A single treatment with acupuncture could reduce the heightened risk of stroke associated with rheumatoid arthritis (RA), according to results of a study published in BMJ Open.1,2 According to a press release, the effects of acupuncture were independent of sex, age, medication use, and coexisting conditions.1
“Unstable blood pressure and lipid profiles are the 2 risk factors for ischemic stroke, and acupuncture therapy has the advantage of controlling both hypertension and dyslipidemia,” the investigators said in the press release. “If acupuncture relieves morning stiffness and joint pain, patients might also benefit from increasing daily activities, which might also reduce the risk of stroke.”1
Acupuncture is used to control pain and decrease inflammation, according to the press release. Investigators aimed to determine whether that could also lower the risk of ischemic stroke by reducing levels of cytokines linked to cardiovascular disease.1 According to the study authors, common prescriptions among study participants included non-steroidal anti-inflammatory drugs, steroids, disease-modifying antirheumatic drugs, and biological agents such as infliximab and etanercept.2
The researchers used medical records from the Registry for Catastrophic Illness Patients Database, including 47,809 individuals who were newly diagnosed with RA between 1997 and 2010. The final analysis included 23,226 individuals, 12,266 of whom were treated with acupuncture following diagnosis until December 2010.1 According to the study authors, ambulatory and inpatient medical records were used.2
Key Takeaways
- The study suggests that acupuncture may lower the risk of ischemic stroke in individuals with rheumatoid arthritis (RA).
- Acupuncture is known to control pain and inflammation, and the study proposes that it may also mitigate the risk of stroke by reducing levels of cytokines associated with cardiovascular disease.
- While the study indicates a lower stroke risk among RA patients treated with acupuncture, it's important to note that the research is observational. Thus, definitive cause-and-effect conclusions cannot be drawn.
Of the individuals treated with acupuncture, 11,613 were matched with those who were not treated with acupuncture for age, sex, co-existing diseases, medication use, and year of diagnosis. The population was majority women, individuals aged 40 through 59, and those with high blood pressure.1 Common comorbidities were hypertension, diabetes, hyperlipidemia, and congestive heart failure, according to the study authors.2
Approximately 87% of those in the acupuncture group were treated with manual acupuncture; 3% were treated with electroacupuncture, which includes a low-pulsing electrode attached to the needle; and 10% received both types, according to the press release. A mean of 1065 days elapsed between RA diagnosis and first acupuncture treatment. Patients received an average total of 10 treatments.1
Investigators found that in the monitoring period, which continued until the end of 2011, 946 individuals had an ischemic stroke with the risk growing with increased age and number of co-existing conditions. Individuals with hypertension were twice as likely to have a stroke compared with those with normal blood pressure, and those with diabetes were also 58% more likely to have a stroke. Investigators reported that in the acupuncture group, 341 individuals compared with 605 individuals in the non-acupuncture group experienced a stroke, which is approximately a 43% lower risk, according to the press release.1
The study was an observational study, so cause and effect could not be established, and the severity of disease was estimated by investigators due to the medication the patients took, according to the press release. Furthermore, information on factors, including height, weight, lab tests, and physical activity levels, were not available. Patients would also have different pressure points needled, the investigators added in the press release.1
Reference
Acupuncture may curb heightened risk of stroke associated with rheumatoid arthritis. News release. EurekAlert. February 13, 2024. Accessed February 13, 2024. https://www.eurekalert.org/news-releases/1034017
Huang CY, Huang MC, Liao HH, L CL, et al. Effect of acupuncture on ischaemic stroke in patients with rheumatoid arthritis: a nationwide propensity score-matched study. BMJ Open. 2024;14(2):e075218. Published 2024 Feb 13. doi:10.1136/bmjopen-2023-075218
