Abstract Background: Chronic hypertension is a major risk factor for cardiovascular complications and can induce pathological myocardial hypertrophy. The hypothalamic paraventricular nucleus (PVN) is a key autonomic regulatory center involved in hypertension through sympathetic overactivation, neuroinflammation, and central renin–angiotensin system dysregulation. Although acupuncture exerts protective effects against hypertension-related target organ damage, its central mechanisms remain unclear.