John C. Longhurst is a professor in the Department of Medicine, the Department of Physiology and Biophysics and the Center for Biomedical Engineering at the University of California, Irvine. After completing his B.S. in Zoology at the University of California, Davis, Longhurst obtained his M.D. from the UC Davis School of Medicine in 1973 and his Ph.D. in Cardiovascular-Pulmonary physiology - also at UC Davis - in 1974.

Longhurst studies interactions between the nervous and cardiovascular systems in a number of different conditions, including in patients with decreased blood flow to the heart, during exercise and during acupuncture. Longhurst focuses on the mechanisms by which sensory nerves become activated under these circumstances. He also studies neural and hormonal mechanisms that underlie acupuncture's influence on the cardiovascular system.

Longhurst has more than 130 peer-reviewed publications to his credit, and currently serves on the editorial board of the professional journal Circulation. In the past, he has served on the boards of the journals Sports & Medicine and Journal of Applied Physiology, and has acted as associate editor for the journal Medicine and Science in Sports and Exercise.

Martha asks:
I am wondering if there are any studies on the affect of acupuncture on glaucoma. I must decide whether to risk the loss of my remaining vision to relieve the glaucoma. Since I live alone, this is a major decision for me. I would appreciate any information about the possibility of acupuncture lowering the pressure and if you would know how to contact a reputable doctor. Thank you for any information you might give me.

Longhurst's response:
As you are aware, glaucoma is a condition associated with increased pressure in the eye, which can, if left untreated, result in loss of vision. This is a very serious disease, which should always be referred to an ophthalmologist. At least two acupoints, UB.67 (Zhiyin) and GB.37 (Guangmin), referring to the urinary and gallbladder meridians, respectively, have been used to treat eye diseases. I am unaware of any studies specifically related to treatment of glaucoma and would refer you to Dr. Edward Wong in the department of ophthalmology at the University of California, Irvine, for further information. .

Joanne asks:
After studying the effect of acupuncture on blood pressure, do you think that acupuncture could have an effect on heart rhythm, especially atrial fibrillation?

Longhurst's response:
Acupuncture has been shown to be effective in treating arrhythmias in experimental animal studies. Generally, acupuncture would be expected to be effective in treating those types of arrhythmias associated with an increase in neural stimulation (i.e., sympathetic nervous system over-activity) of the heart. I am not aware of any studies that have focused on the influence of acupuncture on atrial fibrillation, although theoretically acupuncture might be able to limit the frequency of occurrence of this arrhythmia. Since there are no case studies, I would recommend standard treatment as recommended by your physician.

Julie asks:
Dear Dr. Longhurst, you did a good job explaining your side of alternative medicine the other night. I am currently being denied insurance coverage for my acupuncture treatments, and am appealing the decision. I was wondering if you could give me any advice or any good articles to help my case. I am currently a police officer, and do not want my physical ailments to get in the way of my job. I am a fair person, yet pain can transform people if it gets too bad. Thank you for being open minded with acupuncture, I am living proof that it does work.

Longhurst's response:
Since you mention pain, I assume this is the reason acupuncture has been used. It is unfortunate that many insurance companies do not provide coverage for acupuncture treatments, especially when pain is one of the areas for which there is strong evidence for efficacy. There are a number of plans that do cover acupuncture, at least for a limited period of time. I refer you to an article by David Mayer, Annual Review of Medicine, volume 51, pages 49-63, 2000, which provides an excellent description of the literature on the evidence showing that acupuncture can be used to successfully treat pain. Although acupuncture is not successful in treating all kinds of pain, it sounds as if it was successful in your case.

David asks:
Dear Dr. Longhurst, I saw your segment on Scientific American Frontiers last night and am very excited about the results of acupuncture on blood pressure. I am 66 years old have high blood pressure that is treated with Plendil 10mg, Astra. Lately, I have been taking aspirin as well for joint pain. My stomach is all 'knotted up' and I feel very fatigued. I don't know if these are side effects of the aspirin and Plendil or not. Could acupuncture work to lower my blood pressure to the point I would not need to use Plendil?

Here in rural northwest Iowa, there is a chiropractor who practices acupuncture. Is this someone I could speak with? I'm not sure my physician knows any more about acupuncture than I do. How often would I need to take treatments and how would I know if the acupuncture or the medication is working the best to reduce my blood pressure? Most of all, how does one determine the qualifications of an acupuncturist? Thank you for your time, and your efforts with Scientific American Frontiers.

Longhurst's response:
Acupuncture theoretically may be able to lower your pressure to the extent that it might be possible to reduce the dose of your antihypertensive drug(s). However, the studies are still ongoing on the influence of acupuncture in hypertension. I suggest that you contact Dr. Randall M. Zusman at the Massachusetts General Hospital to get more information.

The Iowa Board of Medical Examiners, located in Des Moines, IA apparently licenses acupuncturists. Their phone number is 515 281-6489. Treatments generally are given two or three times per week for conditions associated with pain. Little information is available on the treatment schedule for hypertension. However, Dr. Zusman, noted above could tell you about his treatment schedule. .

Joanne asks:
If the placebo effect is so common and so powerful, shouldn't there be more research into this effect itself? How much research has their been in the relation between belief and health? Perhaps something like hypnosis (or some other way of manipulating belief) would be able to distill this effect and make it useful and productive in a therapeutic setting.

Longhurst's response:
A Your suggestions are good ones. Perhaps you are suggesting that hypnosis could be used as a surrogate for acupuncture, to enhance the placebo effect. This is an interesting thought that could be pursued by individuals with expertise in hypnosis. More research needs to be done on the placebo effect, although there are some good studies available on its frequency and some of the mechanisms that underlie its action. Hypnosis is not needed in the 70% of patients who respond favorably to acupuncture. With respect to the placebo response occurring in 30-40% of patients, I don't believe that hypnosis would provide an advantage since the patients in this category also report improvement.