Acupuncture decreases the risk of heart disease in rheumatoid arthritis patients. Based on a sample size of 9,932 patients from the Taiwanese National Health Insurance Research Database, researchers determined that rheumatoid arthritis patients had a significantly lower risk of developing coronary heart disease if they received acupuncture. [1] This applies to patients receiving manual acupuncture or electroacupuncture. In addition, beneficial additive effects were found when combining acupuncture with conventional therapies.
Increased mortality rates for rheumatoid arthritis patients are largely due to the increased rate of cardiovascular disorders. Chronic inflammation and immune system regulation dysfunction are factors. The researchers note that prior investigations find acupuncture beneficially reduces inflammation, which may be partially responsible for its therapeutic benefits.
The research team notes that acupuncture is preventative against the development of coronary heart disease in rheumatoid arthritis patients regardless of age, sex, and whether or not patients suffer from diabetes, hyperlipidemia, or hypertension. Also, acupuncture reduced the risk of coronary heart disease in rheumatoid arthritis patients taking statin medications. In addition, the research demonstrates that acupuncture results in a lower incidence of ischemic heart disease.
The research team examined prior clinical trials that find acupuncture effective in reducing swelling and improving range of motion at the knees. Prior trials also indicate that acupuncture improves quality of life scores and the ability to engage in physical activities.
Many rheumatoid arthritis patients take methotrexate (an immune system suppressant) and TNF-α (a proinflammatory cytokine) inhibitors. The research indicates that both of these substances reduce the risk of coronary heart disease. However, for patients taking one or both of these medications, acupuncture provides an added benefit by further decreasing the risk of developing coronary heart disease.
The research team notes that chronic inflammation is a key factor in the development of rheumatoid arthritis and its comorbidities. They add that ameliorating inflammation is an important component of any treatment plan for rheumatoid arthritis patients. The research team cited several investigations finding acupuncture effective in reducing inflammation. One investigation found acupuncture effective in balancing levels of Th17 and Treg cells (T helper cells), which directly correlated with decreases in rheumatoid arthritis severity.
The investigation produced two consistent findings for rheumatoid arthritis patients: acupuncture reduces inflammation and produces an analgesic effect. Additional findings include that acupuncture enhances the effects of conventional therapies for patients with diabetes and hypertension.
The researchers note that it was difficult to quantify the average number of acupuncture office visits and length of treatment time for patients in the study. The national Taiwanese database documents the frequency of care and total number of acupuncture visits based on the amount covered by the NHI (National Health Insurance) program. The NHI covers a maximum of three acupuncture visits per week and a total of fifteen acupuncture visits per month.
Some patients may have received additional acupuncture visits by using self-pay (out of pocket expense). Based on this quantitative limitation, the research team suggests that future research should determine exact treatment frequency protocols that optimize patient outcomes. Additionally, they suggest a comparison between a static set of acupuncture points applied to all patients in one arm of a study with another arm receiving points based on individualized differential diagnostic point prescriptions that reflect actual clinical scenarios.
Reference:
1. Wu, Mei-Yao, Ming-Cheng Huang, Hou-Hsun Liao, Jen-Huai Chiang, Yu-Chen Lee, Chung-Y. Hsu, Mao-Feng Sun, and Hung-Rong Yen. "Acupuncture decreased the risk of coronary heart disease in patients with rheumatoid arthritis in Taiwan: a Nationwide propensity score-matched study." BMC complementary and alternative medicine 18, no. 1 (2018): 341.
