Disease and Condition Overview
Hypertension is characterized by systolic blood pressure is consistently over 140 mmHg and or diastolic blood pressure is consistently over 90 mmHg. Clinical symptoms of hypertension include headache, vertigo and dizziness. In Chinese medicine, hypertension is closely related to kidney yin deficiency, liver yang uprising, emotional issues, improper diet and internal injuries, etc.
Clinically, hypertension is differentiated into “primary hypertension” and “secondary hypertension”. The cause for primary hypertension is non-specific. It may be closely related to heredity, age, body type, profession, emotional well being and diet, etc. Secondary hypertension, which only accounts for 5% of hypertension cases, is caused by existing diseases in one's body or systems.

Pair-point Treatment Combinations

(1) Tianzhu (BL1O), Shugu (BL65) (Fig 91)
Tianzhu (BL10): on the nape, in the depression of the lateral border of the trapezius muscle and 1.3 cun lateral to the midpoint of the posterior hairline.
Shugu (BL65): on the lateral side of the foot, posterior to the fifth metatarsophalangeal joint, at the junction of the red and white skin.
Tianzhu (BL1O) soothes tendons and activates luo-connecting channels, regulates qi and blood, Shugu (BL65) disperses and opens channels, guides blood to flow downward. This pair point combination, the superior echoes the inferior, promotes and elevates qi of the taiyang, soothing tendons and activating luo-connecting channels, regulate and defensive and nutritive qi. Appropriate for treating hypertension accompanied by distension and discomfort in the nape and back.
Needling techniques:
Tianzhu (BL1O) perpendicular insertion 0.5-1 cun.
Shugu (BL65) perpendicular insertion 0.5 cun.

(2) Tianzhu (BL10), Yanglao (SI6) (Fig 35)
Tianzhu (BL10) soothes tendons and activates luo-connecting channels, regulates qi and blood. Yanglao (SI6) regulates and harmonizes the qi in the channel. This pair point combination, both located on the taiyang channel, the two points echo and couple the effects of each other, opens and regulates channels, regulates qi and blood. Appropriate for hypertension accompanied by severe headache 0n the apex and difficulty in head movement.
Needling techniques:
Tianzhu (BL10) perpendicular insertion 0.5-1 cun.
Yanglao (SI6) upwards oblique insertion 0.5 cun.
Use even manipulation method for 10 minutes.

(3) Fengchi (GB20), Hegu (LI4) (Fig 17)
Fengchi (GB20) primarily dispels wind. Hegu (LI4) primarily clears heat. This pair point combination, one clears and one disperses, one elevates while the other lowers, regulates qi and blood, dispels wind and clears orifices. Appropriate for hypertension accompanied by distending occipital headaches, hot and flushed face.
Needling techniques:
Fengchi (GB20) point towards direction of the throat, perpendicular insertion 1.5 cun.
Hegu (LI4) perpendicular insertion 1 cun.

(4) Hegu (LI4), Taichong (LV3)
Hegu (LI4) clears heat, opens fu organs and channels. It also invigorates luo-connecting channels. Taichong (LV3) soothes the liver and regulates qi, pacifies liver and extinguishes wind. This pair point combination, one yin one yang, regulates and harmonize yin and yang, opens channels and invigorates luo-connecting channels, clears heat and extinguishes wind. Appropriate for treating hypertension caused by liver yang uprising.
Needling techniques:
Hegu (LI4) perpendicular insertion 1 cun.
Taichong (LV3) perpendicular insertion 1 cun.

(5) Waiguan (SJ5), Zulinqi (GB41) (Fig 14)
Waiguan (SJ5) unobstructs qi stagnation in Sanjiao (upper, middle and lower jiao) to disperse its stagnated heat. Zulinqi (GB41) disperses and reduces liver and gallbladder, regulate qi and blood. This pair point combination, both located on the shaoyang channel, they echo and couple the effects of each other, clear reduce liver and gallbladder. Appropriate for hypertension with liver yang rising upward.
Needling techniques:
Waiguan (SJ5) perpendicular insertion 1 cun.
Zulinqi (GB41) perpendicular insertion 1 cun.

(6) Fengchi (GB20), Shuiquan (KI5) (Fig 92)
Fengchi (GB20): on the nape at the same level as Fengfu (DU16), in the depression between the origins of the sternocleidomastoid and trapezius muscles.
Shuiquan (KI5): on the medial side of the foot, posten0r and anterior to the medial malleolus, 1 cun inferior to Taixi (KI3), in a depression anterior and superior to the calcaneal tuberosity.
Fengchi (GB20) dispels wind and pacifies liver. Shuiquan (KI5) clears heat and tonifies yin. This pair point combination, tonifies and reduces in conjunction to dispel wind, clears heat, “replenish water to nourish wood”. Appropriate for hypertension caused by yin deficiency with excess fire and liver yang rising upward.
Needling techniques:
Fengchi (GB20) point towards direction of the throat perpendicular insertion 1.5 cun.
Shuiquan (KI5) perpendicular insertion 0.5 cun.

(7) Taixi (KI3), Taichong (LV3) (Fig 19)
Taixi (KI3) tonifies kidney and strengthen yuan, Taichong (LV3) soothes the liver and regulates qi. This pair point combination, tonifies kidney, pacifies liver, subdues liver yang. Appropriate for hypertension caused by yin deficiency with excess fire, liver yang rising upward.
Needling techniques:
Taixi (KI3) perpendicular insertion 0.5 cun.
Taichong (LV3) perpendicular insertion 1 cun.

(8) Erjian (LI2), Lidui ST45) (Fig 93)
Erjian (LI2): on the radial side of the index finger, in the depression distal to the second metacarpo-phalangeal joint on the radial side. Slightly clench fist to locate the point.
Lidui (ST45): on the lateral side of the distal segment of the second toe, 0.1 cun proximal to the comer of the nail.
Erjian (LI2) clears heat in the large intestine. Lidui (ST45) clears and reduces stomach heat. This pair point combination, both located on the yangming channel, echoes and couples the effects of each other, clears head and face, and reduces yangming pathogenic heat. Appropriate for treating hypertension caused by excess yangming heat, turbid ql uprising.
Needling techniques:
Erjian (LI2) perpendicular insertion 0.5 cun.
Lidui (ST45) perpendicular insertion 0.5 cun.

(9) Zusanli (ST36), Xuanzhong (GB39) (Fig 11)
Zusanli (ST36) harmonizes stomach, reverses the rising and regulates qi and blood, Xuanzhong (GB39) reduces heat, dispel wind and strengthen body. This pair point combination, clears pathogenic heat in gallbladder harmonizes stomach, tonify marrow in the orifices. Appropriate for stroke patients with elevated blood pressure.
Needling techniques:
Zusanti (ST36) perpendicular insertion 2 cun.
Xuanzhong (GB39) perpendicular insertion 1 cun.
Or direct moxa using small moxa sticks.
Continued long term treatment can prevent the recurrence of stroke.

(10) Baihui (DU20), Yongquan (KI1) (Fig 20)
Baihui (DU20) strengthens mind, pacifies liver and extinguishes wind. Yongquan (KI1) subdues yang, lowers fire, and calms the mind. This pair point combination, regulates the ascending and descending, working in conjunction to tonify kidney, pacify liver, subdue yang and lower blood pressure. Appropriate for hypertension caused by irregular ascending or descending of yin and yang.
Needling techniques:
Baihui (DU20) posterior subcutaneously needle 1 cun.
Excess yang -- prick a few drops of blood.
Deficient rising yang -- moxa using moxa stick for 10 minates.
Yongquan (KI 1) perpendicular insertion 1 cun.

Commentaries
Acupuncture treatment of hypertension is effective for those in the beginning stage. For later stages of hypertension, although it is possible to improve symptoms, one must take extreme caution when needling or applying moxa.
Before employing acupuncture treatment, it is important to differentiate between various clinical symptoms and select points accordingly.
If accompanied by distension and discomfort in the nape and back, select Tianzhu (BL10), Shugu (BL65).
If accompanied by severe headache and difficulty in head movement, select Tianzhu (BL10), Yanglao (SI6).
If accompanied by distending occipital headaches, hot and flushed face, select Fengchi (GB20), Hegu (LI4).
In addition to clinical symptoms, it is also important to differentiate between various syndromes.
Liver yang uprising:
Heat in the yangming fu organ: select Hegu (LI4), Taichong (LV3).
Liver and gallbladder damp heat: Waiguan (SJ5), Zulinqi (GB41).
Yin deficiency, excess fire:
Deficient yin and excess yang: select Fengchi (GB20), Shuiquan ( KI5 ).
Liver and kidney yin deficiency: select Taixi (KI3), Taichong (LV3).
Heat in yangming accompanied by turbid qi uprising: select Erjian (LI2), Lidui (ST45).
In addition, stroke patients with elevated blood pressure, select Zusanli (ST36), Xuanzhong (GB39).
Irregular ascending or descending of yin and yang: select Baihui (DU20), Yongquan (KI1).
For patients who have been receiving anti-hypertensive drug treatment, they should continue to take medication regularly accompanied by acupuncture treatment. Only when blood pressure has reached a stable, regular level can the dose be reduced or stopped all together.