What is Counterpulsation?

Diastolic Augmentation

Counterpulsation therapy works by increasing pressure in both arteries and veins during the relaxation phase of the heart (diastole). This increase in pressure is known as “Diastolic Augmentation”. It is achieved by sequential inflation of cuffs placed on both lower limbs. This increases blood flow to the heart and other organs such as the kidneys, liver and brain. It also increases venous return to the right side of the heart, so increasing strength of contraction next time the heart pumps (Starlings Law).  

Increased blood flow to the heart and other organs

Systolic Unloading

Immediately before the next contraction of the heart (systole), the pressure in all three cuffs instantaneously falls to zero.
The heart is now able to pump against greatly reduced resistance into empty veins and arteries in the legs. This significantly reduces the amount of work the heart has to do to pump blood around the body. This effect is known as “Systolic unloading”.

The workload of the heart is reduced

Stronger Heart


As the contraction finishes and the next relaxation phase begins (diastole), the cuffs once again sequentially inflate and increase pressure in the arteries and veins. Supporting the heart in this way reduces strain on the heart muscle, allowing it to pump more effectively.

Sustained improvement in Cardiac function

Microscopic effects

Research has now demonstrated that the increased blood flow around the body stimulates the delicate lining of blood vessles. This lining, called the endothelium, releases important chemicals into the blood. This includes nitric oxide, which causes all blood vessles to relax (dilate), further increasing blood flow around the body. There are also strong beneficial reductions in inflammatory substances. Increased flow also stimulates the bone marrow to release stems cells for new blood vessel growth (angiogenesis). 

Improved vascular health