Abstract P191: Improved Systolic and Diastolic Blood Pressure After Enhanced External Counterpulsation Therapy Combined With a Lifestyle Modification Program

Abstract

Background: Enhanced external counterpulsation (EECP) is a noninvasive, FDA approved therapy for refractory angina. Because EECP increases nitric oxide release, it may have an ancillary benefit on blood pressure (BP). Methods: We measured changes in BP at baseline over 35 sessions of EECP, which included lifestyle coaching. Supine blood pressure was measured before and after every EECP session by trained healthcare technicians with calibrated manual sphygmomanometers. Results: 404 patients (age 67.2 ± 10.0, 50% male - 200/404, 77% African American - 311/404) completed the program. Hypertensive subjects at baseline (37% - 150/404) showed an improvement in both systolic and diastolic BP (Table). Notably, there was a marked reduction in BP after the first EECP session, with a further, more modest reduction by the end of the 35 sessions. Weight decreased by a mean 3.0 lbs (p<0.001) and there was no significant difference in the number of patients receiving antihypertensive medications before or after completing EECP (46% - 184/404 vs. 47% - 189/404, p=0.62). Conclusions: EECP therapy leads to a reduction in both systolic and diastolic blood pressure, which is most prominent in patients with baseline hypertension. These results maintain throughout the 35 sessions. These results reflect observational data from one highly experienced clinic in which EECP is routinely combined with daily coaching on vegan plant-based lifestyle modifications and exercise. Further studies are indicated to investigate this observed phenomenon to both confirm these findings as well as assess for the length and durability of the effect.