Acupuncture treatment can regulate blood pressure(BP) through multiple levels and ways. In the present paper

we reviewed the progress of researches on the underlying mechanisms of acupuncture in lowering BP from 1) regulation of activities of the neuroendocrine

2) improvement of metabolic abnormality

and 3) alternation of gene expression in the heart and BP-regulation-related centers of the brain. The neuroendocrine mechanism mainly involves the inhibition of neuroinflammatory reaction in some higher brain regions

reduction of neuronal apoptosis

and suppression of the sympathetic cardiovascular regulatory functional areas of the brain stem

regulation of neurotransmitters and autonomic balance

activation of brain areas related to BP regulation

and promotion of functional connection between brain networks. The improvement of metabolic abnormality mainly refers to amelioration of imbalance of intestinal flora and target metabolites related to hypertension. The alteration of gene expression mainly manifests as up-and down-regulation of expression of genes related to oxidative stress

inflammation and vascular endothelial function in the myocardium

hypothalamus

rostral ventrolateral medulla. We reviewed the new research progress on the mechanism of acupuncture for hypertension

in order to provide evidence and research ideas for the treatment of related cardiovascular diseases by using acupuncture therapy in the future.