Effect of Electrical Stimulation and Exercise on Blood Flow in Patients With Resistant High Blood Pressure

Summary

The goal of this clinical trial is to learn if the combination between transcutaneous electrical nerve stimulation (TENS) and isometric exercise (IE) can improve blood pressure in men and women between 50 to 60 years old suffered from resistant hypertension which is a type of hypertension where blood pressure remains above your target goal despite the use of three or more different classes of antihypertensive medications at their maximum tolerated doses. The main question to answer is:

Is there a significant effect on the combined use of TENS and IE on peripheral hemodynamic parameters in patients with resistant hypertension? Total sample will be 50 patients from both sexes

I will compare between two groups:

Experimental group (15 men, 10 women) will take: medication plus IE and TENS Control group (15 men, 10 women) will take: medication plus Conventional Physical Therapy Program

Conditions

• Resistant Hypertension
• Hemodynamic Instability
• Essential (Primary) Hypertension
• Abdominal Obesity
• Metabolic Syndrome
• Hypertension (HTN)
• Vascular Resistance
• High Blood Pressure

Interventions

DEVICE

Transcutaneous Electrical Nerve Stimulation

Application of TENS Electrode placements: bilaterally over the Paraspinal muscles at the T1-T5 levels (upper thoracic region), targeting sympathetic outflow to the cardiovascular system. Frequency: 2-10 Hz (low frequency stimulation) Pulse duration: 200 microseconds Intensity: strong but comfortable tingling sensations, below motor threshold (typically between 10-20mA) Session duration: 30 minutes per session Session frequency: 3 times per week Total intervention duration: 8 weeks

BEHAVIORAL

Isometric Exercise

Device: Hand grip dynamometer. protocol: * 30% of the participants' maximal voluntary contraction (MVC). * Duration per trial: 2 minutes. * Number of trials per session: 4 repetitions * Rest interval between trials: 1 minute * Session frequency: 3 sessions per week * Total session duration: 14 minutes Per session: * 4 sets × 2 minutes = 8 minutes of active contraction * Rest between sets: 1 to 3 minutes (average 2 min × 3 rests = 6 minutes) * So total session time: average 14 minutes. • Total intervention duration: 8 weeks

BEHAVIORAL

Aerobic, Dynamic Resistance, stretch and Breathing Exercises and Lifestyle Modification Advices

1. Aerobic exercise: moderate (brisk walking): 30 min, 5 times per week. 2. Engage in dynamic resistance exercise (weight training): 2 or more days non-consecutive. 3. Minimize sedentary behavior 4. Maintain healthy weight 5. Nutritional advice like: * Eat at least 5 portions of fruit and vegetables * Eat more lean protein e.g. Fish and nuts * Eat less salt \<5g or 1tsp * Eat 25-29 g of fiber * Limit alcohol * Drink 2-3 cups of coffee and/or tea (unsweetened) 6. Others: * Sleep: 7-9h/day * Reduce stress: practice meditation or yoga 30 min per day * Listen to music at least 25 min, 3 times per week * Stop smoking * Limit pollutions exposure * Use digital wearables/apps to track movement 7. Breathing exercise: Slow breathing at a rate of 6 breath/min for 10 minutes. 8. Stretching exercise: Static stretching exercise is mainly for large bulky muscles 30 sec stretch, 30 sec rest for 5 min

Sponsors & Collaborators

• Mohamed Mohamed Ali Morgan

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

50 Years

Max Age

60 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-01-15

Primary Completion

2026-05-30

Completion

2026-06-10

Countries

• Egypt

Study Locations