Can acupuncture ease chest pain caused by stable angina?

USA: A large body of research has shown that acupuncture can help mitigate many types of chronic pain. But little is known about its effect on ischemic pain, which is caused when the heart isn’t getting enough oxygen, as is the case with stable angina.

Researchers at the University of Illinois Chicago have received a $3.12 million National Institutes of Health grant to study whether acupuncture can alleviate chest pain caused by stable angina. Stable angina is defined as predictable chest pain during exertion or when under mental or emotional stress and is a condition that affects millions of Americans.

The two-site study will be led by principal investigators Judith Schlaeger, associate professor in the College of Nursing, and Holli DeVon, professor emeritus in the College of Nursing who is also a professor and the Audrienne Endowed Chair in Research at UCLA. Dr. Joan Briller, cardiologist and professor of clinical medicine in the College of Medicine, is co-investigator and content expert.

In a previous pilot study, the team found that acupuncture reduced pain and improved the quality of life for participants.

Chest pain from stable angina is often the result of cholesterol buildup in the arteries that reduces blood flow to the heart, Briller explained. But many people with stable angina have it for other reasons, such as when the tiny arteries that deliver blood to tissues malfunction and don’t let enough oxygen through. Treating these patients with therapies that are designed to reduce cholesterol-caused blockages often doesn’t work, leaving them with what can be debilitating flare-ups of chest pain.

“The idea of using acupuncture is a really novel one and it would be terrific if it works,” Briller said.

Chest pain from angina can significantly reduce a person’s quality of life, causing them to avoid physical activity or potentially stressful situations.

“Having chronic pain, no matter what the cause is, is debilitating and exhausting,” said DeVon, who will be recruiting patients at UCLA in addition to those recruited by Briller and Schlaeger at UIC. “I’m excited to be offering an alternative to patients who have not gotten complete pain relief from medication.”

Schlaeger points out that there is a huge disparity among those who have access to acupuncture in this country, both because acupuncturists tend to practice in wealthier neighbourhoods and because the treatment can be costly. Study participants will largely come from medically underrepresented groups who will have access to acupuncture for the first time, as was the case in the pilot study.

“Participants in the pilot were really delighted to be offered an intervention that they’ve heard about but had been beyond their reach,” Schlaeger said.

The grant from the National Institute of Nursing Research is funding the four-year study, which will enroll 112 participants who have been diagnosed with stable angina, are experiencing symptoms at least once a week and have been receiving medical treatment for their pain for at least a month. Participants will be randomly assigned to either receive acupuncture twice a week for five weeks or will watch TED Talk videos for roughly two hours each week for five weeks. They will then be followed for three months to determine how long the acupuncture is effective in reducing pain. Participants will be surveyed on their pain levels, symptom control, quality of life and other health indicators throughout the study.