Cardiovascular DiseasesNCT02292199
Transcutaneous Electrical Nerve Stimulation on Nervous System in Patients With Hypertension.
A study testing TENS High Frequency and TENS Low Frequency in people with Cardiovascular Diseases, run by Federal University of Health Science of Porto Alegre at 1 site in Brazil.
Trial summary
Hypertension has high prevalence and poor control rates and is considered one of the major modifiable risk factors for cardiovascular system diseases, and one of the most important public health problems. Read more about this study
- Who is it for?
- Ages 18 to 80 years
- Conditions the study is for
- Cardiovascular Diseases
- What is being tested?
- TENS High Frequency and TENS Low Frequency
- Type of treatment
- Medical device
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 60 participants
- Where
- 1 siteBrazil
- Study dates
- Aug 2014to Aug 2015
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Previous Hypertension diagnosis, systolic blood pressure (SBP) > 140 mm Hg and/or diastolic blood pressure (DBP) >90 mm Hg and clinical stability with no change in medications for at least 2 months preceding the study.
Who cannot join
- Presence of any comorbidity such as diabetes; congestive heart failure; unstable angina; myocardial infarction; acute inflammation; peripheral vascular disease; associated neurological disease; acute respiratory illness; infectious disease or fever; cardiac pacemaker; unstable ventricular arrhythmia; active smokers; obesity; musculoskeletal disease in the lower limbs; changes in the electrocardiogram; smoker; treatment with beta blockers, steroids, hormones or chemotherapy or change in drug therapy were excluded from the study.
Trial locations and contacts
1 site in 1 country.
Brazil1 site, 1 recruiting
- Recruiting
Rodrigo Della Méa Plentz
Porto Alegre, Rio Grande do Sul, 90050170
Sandra A Sartori, Graduated, +55(51)9949-6180, sandrasartorirs@gmail.com
About this study
Official title: Effects of Transcutaneous Electrical Nerve Stimulation on Sympathetic and Parasympathetic Nervous System in Patients With Hypertension: a Randomized Clinical Trial
Hypertension has high prevalence and poor control rates and is considered one of the major modifiable risk factors for cardiovascular system diseases, and one of the most important public health problems. The imbalance of the autonomic cardiovascular control, which can be considered as a major etiologic factor in the development of essential hypertension is characterized by increased sympathetic activity and reduced parasympathetic activity possible.
Cardiovascular disease is the leading cause of death and disability in the world and autonomic imbalance is associated with several pathological conditions, and may be a final common pathway for the increased morbidity and mortality of cardiovascular diseases. In this sense, the heart rate variability (HRV) is a quantitative marker of sympathetic and parasympathetic activity, which can be used to assess disease and mortality as a noninvasive technique.
Read more
TENS is a noninvasive therapeutic modality, easy to handle, it has no side effects or interactions with medications being used for the relief of pain by sensory stimulation through peripheral nerves and mainly for control and treatment of acute and chronic pain . Research on the effect of TENS on the sympathetic and parasympathetic nervous system activity remain controversial, especially regarding the parameters to use.
The aim of this study is to investigate the effects of TENS on the sympathetic and parasympathetic nervous system in patients with hypertension by heart rate variability and blood pressure variability.
This is a randomized clinical trial, double blind, where hypertensive patients were randomized to three groups: high-frequency TENS (100 Hz) n = 20, low frequency TENS (4 Hz) n = 20 and n = 20 placebo. Evaluations will be made in a single session. The results will be assessed by a blinded investigator and randomization will be done electronically.
It is expected to evaluate how often TENS exerts more influence in the modulation of sympathetic and parasympathetic system.
Read the detailed description
Data collection was performed at the Laboratory of Clinical Investigation (LIC) Institute of Cardiology. Initially, patients rested for 30 minutes, and during this period has been completed the evaluation form with the identification data and questions about the patient's clinical status, such as checking blood pressure, weight and height.
Patients were randomized to group of high frequency (100 Hz / 200μs), low frequency (4 Hz / 200μs) or placebo. The placebo group received an active current for 30 seconds, and then gradually decreased for 15 seconds to not pass any current. This approach aims at masking the investigator and subject (RAKEL et al., 2010). Eligible subjects were randomly assigned in blocks, by electronic randomization (www.randomization.com).
The adhesive electrodes were used, size 9x5 cm, placed in bilateral paravertebral region of the T1 segment of the thoracic spine at L2 lumbar spine. Before the application of TENS (IBRAMED®), the skin was cleaned in place of the current application with alcohol to avoid any barrier conduction of electrical current.
The sessions took place at the same time of the day, throughout the protocol, the participants were comfortably accommodated in an acclimatized room (23ºC) in a supine position, head elevation of 30º with knees resting on a wedge. All the participants were forbidden to perform exhaustive exercises and intake caffeine at least two hours before the intervention and instructed to have a meal before the assessment.
TENS was applied for thirty minutes, with the frequency defined according to randomization. The intensity of the current was delivered at sensory-level intensity, adjusted every 5 minutes by the sensory threshold, during the 30 minutes as tolerated by each subject, but without motor contraction or pain reported by the subject.
The analysis of autonomic control was performed by means of a sensor placed on the middle finger, and connected to the Finapres (Ohmeda 2300, Colorado, USA) by recording beat to beat. Then, the conversion signal was performed using the powerlab (LAB chart). The analysis will be performed using the software Kubios.
- Conditions
- Cardiovascular Diseases
- Being tested
- TENS High Frequency, TENS Low Frequency, TENS Placebo
- Keywords
- Hypertension, TENS, Sympathetic and Parasympathetic nervous system
- Medical subject headings
- Cardiovascular Diseases, Hypertension
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TENS High FrequencyDevice
TENS high frequency (100 Hz / 200μs) was applied in bilateral paravertebral region of the T1 segment of the thoracic spine at L2 lumbar spine. The intensity of the current was delivered at sensory-level intensity, adjusted every 5 minutes by the sensory threshold, during the 30 minutes as tolerated by each subject, but without motor contraction or pain reported by the subject.
TENS Low FrequencyDevice
TENS low frequency (4 Hz / 200μs) was applied in bilateral paravertebral region of the T1 segment of the thoracic spine at L2 lumbar spine. The intensity of the current was delivered at sensory-level intensity, adjusted every 5 minutes by the sensory threshold, during the 30 minutes as tolerated by each subject, but without motor contraction or pain reported by the subject.
TENS PlaceboDevice
TENS was applied in bilateral paravertebral region of the T1 segment of the thoracic spine at L2 lumbar spine. The placebo group received an active current for 30 seconds, and then gradually decreased for 15 seconds to not pass any current. This approach aims at masking the investigator and subject (RAKEL et al., 2010).
| Study group | Role | What they receive |
|---|---|---|
| TENS High Frequency 100 Hz | Experimental | TENS was applied for thirty minutes, with the frequency defined according to randomization. The intensity of the current was delivered at sensory-level intensity, adjusted every 5 minutes by the sensory threshold, during the 30 minutes as tolerated by each subject, but without motor contraction or pain reported by the subject. Receives: Device: TENS High Frequency |
| TENS Low Frequency 4 Hz | Active comparator | TENS was applied for thirty minutes, with the frequency defined according to randomization. The intensity of the current was delivered at sensory-level intensity, adjusted every 5 minutes by the sensory threshold, during the 30 minutes as tolerated by each subject, but without motor contraction or pain reported by the subject. Receives: Device: TENS Low Frequency |
| TENS Placebo | Placebo comparator | The placebo group received an active current for 30 seconds, and then gradually decreased for 15 seconds to not pass any current. This approach aims at masking the investigator and subject (RAKEL et al., 2010). Receives: Device: TENS Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Heart Rate Variability
For the analysis of heart rate variability (HRV), the time of RR intervals obtained from continuous ECG signal recorded by Finapres device (Ohmeda 2300, Colorado, USA) series. The time series of RR will be analyzed in the time and frequency and variability parameters and autonomic balance will be obtained. In the time domain we calculate the mean values of RR intervals, standard deviation and the square root of the sum of the square of successive differences (rMSSD). The acquisition of electrocardiogram signal (ECG) was performed immediately before and after the interventions for a 10-minute period, with the subject at rest.
Measured: 2 Hours
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Nov 2014 (estimated)
- Study startAug 2014
- Primary completionJan 2015 (estimated)
- Study completionAug 2015 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Cardiovascular DiseasesStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Federal University of Health Science of Porto Alegre
- Sponsor type
- University, hospital or other
- Collaborators
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior., Instituto de Cardiologia do Rio Grande do Sul
- Responsible party
- Principal investigator, Rodrigo Della Méa Plentz, Federal University of Health Science of Porto Alegre
- Investigators
- Rodrigo DM Plentz, Phd, Principal investigator, Federal University of Health Science of Porto Alegre
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02292199
- Sponsor's protocol ID
- HYPERTENSIONTENS
- Status last verified
- Nov 2014
- First submitted
- 12 Nov 2014
- Last updated
- 17 Nov 2014
- Results posted
- No
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 17 Nov 2014. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Transcutaneous Electrical Nerve Stimulation on Sympathetic and Parasympathetic Nervous System in Patients With Hypertension: a Randomized Clinical Trial
- ClinicalTrials.gov ID
- NCT02292199
- Acronym / sponsor ID
- HYPERTENSIONTENS
- Conditions
- Cardiovascular Diseases
- Keywords
- Hypertension, TENS, Sympathetic and Parasympathetic nervous system
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- Federal University of Health Science of Porto AlegreUniversity, hospital or other
- Collaborators
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior., Instituto de Cardiologia do Rio Grande do Sul
- Study start
- Aug 2014
- Primary completion
- Jan 2015 (estimated)
- Study completion
- Aug 2015 (estimated)
- First posted
- 17 Nov 2014 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Hypertension has high prevalence and poor control rates and is considered one of the major modifiable risk factors for cardiovascular system diseases, and one of the most important public health problems. The imbalance of the autonomic cardiovascular control, which can be considered as a major etiologic factor in the development of essential hypertension is characterized by increased sympathetic activity and reduced parasympathetic activity possible.
Cardiovascular disease is the leading cause of death and disability in the world and autonomic imbalance is associated with several pathological conditions, and may be a final common pathway for the increased morbidity and mortality of cardiovascular diseases. In this sense, the heart rate variability (HRV) is a quantitative marker of sympathetic and parasympathetic activity, which can be used to assess disease and mortality as a noninvasive technique.
TENS is a noninvasive therapeutic modality, easy to handle, it has no side effects or interactions with medications being used for the relief of pain by sensory stimulation through peripheral nerves and mainly for control and treatment of acute and chronic pain . Research on the effect of TENS on the sympathetic and parasympathetic nervous system activity remain controversial, especially regarding the parameters to use.
The aim of this study is to investigate the effects of TENS on the sympathetic and parasympathetic nervous system in patients with hypertension by heart rate variability and blood pressure variability.
This is a randomized clinical trial, double blind, where hypertensive patients were randomized to three groups: high-frequency TENS (100 Hz) n = 20, low frequency TENS (4 Hz) n = 20 and n = 20 placebo. Evaluations will be made in a single session. The results will be assessed by a blinded investigator and randomization will be done electronically.
It is expected to evaluate how often TENS exerts more influence in the modulation of sympathetic and parasympathetic system.
Detailed description
Data collection was performed at the Laboratory of Clinical Investigation (LIC) Institute of Cardiology. Initially, patients rested for 30 minutes, and during this period has been completed the evaluation form with the identification data and questions about the patient's clinical status, such as checking blood pressure, weight and height.
Patients were randomized to group of high frequency (100 Hz / 200μs), low frequency (4 Hz / 200μs) or placebo. The placebo group received an active current for 30 seconds, and then gradually decreased for 15 seconds to not pass any current. This approach aims at masking the investigator and subject (RAKEL et al., 2010). Eligible subjects were randomly assigned in blocks, by electronic randomization (www.randomization.com).
The adhesive electrodes were used, size 9x5 cm, placed in bilateral paravertebral region of the T1 segment of the thoracic spine at L2 lumbar spine. Before the application of TENS (IBRAMED®), the skin was cleaned in place of the current application with alcohol to avoid any barrier conduction of electrical current.
The sessions took place at the same time of the day, throughout the protocol, the participants were comfortably accommodated in an acclimatized room (23ºC) in a supine position, head elevation of 30º with knees resting on a wedge. All the participants were forbidden to perform exhaustive exercises and intake caffeine at least two hours before the intervention and instructed to have a meal before the assessment.
TENS was applied for thirty minutes, with the frequency defined according to randomization. The intensity of the current was delivered at sensory-level intensity, adjusted every 5 minutes by the sensory threshold, during the 30 minutes as tolerated by each subject, but without motor contraction or pain reported by the subject.
The analysis of autonomic control was performed by means of a sensor placed on the middle finger, and connected to the Finapres (Ohmeda 2300, Colorado, USA) by recording beat to beat. Then, the conversion signal was performed using the powerlab (LAB chart). The analysis will be performed using the software Kubios.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| TENS High Frequency 100 Hz | Experimental | Device: TENS High FrequencyTENS was applied for thirty minutes, with the frequency defined according to randomization. The intensity of the current was delivered at sensory-level intensity, adjusted every 5 minutes by the sensory threshold, during the 30 minutes as tolerated by each subject, but without motor contraction or pain reported by the subject. |
| TENS Low Frequency 4 Hz | Active comparator | Device: TENS Low FrequencyTENS was applied for thirty minutes, with the frequency defined according to randomization. The intensity of the current was delivered at sensory-level intensity, adjusted every 5 minutes by the sensory threshold, during the 30 minutes as tolerated by each subject, but without motor contraction or pain reported by the subject. |
| TENS Placebo | Placebo comparator | Device: TENS PlaceboThe placebo group received an active current for 30 seconds, and then gradually decreased for 15 seconds to not pass any current. This approach aims at masking the investigator and subject (RAKEL et al., 2010). |
Who may qualify
- Ages
- 18 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- Previous Hypertension diagnosis, systolic blood pressure (SBP) > 140 mm Hg and/or diastolic blood pressure (DBP) >90 mm Hg and clinical stability with no change in medications for at least 2 months preceding the study.
Key exclusion criteria (1 listed)
- Presence of any comorbidity such as diabetes; congestive heart failure; unstable angina; myocardial infarction; acute inflammation; peripheral vascular disease; associated neurological disease; acute respiratory illness; infectious disease or fever; cardiac pacemaker; unstable ventricular arrhythmia; active smokers; obesity; musculoskeletal disease in the lower limbs; changes in the electrocardiogram; smoker; treatment with beta blockers, steroids, hormones or chemotherapy or change in drug therapy were excluded from the study.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| TENS High FrequencyTENS high frequency (100 Hz / 200μs) was applied in bilateral paravertebral region of the T1 segment of the thoracic spine at L2 lumbar spine. The intensity of the current was delivered at sensory-level intensity, adjusted every 5 minutes by the sensory threshold, during the 30 minutes as tolerated by each subject, but without motor contraction or pain reported by the subject. | Device | TENS High Frequency 100 Hz |
| TENS Low FrequencyTENS low frequency (4 Hz / 200μs) was applied in bilateral paravertebral region of the T1 segment of the thoracic spine at L2 lumbar spine. The intensity of the current was delivered at sensory-level intensity, adjusted every 5 minutes by the sensory threshold, during the 30 minutes as tolerated by each subject, but without motor contraction or pain reported by the subject. | Device | TENS Low Frequency 4 Hz |
| TENS PlaceboTENS was applied in bilateral paravertebral region of the T1 segment of the thoracic spine at L2 lumbar spine. The placebo group received an active current for 30 seconds, and then gradually decreased for 15 seconds to not pass any current. This approach aims at masking the investigator and subject (RAKEL et al., 2010). | Device | TENS Placebo |
Primary outcome
Heart Rate Variability
Time frame: 2 Hours
For the analysis of heart rate variability (HRV), the time of RR intervals obtained from continuous ECG signal recorded by Finapres device (Ohmeda 2300, Colorado, USA) series. The time series of RR will be analyzed in the time and frequency and variability parameters and autonomic balance will be obtained. In the time domain we calculate the mean values of RR intervals, standard deviation and the square root of the sum of the square of successive differences (rMSSD). The acquisition of electrocardiogram signal (ECG) was performed immediately before and after the interventions for a 10-minute period, with the subject at rest.
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Nov 2014.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Rodrigo DM Plentz, Phd principal investigator
Federal University of Health Science of Porto Alegre
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing TENS High Frequency and TENS Low Frequency in people with Cardiovascular Diseases, run by Federal University of Health Science of Porto Alegre at 1 site in Brazil.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 17 Nov 2014. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Brazil. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Rodrigo DM Plentz, Phd (+55(51)9179-4399, roplentz@yahoo.com.br), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Heart Rate Variability (time frame: 2 Hours). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Nov 2014.