NCT02365974

Brief Summary

Uncontrolled blood pressure represents the main factor in the development of target organ lesions and, consequently, cardiovascular events, which are the leading cause of morbidity and mortality worldwide. In most cases resistant hypertension is preceded by target organ lesions, and is strongly influenced by risk factors or associated diseases. To control this disease requires an adequate and intense therapeutic approach that includes lifestyle changes and the use of several antihypertensive drugs. However, the results are not always satisfactory despite intensive treatment. Of the different pathophysiological mechanisms involved in the pathogenesis of resistant hypertension (RH), two, sympathetic overstimulation and therapies that block the sympathetic system, have been widely studied. But, these approaches are invasive and expensive. Another possible approach is by transcutaneous electrical nerve stimulation (TENS), a non-invasive method that modulates activity by inhibiting primary afferent pathways using low-frequency transcutaneous electrical stimulation. Some studies have shown that TENS reduces blood pressure in patients with hypertension. The current study will evaluate the effect of applying TENS in the cervicothoracic region of subjects with resistant hypertension, seeking to develop a new low cost and readily available therapy to treat this group of hypertensive individuals.

Trial Health

35
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
64

participants targeted

Target at P25-P50 for not_applicable hypertension

Timeline
Completed

Started Jun 2021

Shorter than P25 for not_applicable hypertension

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 8, 2015

Completed
11 days until next milestone

First Posted

Study publicly available on registry

February 19, 2015

Completed
6.3 years until next milestone

Study Start

First participant enrolled

June 1, 2021

Completed
6 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2021

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2022

Completed
Last Updated

February 10, 2021

Status Verified

February 1, 2021

Enrollment Period

6 months

First QC Date

February 8, 2015

Last Update Submit

February 8, 2021

Conditions

Keywords

arterial stiffnessresistant hypertensionsympathetic systemblood pressuretranscutaneous electrical nerve stimulation

Outcome Measures

Primary Outcomes (1)

  • Change from baseline in peripheral blood pressure of individuals with resistant hypertension after transcutaneous electrical nervous stimulation.

    30 days

Secondary Outcomes (1)

  • Change from baseline in central blood pressure of individuals with resistant hypertension after transcutaneous electrical nervous stimulation.

    30 days

Study Arms (2)

Transcutaneous Electrical Stimulation

ACTIVE COMPARATOR

TENS will be applied in the cervicothoracic ganglion region located between the C7 and T4 vertebral processes for 40 minutes three times weekly for a total of four weeks. The intensity in milliamps (mA) will be adjusted depending on the sensitivity of each individual patient. The arrangement thereof will be parallel on each side of the C7 (channel 1) and T4 (channel 2) vertebral spinous processes.

Device: Transcutaneous Electrical Stimulation

No Transcutaneous Electrical Stimulation

SHAM COMPARATOR

The sham group will be submitted to the procedure to fit the stimulation equipment without be submitted to stimulation.

Device: No Transcutaneous Electrical Stimulation

Interventions

TENS will be applied in the cervicothoracic ganglion region located between the C7 and T4 vertebral processes for 40 minutes three times weekly for a total of four weeks. The intensity in milliamps will be adjusted depending on the sensitivity of each individual patient.

Transcutaneous Electrical Stimulation

The sham group will be submitted to the procedure to fit the stimulation equipment. without be submitted to stimulation.

No Transcutaneous Electrical Stimulation

Eligibility Criteria

Age40 Years - 70 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • RH patients taking at least three antihypertensive drugs at full doses, one of which is preferably a thiazide diuretic; Age between 40 and 70 years.

You may not qualify if:

  • Use of a cardiac pacemaker
  • Cardiac electrical conduction abnormalities evidenced by ECG or stress test (ergometry)
  • Dermatological abnormalities at the site of the application of TENS
  • Uncontrolled diabetes patients using oral hypoglycemic agents or insulin with glycated Hb ≥ 7.5%
  • Secondary Hypertension
  • Patients who do not adhere to the lifestyle changes recommended by their physician such as low-sodium diet and weight loss
  • Moderate to severe cervical-thoracic scoliosis
  • Obesity with body mass index (BMI) ≥35 kg/m2

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (3)

  • da Silva ML, Chiappa GR, da Silva VM, Neves LM, de Lima AC, Tomasi FP, Junior LT, Vilela-Martin JF, Bottaro M, Junior GC. Effect of transcutaneous electrical nerve stimulation on peripheral to central blood pressure ratio in healthy subjects. Clin Physiol Funct Imaging. 2016 Jul;36(4):293-7. doi: 10.1111/cpf.12227. Epub 2015 Jan 30.

    PMID: 25640037BACKGROUND
  • Cipriano G Jr, Neder JA, Umpierre D, Arena R, Vieira PJ, Chiappa AM, Ribeiro JP, Chiappa GR. Sympathetic ganglion transcutaneous electrical nerve stimulation after coronary artery bypass graft surgery improves femoral blood flow and exercise tolerance. J Appl Physiol (1985). 2014 Sep 15;117(6):633-8. doi: 10.1152/japplphysiol.00993.2013. Epub 2014 Aug 7.

    PMID: 25103974BACKGROUND
  • Vilela-Martin JF, Giollo-Junior LT, Chiappa GR, Cipriano-Junior G, Vieira PJ, dos Santos Ricardi F, Paz-Landim MI, de Andrade DO, Cestario Edo E, Cosenso-Martin LN, Yugar-Toledo JC, Cipullo JP. Effects of transcutaneous electrical nerve stimulation (TENS) on arterial stiffness and blood pressure in resistant hypertensive individuals: study protocol for a randomized controlled trial. Trials. 2016 Mar 29;17:168. doi: 10.1186/s13063-016-1302-8.

MeSH Terms

Conditions

HypertensionAutonomic Nervous System Diseases

Interventions

Transcutaneous Electric Nerve Stimulation

Condition Hierarchy (Ancestors)

Vascular DiseasesCardiovascular DiseasesNervous System Diseases

Intervention Hierarchy (Ancestors)

Electric Stimulation TherapyTherapeuticsPhysical Therapy ModalitiesRehabilitationAnalgesiaAnesthesia and Analgesia

Study Officials

  • José F Vilela-Martin, MD PhD

    Fundação Faculdade Regional de Medicina de São José do Rio Preto

    PRINCIPAL INVESTIGATOR

Central Study Contacts

José F Vilela-Martin, MD PhD

CONTACT

Luiz Tadeu Giollo Júnior, PT

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Coordinator of Hypertension Clinic

Study Record Dates

First Submitted

February 8, 2015

First Posted

February 19, 2015

Study Start

June 1, 2021

Primary Completion

December 1, 2021

Study Completion

June 1, 2022

Last Updated

February 10, 2021

Record last verified: 2021-02

Data Sharing

IPD Sharing
Will not share