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Low- and high-frequency spinal cord stimulation and arterial blood pressure in patients with chronic pain and hypertension: a retrospective study

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Abstract

Purpose

Evidence suggests that traditional low-frequency spinal cord stimulation (LF-SCS) reduces arterial blood pressure (BP) in patients with chronic pain and hypertension independent of improved pain symptoms. However, it remains unclear whether high-frequency spinal cord stimulation (HF-SCS) also lowers BP in chronic pain patients with hypertension. Therefore, in a retrospective study design, we tested the hypothesis that clinic BP would be significantly reduced following implantation of HF-SCS in patients with chronic pain and hypertension.

Methods

Clinic BP within 3 months before and after surgical implantation of either a LF-SCS or HF-SCS device between 2010 and 2020 were collected from electronic medical records at The University of Kansas Health System (TUKHS).

Results

A total of 132 patients had available records of clinic BP (64 ± 13 years of age). Patients with hypertension (n = 32) demonstrated a significantly greater reduction in systolic BP (−8 ± 12 versus 2 ± 9 mmHg, P < 0.001) following implantation compared with normotensive patients (n = 100). Importantly, the change in BP was inversely related to baseline BP independent of age and sex following implantation of HF-SCS (n = 70, R =  −0.50, P < 0.001) or LF-SCS (n = 62, R =  −0.42, P = 0.001). Higher pain scores before implantation were not associated with reduction in systolic BP (R = 0.10, P = 0.43) or diastolic BP (R =  −0.08, P = 0.53) (n = 69) after implantation.

Conclusion

These findings confirm previous studies showing reduced BP following implantation of LF-SCS in patients with chronic pain and hypertension and provide novel data regarding reduced BP following implantation of newer generation HF-SCS devices.

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Funding

R01HL159370-01 (S.W. H.)

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Authors and Affiliations

  1. Department of Anesthesiology, University of Kansas Medical Center, 3901 Rainbow Blvd, Mail Stop 7013, Kansas City, KS, 66160-7415, USA

    Kimia Memar, Sunita N. Varghese, Davina A. Clonch, Christopher M. Lam & Seth W. Holwerda

  2. Department of Cell Biology and Physiology, University of Kansas Medical Center, Kansas City, KS, USA

    Austin G. Morrison & Seth W. Holwerda

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  1. Kimia Memar
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  2. Sunita N. Varghese
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  3. Austin G. Morrison
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  4. Davina A. Clonch
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Correspondence to Seth W. Holwerda.

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Memar, K., Varghese, S.N., Morrison, A.G. et al. Low- and high-frequency spinal cord stimulation and arterial blood pressure in patients with chronic pain and hypertension: a retrospective study. Clin Auton Res 33, 443–449 (2023). https://doi.org/10.1007/s10286-023-00947-9

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