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Acupuncture and blood pressure

Q: I was wondering what the BAcC said on blood pressure limits;  specifically when should practitioners refuse treatment. Or more accurately could you provide figures on the lower and upper limits with regard to acupuncture treatment?

A:  There is nO point at which a BAcC member will refuse treatment because of any inherent risk in the use of acupuncture treatment when someone has extremely high or low blood pressure. In fact, the use of acupuncture for hypertension is reasonably well-researched, and although the evidence is far from conclusive (at least in those studies which meet the perhaps over-strict inclusion criteria used in the West) it is certainly encouraging. At the other end of the scale, there are a number of points which are known to lower blood pressure, and a practitioner may be a little cautious if treating someone who has hypotension, but the needle techniques used in the West are probably too gentle to creat much in the way of a major reaction. However, we have pointed out to medical colleagues that one of the points they use rather vigorously for treating tennis elbow can lower BP by ten points, and to be wary of over-doing it.

The real issue is one of patient management. We all routinely take the BP of a new patient, and if it sits at the end of what doctors take to be the normal range (above 145/95, below 90/60) we all refer to GPs to get the pressure tested in a surgery and officially noted. This would not preclude treatment, but would be simply offering the best care to the patient. If someone with very high blood pressure refused to see their GP and wanted to try to use acupuncture as a main intervention, we would almost certainly advise members to tread very carefully. Refusing to treat would not be an option - it is not our job to 'sack' patients who want to pursue their own choices and the treatment may well work - but we would want to see a member obtaining some very specific consents to treatment, and writing very thorough accounts in their notes of what is happening.

Sadly without statutory regulation we are not formally recognised within the NHS, and therefore we are subject to very strict rules about disclosure without consent. As such we could not go to a patient's GP without their consent. However, where we have met situations like this the persistence of the practitioner has invariably won in the end.

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