Improving Pain Management Via Spinal Cord Stimulation and Blood Pressure Reduction
Improving Pain Management Via Spinal Cord Stimulation and Blood Pressure Reduction
The purpose of this study (PASSION study) is to monitor symptoms of chronic pain before and
 after 4 weeks of a standard drug commonly used to treat elevated blood pressure so that we
 may better understand how blood pressure affects your level of pain. This study is not
 testing an experimental drug.
The goal of the PASSION study is to determine the extent to which reductions in blood
 pressure improve pain management via SCS

 1. Examine the extent to which reductions in blood pressure (4 weeks of diuretic) improve a
 SCS device among patients with chronic pain and hypertension compared with placebo.

 2. Examine the extent to which arterial baroreflex function, which is critical to blood
 pressure regulation, is impaired in patients with chronic pain and hypertension and is
 correlated with chronic pain symptoms.
Inclusion Criteria:

 1. Male or Female, age 40-79

 2. Chronic low back pain

 3. Permanent spinal cord stimulator implant for chronic pain

 4. Stage 1 hypertension (BP 130-139/80-89 mmHg) with ASCVD risk ≥10%

 5. Stage 2 hypertension (BP ≥ 140/90 mmHg)

 6. Willing to visit research lab (Fairway CTSU)

 7. Willing to undergo a blood draw

 8. Able to provide written informed consent

 Exclusion Criteria:

 1. Any history of abnormal responses (allergy) to thiazide-type drugs

 2. Currently taking any antihypertensive medication

 3. Stage 1 hypertension (BP 130-139/80-89 mmHg) with ASCVD risk <10%

 4. BP ≥160/100 (these patients should be promptly treated with 2 medications)

 5. Secondary hypertension (e.g., aldosteronism, renal artery stenosis)

 6. Symptomatic hypotension (weakness or syncope upon standing)

 7. Renal failure

 8. Diabetes requiring insulin or glucose-lowering drugs

 9. History of neurological disease (e.g., dementias, Parkinson's)

 10. History of stroke

 11. Current diagnosis of cancer

 12. Women who are pregnant or planning to become pregnant

 13. Any active infection

 14. Subject is unwilling or unable to comply with the protocol

 15. If currently taking a NSAID, willing to stop for at least 3 days prior to beginning
 study and throughout study