Traditional acupuncture does not modulate the endothelial dysfunction induced by mental stress Acupuncture and endothelial dysfunction Zolta´n Jambrik 1 , Lu Chunzeng 1 , Enrica L. Santarcangelo 2 , Laura Sebastiani 2 , Brunello Ghelarducci 2 & Eugenio Picano 1 1 Echocardiography Lab, Institute of Clinical Physiology, CNR, Pisa, Italy; 2 Department of Physiology and Biochemistry ‘‘G. Moruzzi’’, University of Pisa, Italy Received 12 December 2003; accepted in revised form 22 April 2004 Key words: acupuncture, endothelial function, mental stress, hypnotizability Abstract Acupuncture is a useful tool to treat many diseases, including cardiovascular disorders, but its modulation of stress-related responses is still debated. Aim of this study was to estimate whether the traditional Chinese acupuncture affected the transient impairment of the brachial artery flow-mediated dilation (FMD) pro- duced by acute mental stress. In addition, since a high susceptibility to hypnosis attenuates the endothelial dysfunction elicited by mental calculation, the possible interaction between acupuncture and hypnotiz- ability was investigated. Five low-to-medium and five medium-to-high hypnotizable healthy subjects joined two experimental sessions, for real and sham acupuncture. FMD and heart rate were measured in three conditions: baseline (PRE), after the real or sham acupuncture (ACU) and after mental calculation (MS). Needles were inserted into specific acupoints for real acupuncture and into non-acupoints, corresponding to the same spinal segment, for sham acupuncture. Results showed that the stress-related endothelial dys- function was not modulated by acupuncture, but influenced by hypnotizability. In fact, highly hypnotizable subjects did not present any dysfunction, at variance with non-susceptible individuals that exhibited the expected stress-related FMD reduction (Mean ± SD; PRE, 12.10 ± 2.59; ACU, 10.73 ± 3.45; MS, 6.48 ± 1.72). Thus, hypnotizability appears more effective than acupuncture in contrasting the stress effects on the endothelial function. In conclusion, our study indicates the importance of patients’ psychological evaluation in order to choose proper relaxation techniques and to evaluate therapeutic results and the necessity to integrate the alternative medicine practice with scientific research. Introduction According to the traditional Chinese medicine, acupuncture stimulation at sites along specific meridians restores the flow of vital energy in the body [1]. Indeed, acupuncture has been proven to be a useful tool to treat many diseases, including cardiovascular disorders [2, 3]. Recent studies in animal models have shown that it lowers blood pressure [4], nor-epinephrine in the brain circula- tion and blood adrenal hormones [5] and reduces the post-stress elevation of the heart rate, blood pressure and plasma catecholamines level [6, 7]. Results on the cardiovascular effects of acute acupuncture in humans are not univocal. Indeed, sensory stimulation by acupuncture in healthy persons is associated with changed activity in the sympathetic and parasympathetic nervous system depending on the site of stimulation and on the period of observation [8]. Also, acupuncture The International Journal of Cardiovascular Imaging 20: 357–362, 2004. Ó 2004 Kluwer Academic Publishers. Printed in the Netherlands. 357