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

Eligibility

Inclusion Criteria:

* Age between 50 and 60 years. Both sexes were included Patients had been diagnosed with hypertension for at least 5 years.

Patients had resistant hypertension according to (Whelton et al 2018), defined as:

* Systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg despite the use of three or more antihypertensive medications of different classes, including a diuretic,
* or controlled blood pressure (\<140/90 mmHg) while on four or more antihypertensive medications.

Body Mass Index (BMI) 25: 34.9 kg/m²

Increased waist circumference, defined as:

* Greater than 102 cm for males.
* Greater than 88 cm for females.

Exclusion Criteria:

* Secondary hypertension due to identifiable causes (e.g., renal artery stenosis, primary aldosteronism, pheochromocytoma).
* History of major cardiovascular events in the last 6 months (e.g., myocardial infarction, stroke, or heart failure exacerbation).
* Severe musculoskeletal or neurological disorders that impair the ability to perform isometric exercise safely (e.g., recent joint replacement, severe osteoarthritis, stroke with residual motor deficit).
* Contraindications to the use of Transcutaneous Electrical Nerve Stimulation (TENS):

Implanted electronic devices: pacemakers, cardioverter defibrillators. Uncontrolled arrhythmias. Sever skin condition: open wounds, rashes, burns, eczema. Peripheral neuropathy or sensory loss.

-Known cognitive impairment or psychiatric conditions that would limit the ability to follow instructions or provide informed consent.

Conditions9

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