | VL | |
| Acupuncture+traditional therapy(western medicine/lifestyle modification) vs. traditional therapy | 2 | -1① | -1② | 0 | -1③ | -1⑤ | MD = −2.27 (-4.32, -0.22) | No information | VL | ||
| The efficacy of improving 12 h SBP | Acupuncture vs. sham acupuncture | 1 | -1① | -1② | 0 | -1③ | -1⑤ | MD = −5.00 (-8.56, -1.44) | No information | VL | |
| Acupuncture+traditional therapy(western medicine/lifestyle modification) vs. traditional therapy | 6 | -1① | -1② | 0 | -1③ | 0 | MD = −7.66 (-9.45, -5.86) | No information | VL | ||
| The efficacy of improving 12 h DBP | Acupuncture vs. sham acupuncture | 1 | -1① | -1② | 0 | -1③ | -1⑤ | No statistical significance | No information | VL | |
| Acupuncture+traditional therapy(western medicine/lifestyle modification) vs. traditional therapy | 6 | -1① | -1② | 0 | -1③ | 0 | MD = −2.87 (-4.16, -1.57) | No information | VL | ||
|
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| Guo et al., 2013 [30] | The effective rate of lowering blood pressure | Acupuncture+western medicine vs. western medicine | 10 (679) | -1① | 0 | 0 | -1③ | 0 | OR = 5.23 (3.24, 8.44) | I 2 = 0% | L |
| The efficacy of improving SBP | 4 (275) | -1① | 0 | 0 | -1③ | 0 | MD = −8.35 (-10.89, -5.81) | I 2 = 0% | L | ||
| The efficacy of improving DBP | 4 (275) | -1① | -1② | 0 | -1③ | 0 | MD = −6.33 (-7.97, -4.69) | I 2 = 92% | VL | ||
|
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| Zhang et al., 2014 [31] | The effective rate of lowering blood pressure | Acupuncture vs. western medicine | 7 (612) | -1① | -1② | 0 | -1③ | 0 | OR = 0.95 (0.45, 2.00) | I 2 = 55% | VL |
| Acupuncture+western medicine vs. western medicine | 4 (262) | -1① | 0 | 0 | -1③ | 0 | OR = 5.13 (2.60, 10.11) | I 2 = 0% | L | ||
| The efficacy of improving SBP | Acupuncture vs. western medicine | 3 (180) | -1① | 0 | 0 | -1③ | -1⑤ | WMD = −3.26 (-7.98, 1.46) | I 2 = 0% | VL | |
| Acupuncture+western medicine vs. western medicine | 2 (152) | -1① | 0 | 0 | -1③ | -1⑤ | WMD = −9.50 (-13.66, -5.34) | I 2 = 0% | VL | ||
| The efficacy of improving DBP | Acupuncture vs. western medicine | 3 (180) | -1① | 0 | 0 | -1③ | -1⑤ | WMD = −2.17 (-5.02, 0.68) | I 2 = 0% | VL | |
| Acupuncture+western medicine vs. western medicine | 2 (152) | -1① | 0 | 0 | -1③ | -1⑤ | WMD = −0.16 (-2.52, 2.19) | I 2 = 0% | VL | ||
|
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| Zhang L, 2017 [32] | The efficacy of improving SBP | Acupuncture vs. western medicine | 23 (1705) | -1① | -1② | 0 | 0 | -1④ | SMD = −0.66 (-1.03, -0.29) | I 2 = 92% | VL |
| Acupuncture+western medicine vs. western medicine | 11 (1029) | -1① | 0 | 0 | 0 | -1④ | SMD = −1.14 (-1.31, -0.96) | I 2 = 38% | L | ||
| The efficacy of improving DBP | Acupuncture vs. western medicine | 23 (1705) | -1① | -1② | 0 | 0 | -1④ | SMD = −0.61 (-1.02, -0.21) | I 2 = 93% | VL | |
| Acupuncture+western medicine vs. western medicine | 11 (1029) | -1① | -1② | 0 | 0 | -1④ | SMD = −1.10 (-1.63, -0.58) | I 2 = 93% | VL | ||
| The effective rate of lowering blood pressure | Acupuncture vs. western medicine | 28 (2271) | -1① | -1② | 0 | 0 | -1④ | RR = 1.10 (1.03, 1.17) | I 2 = 69% | VL | |
| Acupuncture+western medicine vs. western medicine | 14 (1125) | -1① | 0 | 0 | 0 | -1④ | RR = 1.19 (1.13, 1.25) | I 2 = 5% | L | ||
| The effective rate of improving symptoms | Acupuncture vs. western medicine | 7 (465) | -1① | 0 | 0 | 0 | -1④ | RR = 1.21 (1.11,1.31) | I 2 = 0% | L | |
| Acupuncture+western medicine vs. western medicine | 3 (276) | -1① | 0 | 0 | 0 | -1④ | RR = 1.19 (1.09,1.31) | I 2 = 12% | L | ||
| The effective rate of comprehensive treatment | Acupuncture vs. western medicine | 5 (394) | -1① | -1② | 0 | 0 | -1④ | RR = 1.38 (1.14, 1.66) | I 2 = 61% | VL | |
| Acupuncture+western medicine vs. western medicine | 2 (184) | -1① | 0 | 0 | 0 | -1④⑤ | RR = 1.20 (1.07, 1.33) | I 2 = 0% | L | ||
|
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| Zhu and Ding, 2018 [33] | The effective rate of comprehensive treatment | Acupuncture vs. western medicine/acupuncture+western medicine vs. western medicine/acupuncture+behavior therapy vs. western medicine | 22 (1758) | -1① | 0 | 0 | -1③ | 0 | OR = 2.49 (1.92, 4.24) | I 2 = 47% | L |
| The efficacy of improving SBP | 13 (908) | -1① | -1② | 0 | 0 | 0 | WMD = −4.50 (-6.45,-2.55) | I 2 = 86% | L | ||
| The efficacy of improving DBP | 13 (908) | -1① | -1② | 0 | 0 | 0 | WMD = −3.14 (-4.61, -1.66) | I 2 = 86% | L | ||
|
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| Han et al., 2019 [34] | The effective rate of comprehensive treatment | Acupuncture+Tianma Gouteng decoction vs. western medicine/Tianma Gouteng decoction | 6 (694) | -1① | 0 | 0 | -1③ | -1④ | OR = 5.39 (2.97, 9.80) | I 2 = 0% | VL |
| The efficacy of improving SBP | 3 (358) | -1① | -1② | 0 | -1③ | -1④ | OR = −15.49 (-18.48, -12.50) | I 2 = 53% | VL | ||
| The efficacy of improving DBP | 3 (358) | -1① | 0 | 0 | -1③ | -1④ | OR = −9.71 (-11.84, -7.57) | I 2 = 50% | VL | ||
|
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| Lee et al., 2009 [35] | The effect of reducing the magnitude of SBP | Acupuncture vs. sham acupuncture | 3 (358) | -1① | -1② | 0 | -1③ | 0 | MD = −5 (-12, 1) | I 2 = 92% | VL |
| Acupuncture+medication vs. sham acupuncture+western medicine | 2 (170) | -1① | 0 | 0 | -1③ | -1⑤ | MD = −8 (-10, -5) | I 2 = 0% | VL | ||
| The effect of reducing the magnitude of DBP | Acupuncture vs. sham acupuncture | 3 (358) | -1① | -1② | 0 | -1③ | 0 | MD = −3 (-6, 0) | I 2 = 79% | VL | |
| Acupuncture+medication vs. sham acupuncture+western medicine | 2 (170) | -1① | 0 | 0 | -1③ | -1⑤ | MD = −4 (-6, -2) | I 2 = 0% | VL | ||
|
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| Li DZ, 2014 [36] | The efficacy of improving SBP | Electroacupuncture/auricular acupuncture vs. sham acupuncture | 2 (216) | -1① | 0 | 0 | -1③ | 0 | MD = 1.33 (-2.50,5.16) | I 2 = 44% | L |
| Electroacupuncture/auricular acupuncture or + antihypertensive drugs vs. sham acupuncture | 2 (170) | -1① | 0 | 0 | -1③ | -1⑤ | MD = −8.58 (-10.13, -7.03) | I 2 = 17% | VL | ||
| The efficacy of improving DBP | Electroacupuncture/auricular acupuncture vs. sham acupuncture | 2 (216) | -1① | -1② | 0 | -1③ | 0 | MD = −0.18 (-3.98, 3.62) | I2 = 63% | VL | |
| Electroacupuncture/auricular acupuncture or + antihypertensive drugs vs. sham acupuncture | 2 (170) | -1① | 0 | 0 | 0 | -1⑤ | MD = −4, 54 (-5.08, -4.00) | I 2 = 0% | L | ||
|
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| Zhao et al., 2015 [37] | The efficacy of improving SBP | Acupuncture vs. western medicine | 7 (510) | -1① | -1② | 0 | -1③ | 0 | MD = −0.56 (-3.02, 1.89) | I 2 = 60% | VL |
| Acupuncture+western medicine vs. western medicine | 3 (170) | -1① | -1② | 0 | -1③ | -1⑤ | MD = −9.04 (-20.11, 2.02) | I 2 = 94% | VL | ||
| Acupuncture+lifestyle modification vs. lifestyle modification | 1 (60) | -1① | -1② | 0 | -1③ | -1⑤ | MD = −10.53 (-27.52, 6.46) | Not applicable | VL | ||
| The efficacy of improving DBP | Acupuncture vs. western medicine | 7 (510) | -1① | 0 | 0 | -1③ | 0 | MD = −1.01 (-2.26, 0.24) | I 2 = 23% | L | |
| Acupuncture+western medicine vs. western medicine | 3 (170) | -1① | -1② | 0 | -1③ | -1⑤ | MD = −2.87 (-8.45, 2.72) | I 2 = 86% | VL | ||
| Acupuncture+lifestyle modification vs. lifestyle modification | 1 (60) | -1① | -1② | 0 | -1③ | -1⑤ | MD = −7.52 (-15.06, 0.02) | Not applicable | VL | ||
| The effect of reducing the magnitude of SBP | Acupuncture vs. sham acupuncture | 2 (216) | -1① | 0 | 0 | 0 | 0 | MD = 0.30 (-0.27, 0.88) | I 2 = 0% | M | |
| Acupuncture+western medicine vs. sham acupuncture+western medicine | 2 (170) | -1① | 0 | 0 | -1③ | -1⑤ | MD = −7.47 (-10.43, -4.51) | I 2 = 0% | VL | ||
| The effect of reducing the magnitude of DBP | Acupuncture vs. sham acupuncture | 2 (216) | -1① | 0 | 0 | -1③ | 0 | MD = −1.40 (-2.37, -0.44) | I 2 = 8% | L | |
| Acupuncture+western medicine vs. sham acupuncture+western medicine | 2 (170) | -1① | 0 | 0 | -1③ | -1⑤ | MD = −4.22 (-6.26, -2.18) | I 2 = 0% | VL | ||
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| Chen et al., 2018 [38] | The effective rate of lowering blood pressure | Acupuncture vs. antihypertensive drugs | 9 (517) | -1① | -1② | 0 | 0 | -1④ | RR = 1.12 (0.98, 1.28) | I 2 = 78% | VL |
| Acupuncture+lifestyle modifications vs. lifestyle modifications | 2 (187) | -1① | 0 | 0 | 0 | -1④⑤ | RR = 1.2 (1.05, 1.36) | I 2 = 0% | L | ||
| Acupuncture+antihypertensive drugs vs. antihypertensive drugs | 7 (517) | -1① | 0 | 0 | 0 | -1④ | RR = 1.17 (1.08, 1.27) | I 2 = 0% | L | ||
| Electro-acupuncture vs. antihypertensive drugs | 2 (99) | -1① | 0 | 0 | 0 | -1④⑤ | RR = 0.94 (0.76, 1.16) | I 2 = 0% | L | ||
| The efficacy of improving SBP | Acupuncture vs. antihypertensive drugs | 8 (541) | -1① | 0 | 0 | -1③ | -1④ | MD =1.4 (-1.32,4.12) | I2 = 57% | VL | |
| Acupuncture vs. no treatment | 1 (30) | -1① | -1② | 0 | -1③ | -1④⑤ | MD = 5.2 (-2.99, 13.39) | Not applicable | VL | ||
| Acupuncture vs. sham acupuncture | 3 (106) | -1① | 0 | 0 | -1③ | -1④⑤ | MD = 1.59 (-4.63, 7.8) | I 2 = 65% | VL | ||
| Acupuncture+lifestyle modifications vs. lifestyle modifications | 3 (246) | -1① | -1② | 0 | -1③ | -1④ | MD = 10.38 (6.72, 14.04) | I 2 = 86% | VL | ||
| Acupuncture+antihypertensive drugs vs. antihypertensive drugs | 5 (365) | -1① | -1② | 0 | -1③ | -1④ | MD = 9.8 (2.95, 16.65) | I 2 = 94% | VL | ||
| Acupuncture+antihypertesive drugs vs. sham acupuncture+antihypertensive drugs | 2 (170) | -1① | 0 | 0 | -1③ | -1④⑤ | MD = 8.82 (5.1, 12.54) | I 2 = 35% | VL | ||
| Electroacupuncture vs. antihypertensive drug | 3 (200) | -1① | -1② | 0 | -1③ | -1④ | MD = 1.63 (-3.25, 6.52) | I 2 = 57% | VL | ||
| Electroacupuncture+antihypertensive drugs vs. antihypertensive drugs | 1 (59) | -1① | -1② | 0 | -1③ | -1④⑤ | MD = 9.12 (3.96, 14.28) | Not applicable | VL | ||
| The efficacy of improving DBP | Acupuncture vs. antihypertensive drugs | 8 (541) | -1① | -1② | 0 | -1③ | -1④ | MD = 2.04 (-0.59, 4.67) | I 2 = 83% | VL | |
| Acupuncture vs. no treatment | 1 (30) | -1① | -1② | 0 | -1③ | -1④⑤ | MD = 6.1 (1.27,10.93) | Not applicable | VL | ||
| Acupuncture vs. sham acupuncture | 3 (106) | -1① | 0 | 0 | -1③ | -1④⑤ | MD = –0.01 (-2.59, 2.57) | I 2 = 15% | VL | ||
| Acupuncture+lifestyle modifications vs. lifestyle modifications | 3 (246) | -1① | -1② | 0 | -1③ | -1④ | MD = 5.74 (1.94, 9.54) | I 2 = 91% | VL | ||
| Acupuncture+antihypertensive drugs vs. antihypertensive drugs | 5 (365) | -1① | -1② | 0 | -1③ | -1④ | MD = 7.82 (4.67, 10.96) | I 2 = 79% | VL | ||
| Acupuncture+antihypertensive drugs vs. sham acupuncture+antihypertensive drugs | 2 (170) | -1① | 0 | 0 | -1③ | -1④⑤ | MD = 4.44 (1.7, 7.19) | I 2 = 36% | VL | ||
| Electroacupuncture vs. antihypertensive drug | 3 (200) | -1① | 0 | 0 | -1③ | -1④ | MD = −1.98 (-4.85, 0.62) | I 2 = 31% | VL | ||
| Electroacupuncture+antihypertensive drugs vs. antihypertensive drugs | 1 (59) | -1① | -1② | 0 | -1③ | -1④⑤ | MD = 4.46 (-0.25, 9.17) | Not applicable | VL | ||
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| Zhang et al., 2022 [39] | The efficacy of improving SBP | Acupuncture/electroacupuncture/needle warming therapy vs. antihypertensive drugs | 4 (1176) | -1① | 0 | 0 | 0 | -1④ | MD = 3.62 (1.34, 5.90) | I 2 = 56% | L |
| The efficacy of improving DBP | 4 (1176) | 1① | 0 | 0 | 0 | -1④ | MD = 3.12 (1.03, 5.20) | I 2 = 77% | L | ||
Note: VL: very low; L: low; M: moderate; H: high. ① The included studies have a large bias in methodology such as randomization, allocation concealment, and blinding. ② The confidence interval overlaps less or the I2 value of the combined results was larger. ③ The sample size from the included studies does not meet the optimal sample size or the confidence interval was not narrow enough. ④ The funnel chart is asymmetry. ⑤ Fewer studies were included, and their results were all positive, which may result in a large publication bias. ∗The 95% confidence interval does not cross the invalid line.