EUROMEDICA  Hanover 6-7  Juni 2008	Advanced methods of diagnosis, treatment and prophylactics
	European Academy of Natural Sciences, Hanover European Scientific Society, Hanover Russian Academy of Natural Sciences, Moscow

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Background. Arterial hypertension (AH) is one of the most wide-spread vascular heart diseases, which is very dangerous for its complications. In spite of a wide range of drugs for correction of AH the efficiency of therapy is still insufficient. Researches on new non-drug methods of treatment of AH are continuously carried out. Transcutaneous electroneurostimulation (TENS) is one of such methods.

Dynamic electroneurostimulation (DENS) is a new variant of TENS consisting in stimulus of reflexogeous zones with short electric current impulses which form changes depending on values of electric impedance of skin surface in subelectrode zone. So that dynamic change of the impulse form during the procedure minimizes habituation effect of stimulated tissues and therefore allows DENS application within a longer period.

The purpose of this trial is to evaluate the hypotensive effect of DENS in patients with different variants of arterial hypertension.

Patients and methods. It was a randomized double-blind placebo-controlled research. 60 patients with hypertension of stages I-II were treated and examined in the trial. All patients had hypotensive drug therapy. The main group of patients (30 persons) also had DENS-treatment with the DiaDENS-Cardio apparatus (Certificate No.: CQ070361-V dd. 05 February 2007 issued by EUROCAT Institute for Certification and Testing GmbH, Darmstadt, Germany) on the neiguan zone on the inner surface of lower third part of forearm.

The DiaDENS-Cardio apparatus combines stimulation at 9.2 Hz and a special mode 77 10 under which the apparatus automatically alternates stimulation at 77 and 10 Hz. The duration of procedures was 5-6 minutes and determined by the apparatus depending on the change of skin surface impedance in subelectrode zone. The procedures were taken daily during 10 days.

An imitation of DENS-effect was created in a control group (30 persons) by DiaDENS-Cardio apparatus-placebo.

All the patients had daily monitoring of ABP and ECG before and after the treatment course. In addition the intensity of headache was assessed by 10 cm VAS.

Results and discussion. Before start of treatment course the compared groups did not differ by age, duration of the disease, daily average systolic blood pressure (BP) and intensity of headache by VAS.

After 10-day treatment course the reduction of systolic BP was registered in both groups (table), but in the main group who had DENS this reduction was more considerable. In the main group the headache intensity (average indexes of VAS) significantly reduced compared to placebo group.

The presented data confirm the information that arterial hypertension is a psychosomatic disease. Even application of placebo apparatus with basic drug therapy results in reduction of blood pressure (BP). But influence of the DiaDENS-Cardio apparatus adds up the hypotensive effect and is more efficient than placebo. More over, clinical presentation of the disease namely headache did not change at all in the group of patients who had placebo in spite of reduction of BP. But patients in DENS group had a considerable reduction of headache which confirms an analgesic effect of electroneurostimulation of the neiguan reflexogenous zone.

Conclusions. DENS was superior over placebo in BP reduction in patients with arterial hypertension. Under influence of the DENS-therapy a positive dynamics of the clinical presentation of AH is observed.

Dynamics of daily average blood pressure and headache intensity by 10 cm VAS before and after the treatment course

Groups of Patients	Before treatment	After treatment	р
	Average Blood Pressure, mm Hg
Main group (n=30)	141.9±17.0	125.8±16.4	0.001
Control group (n=30)	149.7±15.3	138.3±20.8	0.019
р	0.067	0.012
	Headache Intensity, cm VAS
Main group (n=30)	4.35±0.36	1.95±0.26	0.000
Control group (n=30)	3.90±0.24	3.30±0.30	0.124
р	0.303	0.003