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Effect of transcranial direct current stimulation on central blood pressure in resistant hypertensive subjects

Grant number: 16/02317-0
Support type:Scholarships abroad - Research Internship - Post-doctor
Effective date (Start): August 01, 2016
Effective date (End): October 31, 2016
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal Investigator:Heitor Moreno Junior
Grantee:Alessandra Mileni Versuti Ritter
Supervisor abroad: Felipe Fregni
Home Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil
Research place: Harvard University, Boston, United States  
Associated to the scholarship:14/03285-9 - Obesity and target organs damage in resistant hypertension: role of metaloproteinases, BP.PD

Abstract

Resistant hypertension (RHTN) is defined as high blood pressure (BP) in spite of concurrent use of three or more antihypertensive drugs of different classes, combined at optimal doses and including a diuretic. The mechanisms of resistance to antihypertensive treatment is a multifactorial condition not fully elucidated, but it has been associated to hyperactivity of sympathetic nervous system (SNS). Indeed, invasive therapies have been development for the treatment of RHTN, but SNS hyperactivity remains as a challenge in clinical practice. Thus, the use of cerebral stimulation techniques, such as non-invasive transcranial direct current stimulation (tDCS) on cortex in HAR subjects seems promising due to potential modulation of SNS and BP. This project aims to learn and further implant the transcranial direct current stimulation technique in Brazil with the equipment DC Stimulation Plus SHAM (neuroConn GmbH, Germany), recently acquired by CEPID FAPESP process (2013/07607-8). Also, we aim to evaluate whether the use of tDCS is able to reduce BP levels in HAR. It will be done a double-blind, placebo-sham study in 10 patients RHTN. These patients will receive tDCS intervention during 2 weeks and the central BP (Sphygmocor) will be assessed in the pre- and pos-period of tDCS. We hypothesize that tDCS acutely reduce BP levels in RHTN patients by modulating the sympathetic nervous system. Learn and improvement neuroestimulation technique in Dr. Felipe Fregni laboratory at Harvard Medical School will provide scientific knowledge to implant tDCS procedure in our laboratory in Brazil, allowing a new therapy conduct for resistant hypertensive patients.