From the perspective of Traditional Chinese Medicine (TCM), hypertension is understood as a multifactorial condition associated with functional disturbances of the heart, liver, spleen, and kidneys, as well as impaired circulation of qi and blood. Contributing factors may include cardiovascular dysfunction such as coronary heart disease or arteriosclerosis; reduced cardiac output leading to tissue ischemia and hypoxia; vascular narrowing related to metabolic disorders including hyperglycemia, dyslipidemia, and elevated cholesterol; increased peripheral vascular resistance associated with chronic digestive dysfunction; and secondary causes such as renal impairment or space-occupying lesion. Clinically, hypertension is classified into primary (essential) and secondary Hypertension. In cases of essential hypertension, TCM interventions are often used as adjunctive therapies to conventional care. Clinical experience and emerging research suggest that individualized TCM treatment may help improve blood pressure regulation and, in some patients, support a reduction in antihypertensive medication under medical supervision, rather than long-term sole reliance on pharmacotherapy.

Classical TCM literature describes the formula Xuefu Zhuyu Decoction (Blood Stasis–Expelling Decoction) as having effects on promoting blood circulation, reducing blood stasis, and regulating blood lipids. Modern clinical observations indicate that this formula may improve blood viscosity, support cardiac function, and contribute to blood pressure regulation. Furthermore, clinical studies, including reports referenced by the World Health Organization, suggest that acupuncture combined with herbal medicine may produce a modest but clinically meaningful reduction in systolic blood pressure, with an average decrease of approximately 8 mmHg in patients with essential hypertension.

In TCM practice, hypertension is differentiated into patterns of excess and deficiency, and treatment is individualized based on the patient’s constitutional characteristics and clinical presentation. Common excess patterns include:

• Liver yang hyperactivity, treated with herbs such as Gastrodia elata (Tian Ma), Uncaria (Gou Teng), and Cassia seed (Jue Ming Zi), which are traditionally used to calm the liver and subdue hyperactive yang.

• Phlegm turbidity with middle jiao obstruction, managed with herbs including Pinellia ternata (Ban Xia), Atractylodes rhizome (Bai Zhu), and Poria cocos (Fu Ling) to strengthen spleen function and resolve phlegm.

• Blood stasis, addressed with herbs such as peach kernel (Tao Ren), safflower (Hong Hua), and red peony root (Chi Shao), which are traditionally used to promote circulation and alleviate blood stasis.

Among deficiency patterns, liver and kidney yin deficiency is the most commonly observed in patients with hypertension. Herbal medicines such as Rehmannia glutinosa (Shu Di Huang), Chinese yam (Shan Yao), and Eucommia ulmoides (Du Zhong) are commonly used to nourish the liver and kidneys and may help alleviate associated symptoms such as dizziness, tinnitus, and nocturia.

Overall, TCM aims to address hypertension by targeting underlying functional imbalances, improving systemic regulation, and alleviating associated symptoms, while minimizing adverse effects. Optimal outcomes depend on accurate pattern differentiation and individualized treatment prescribed by qualified TCM practitioners, often in coordination with conventional medical care.