{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T13:11:21Z","timestamp":1778073081943,"version":"3.51.4"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypertension is a major risk factor for cardiovascular diseases, affecting over 1.28 billion adults worldwide, with nearly 46% remaining undiagnosed or untreated. Auricular vagus nerve stimulation (aVNS) has emerged as a promising non-invasive neuromodulation approach for autonomic regulation, yet its effects on blood pressure (BP) remain underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The effects of aVNS on blood pressure in chronic pain patients were evaluated, with a specific focus on differential responses by hypertensive status and antihypertensive treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective dual-center study analyzed the impact of aVNS on BP in 24 chronic pain patients [mean age 48.5 (9.1) years; 75% female], categorized into non-hypertensive (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913) and hypertensive (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911) individuals. The hypertensive cohort was further stratified into patients receiving pharmacological hypertension treatment (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095) and those untreated (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096). Patients received aVNS over an 8-week treatment period, followed by a 4-week follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over an 8-week treatment period, hypertensive patients exhibited significant reductions in systolic BP [\u221210.7 (2.9) mmHg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0003] and diastolic BP [\u22125.8 (2.0) mmHg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0357], while non-hypertensive individuals showed no significant BP changes. Subgroup analysis revealed that BP reductions were most robust and consistent in untreated hypertensive patients (SBP: \u221211.0 mmHg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), whereas patients on antihypertensive medication showed greater variability. Mean arterial pressure (MAP) declined significantly in hypertensive individuals [\u22129.3 (6.7) mmHg,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0022]. In contrast, no significant changes were observed in heart rate or heart rate variability [e.g., heart rate: \u22120.9 (1.8) beats\/min; root mean square of successive differences in normal RR intervals: \u221212.8 (9.0) ms at week 12, both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20091.0000], suggesting preserved autonomic stability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>aVNS may be associated with BP reductions in hypertensive patients particularly those not receiving pharmacological treatment, with minimal effects in normotensive individuals. These retrospective findings suggest a potential sustained benefit in patients with comorbid chronic pain and support further investigation through prospective, sham-controlled trials to confirm efficacy and clarify underlying mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1736774","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T05:26:55Z","timestamp":1774848415000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Sustained blood pressure reduction associated with percutaneous auricular vagus nerve stimulation in hypertensive chronic pain patients: a retrospective dual-center analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Laurenz","family":"Berger","sequence":"first","affiliation":[{"name":"Center for Medical Physics and Biomedical Engineering, Medical University of Vienna","place":["Vienna, Austria"]},{"name":"Ludwig Boltzmann 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