Introduction
Hypertension is a series of clinical symptoms marked by increase of blood pressure in the arteries of body circulation. According to the criteria suggested by WHO in 1996, adults with systolic pressure ≥140  mmHg (18.72kPa) and/or diastolic pressure ≥90  mmHg (12.3 kPa)can be diagnosed with hypertension (result of three times of test done not continually in one day). Hypertension should be differentiated from secondary hypertension (symptomatic hypertension). This disease is similar to dizziness and headache in TCM.

It is usually caused by emotional factors, constitutional defects, diet and overstrain that lead to imbalance of yin and yang in the liver, spleen and kidney, eventually resulting in hyperactivity of liver fire, or phlegm disturbing the upper, or frequent asthenia of kidney yin and failing of yin to control yang. It may be caused by consumption of yin involving yang and asthenia of both yin and yang in prolonged disease.

Syndrome Differentiation
1. Hyperactivity of Liver Fire
Headache and dizziness, susceptibility to restlessness and rage, flushed cheeks and redness of eyes, bitter taste in the mouth and dry throat, constipation and brown utine, red tongue and yellow fur, taut and rapid pulse.

2. Phlegm Disturbing the Upper
Headache and dizziness, distension and heaviness of head, fullness and oppression in the chest and epigastrium, anorexia and lassitude, white and greasy tongue fur, taut and slippery pulse.

3. Yin Asthenia and Yang Hyperactivity
Dizziness, headache, tinnitus, top-heaviness, dysphoria and insomnia, aching and weakness of loins and knees, numbness of limbs or tremor of hands and feet, red tongue with scanty fur and thin and taut pulse.

4. Asthenia of Yin and Yang
Dizziness, pale complexion, cold limbs and aching of loins, frequent urination in the night, or vexation, thirst, flushed cheeks, mirror-like tongue with light-red color, deep and thin pulse.

Treatment
1. Body Acupuncture
Prescription:
Fengchi (GB 20), Quchi (LI 11), Hegu (LI 4), Xuehai (SP 10), Fenglong (ST 40) and Taichong (LR 3).

Modification:
For hyperactivity of liver yang, Xingjian (LR 2) and Baihui (GV 20) are added; for phlegm-fire disturbing the upper; Fenglong (ST 40) and Yinlingquan (SP 9) are added; for yin asthenia and yang hyperactivity, Ganshu (BL 18), Shenshu (BL 23), Sanyinjiao (SP 6) and Taixi (KI 3) are added; for asthenia of both yin and yang, Shenshu (BL 23), Guanyuan (CV 4), Zusanli (ST 36) and Sanyinjiao (SP 6) are added; for insomnia and dysphoria, Shenmen (HT 7) is added; for constipation, Zhigou (TE 6) is added; for oppression and fullness in the chest and epigastrium, Neiguan (PC 6) and Zusanli (ST 36) are added; for numbness of limbs, Yanglingquan (GB 34) is added.

Performance:
The needling techniques are selected according to the manifestations of syndromes. For asthenia of both yin and yang, moxibustion can be used or electropuncture may be resorted to for supplementary purpose.

2. Ear Acupuncture
Prescription:
Ear Shenmen (TF4), Upper Fossa (TF1), Liver (CO12), Kidney (CO10), Tubercule (HX8), Adrenal Gland (TG2p), Sympathetic (AH6a) and Subcortical (AT4).

Performance:
Each time 3 - 5 acupoints can be selected and needled with filiform needles with moderate and strong stimulation. The needles are retained for 30 minutes and manipulated once every 5 - 10 minutes, once a day or once every other day. Or Wangbuliuxingzi (Semen Vaccariae) is used for ear pressure. Or three-edged needle is used for bloodletting on the tip of the ear or back of the ear, once every other day.