Summary of findings 2. Safety of acupuncture for primary hypertension.

Safety of acupuncture for primary hypertension
Patient or population: people with primary hypertension Settings: primary care and community settings Intervention: acupuncture for 6‐10 weeks Comparison: sham acupuncture and antihypertensive drugs
Outcomes	Impacts	No of participants (studies)	Certainty of the evidence (GRADE)
Adverse events	There were adverse events associated with acupuncture in treating hypertension. Most events were trivial, including pain sensation during needle insertion and small spot‐bleeding (Kim 2012; Macklin 2006; Yin 2007). One study reported a serious adverse event, hypertensive emergency, in the acupuncture group (Flachskampf 2007). No deaths were reported from these trials.	426 (4 studies)	⊕⊕⊝⊝1 Low
GRADE Working Group grades of evidence High certainty: Further research is very unlikely to change our confidence in the estimate of effect. Moderate certainty: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low certainty: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low certainty: We are very uncertain about the estimate.

¹Downgraded 2 levels due to limited available data for judgment and lack of consistency of reports across studies.