Effectiveness evaluation of heat-sensitive moxibustion self-management in community patients with essential hypertension: a randomized controlled trial

To evaluate the effectiveness, safety and compliance of heat-sensitive moxibustion self-management in community patients with essential hypertension.

A total of 120 patients with essential hypertension were recruited from three communities and randomly assigned at a 1∶1 ratio to either the intervention group (heat-sensitive moxibustion self-management combined with original antihypertensive regimen) or the control group (original antihypertensive regimen alone). In the intervention group, heat-sensitive moxibustion was applied to one main acupoint with the strongest moxibustion sensation selected from three main acupoints (Yongquan[KI1], Baihui [GV20], Shenque[CV8]) and one adjunct acupoint with the strongest moxibustion sensation selected from five adjunct acupoints (Quchi [LI11], Zusanli [ST36], Hegu[LI4], Taichong[LR3], Dazhui [GV14]). The treatment lasted approximately 30 minutes once daily, with flexible adjustment of frequency allowed. The intervention and follow-up period lasted 6 months. The primary outcome was the reduction in systolic blood pressure. Secondary outcomes included the reduction in diastolic blood pressure, antihypertensive effective rate, changes in antihypertensive medication dosage, traditional Chinese medicine (TCM) symptom score for hypertension, quality of life score measured by the EuroQol Five-Dimension Five-Level Questionnaire (EQ-5D-5L), and incidence of new-onset cardiovascular and cerebrovascular events. Compliance with heat-sensitive moxibustion self-management and incidence of adverse events were also assessed.

A total of 89.2% (107/120) of patients completed the 6-month follow-up. At the end of the 6-month intervention, the reduction in systolic blood pressure from baseline was significantly greater in the intervention group than in the control group (P<0.01), whereas no significant difference was observed in the change in diastolic blood pressure from baseline between the two groups. The antihypertensive effective rate was significantly higher in the intervention group than in the control group (P<0.05). The intervention group showed significantly greater improvements in the EQ-5D-5L overall health self-rating score, total TCM hypertension symptom score, and individual symptoms including headache, tinnitus and red eyes compared with the control group (P<0.01, P<0.05). All heat-sensitive moxibustion-related adverse events were mild.

Heat-sensitive moxibustion self-management can reduce systolic blood pressure, improve antihypertensive effective rate, and alleviate hypertension-related symptoms and quality of life in community patients with essential hypertension, with favorable safety and compliance. These findings suggest that heat-sensitive moxibustion can be promoted as an adjunctive management strategy for essential hypertension in community settings.