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External Counterpulsation Therapy (ECP) therapy is an exciting option for the treatment of heart disease, specifically Coronary Artery Disease. Many people who suffer from heart disease are unable to supply enough oxygen-rich blood to nourish the heart muscle (ischemia). The symptom commonly associated is angina (angina pectoris), or chest pain. Currently, many cardiologists prescribe ECP therapy for the treatment of angina.
ECP has helped people throughout the world regain their quality of life. It has given new hope to many of those suffering from heart disease. After completion of ECP therapy, many people return to an active and fulfilling lifestyle.

What is ECP?

ECP is a non-invasive therapy designed to improve circulation and blood flow to the heart. ECP therapy is prescribed for the treatment of Coronary Artery Disease.

ECP is safe, easy, and effective. The therapy consists of 35 daily treatments lasting for one hour per day. ECP is administered on an outpatient basis and requires no hospitalization.

Best of all, ECP is an exciting option for those people who have had, or are not good candidates for bypass surgery or angioplasty. If medication does not provide adequate relief from angina, ECP could be a positive alternative to invasive procedures.

What does ECP do?

ECP helps to alleviate symptoms of angina by increasing blood flow to the coronary arteries and heart muscle. This therapy does not remove blockages or stop the disease process. However, ECP helps revascularize the heart muscle through the development of collateral vessels. Collateral vessels help to increase blood supply to the heart muscle.

Clinical Studies have shown:
  • ECP provides Relief from Angina (chest pain)
  • ECP may decrease need or use of medication
  • ECP helps to improve exercise tolerance and daily activities
  • ECP improves Overall Quality of Life
  • ECP provides Results that can Last for Years
How does ECP work?

During ECP therapy, pressure cuffs are wrapped firmly around the calves, thighs, and buttocks. The cuffs inflate and deflate between each heart beat. When inflated, the cuffs squeeze blood toward the heart increasing coronary perfusion pressure, coronary blood flow and oxygen supply. This process helps oxygenated blood reach the heart muscle, further reducing or eliminating angina pain.

Is ECP Painful?

No. ECP is a non-invasive procedure that does not typically cause pain. However, some patients may experience minor bruising or skin irritation as a side-effect of ECP treatment.

Do insurance companies pay for ECP?

Yes. Medicare will pay for ECP treatment when it is prescribed by a cardiologist. Many private insurance companies are also paying for ECP treatment.

Is ECP an appropriate treatment option?

ECP may be appropriate if you answer "yes" to one or more of the following questions:

  • Do you suffer daily from chest pain?
  • Does your chest pain stopping you from performing daily activities?
  • Do you become short of breath with regular activity?
  • Do you suffer from Congestive Heart Failure (CHF)?
  • Are you anxious about the possibility of undergoing bypass surgery or angioplasty?


Hypertension is high blood pressure that persists over time.

More Americans visit their physician for the management of hypertension than for any other disease-specific reason.

Compared to people with normal blood pressure, people with hypertension are three times more likely to develop coronary heart disease, six times more likely to develop congestive heart failure, and seven times more likely to have a stroke.

Blood pressure is the outward pressure that blood exerts on the walls of the arteries as it flows through them. This outward pressure is determined by how much blood the heart pumps and the resistance of artery walls to the blood. Blood that enters and flows through arteries easily results in normal blood pressure. When the heart faces resistance and it must work harder to pump blood through the body, high blood pressure results. Hypertension is high blood pressure that persists over time.

As blood is pumped from the heart to the body, the force it exerts against the walls of the arteries is called blood pressure.

A blood pressure reading uses two numbers that represent the two phases of the heartbeat. The systolic reading corresponds to blood pressure when the heart contracts; the diastolic reading corresponds to blood pressure when the heart relaxes. Normal blood pressure is less than 130 millimeters of mercury, (mm Hg) systolic and less than 85 mm Hg diastolic, expressed as 130 over 85 (for example 130/85). A person has hypertension if his or her blood pressure is consistently 140 over 90 mm Hg or higher.

Hypertension can accelerate atherosclerosis, or hardening of arteries, because arteries that carry blood under high pressures thicken, and arteries thickened from hypertension are more susceptible to atherosclerosis. Because hypertension affects the arterial system in this way, it can contribute to various conditions, including:

  • Heart attack;
  • Stroke;
  • Kidney failure;
  • Coronary heart disease;
  • Congestive heart failure;
  • Cardiomyopathy;
  • Angina pectoris; and
  • Blurred vision and blindness.


Most people with hypertension initially have no symptoms. When
symptoms occur, they can include:

  • Headache;
  • Nosebleeds;
  • Fatigue;
  • Dizziness; and
  • Flushed face.

Left untreated, the symptoms of severe hypertension
can advance to include:

  • Nausea;
  • Irregular or rapid heartbeat;
  • Vomiting;
  • Shortness of breath;
  • Blurred vision; and
  • A buzzing noise inside the head.


Most often, when the cause of hypertension is unknown, it is called primary, or essential, hypertension. Secondary hypertension is high blood pressure caused by another condition (such as kidney problems, adrenal gland disorders, narrowing of the aorta, or pregnancy). Some potential causes of primary hypertension include:

  • Narrowed arteries;
  • Excessive blood volume; and
  • An abnormally faster or forceful heartbeat.

Several risk factors influence the development of hypertension,

  • Age (The risk of developing hypertension increases after age 35; 65 percent of people older than 60 have hypertension.);
  • Heredity;
  • Race (African Americans are more likely to develop hypertension than Caucasians.);
  • Gender (Until age 55, men are more likely to develop hypertension than women. Women become more likely to develop hypertension with age, however.);
  • Smoking;
  • Being overweight;
  • Alcohol;
  • Sedentary lifestyle; and
  • Medications.


Blood pressure normally fluctuates. Therefore, hypertension is only
diagnosed if blood pressure is consistently high over time.

A physician measures blood pressure using a device called a sphygmomanometer, which is attached to an armband-like cuff that is wrapped snugly around the upper arm. The cuff is inflated so that it momentarily blocks blood flow. The physician then slowly releases the air from the cuff, resuming blood flow, and listens to the sounds of blood flowing to the artery while watching the dial on the sphygmomanometer. The position of the dial during the first audible thump is the systolic pressure, while the position when the thumping becomes inaudible is the diastolic pressure.
Some people experience high blood pressure related to anxiety and nervousness caused by a visit to a doctor's office, called white-coat syndrome. Patients who experience this can use mobile blood pressure monitors away from the doctor's office to accurately measure their blood pressure.


Primary hypertension can be controlled, but not cured. Secondary hypertension
can be cured by treating the underlying condition. Because a person's diet and
exercise habits can affect blood pressure, physicians first recommend making
lifestyle changes, including:

  • Stopping smoking;
  • Losing weight;
  • Limiting alcohol consumption to 1 to 2 drinks per day;
  • Exercising; and
  • Eating a low-sodium diet.

Physicians commonly prescribe medications in addition to recommending lifestyle
changes, or if lifestyle changes do not control hypertension. Medications called
antihypertensives are commonly prescribed to control hypertension including:

  • Centrally acting agents (affect brain chemistry);
  • Peripherally acting agents (act on the nerves that regulate blood pressure);
  • Direct-acting vasodilators (relax blood vessel walls);
  • Beta-blockers;
  • Calcium channel blockers;
  • Diuretics; and
  • Angiotensin drugs.