People suffering from angina may find acupuncture to reduce symptoms, the need for medication, and even the need for invasive surgery. While some studies of acupuncture treatment for angina found no benefit,4 others have demonstrated positive results. An uncontrolled trial of 49 angina patients found that acupuncture resulted in 58% less nitroglycerin use and a 38% decrease in the number of angina attacks.5 In another study, 69 patients suffering with severe angina were treated with a combination of acupuncture, shiatsu (acupressure), and lifestyle changes. The results were compared to patients with severe angina treated with coronary artery bypass grafting (CABG). The incidence of heart attack and death was 21% among those treated with CABG and 7% among those treated with the combined therapy including acupuncture. In addition, 61% of those treated with the combination therapy, because of their improved health, postponed any further invasive treatment.6 In a single-blind study of 26 patients, a reduction in angina attack rate and nitroglycerin use, as well as an improvement in exercise performance, occurred in the treatment group compared to a sham (fake) acupuncture group.7 Findings from a controlled trial comparing acupuncture treatment (three treatments per week for four weeks) to placebo tablets support these results, demonstrating a reduction in the number of angina attacks, improved exercise performance, and corresponding improvements in ECG readings.8
Transcendental meditation (20 minutes twice daily of silently chanting a mantra with eyes closed) was found in a small controlled trial to reduce angina-like chest pain and to normalize electrocardiograms (ECGs) in patients with cardiac syndrome X, a form of angina in people with otherwise normal coronary arteries.9 While these patients did not have angina in the classic sense, their chest pain was thought to result from anxiety, which may reduce blood flow to the heart, and their ECGs resembled those of classic angina patients. It is not yet known whether transcendental meditation would have the same effect on patients with angina pectoris.
Evidence from preliminary10, 11, 12 and controlled13 studies suggests that there may be a relationship between the presence of heart disease and changes to the muscles and joints of the spine that are detectable by practitioners of spinal manipulation. In a double-blind study, patients with proven coronary disease were more likely to have specific changes in their spine detectable by palpating or "feeling" their backs than were subjects who were healthy.14 Controlled studies have demonstrated that manipulation of the joints in the middle of the neck can increase heart rate, respiratory rate, and blood pressure,15, 16 but manipulation of the lower neck does not appear to have the same effect.17 Despite these intriguing findings, there is no research investigating whether manipulation reduces angina symptoms or otherwise benefits the heart and cardiovascular system.