Remote Ischemic Conditioning

Ischemic disorders are among the most frequent causes of debilitating disease and death. They include heart attack, TIA and stroke, diabetic foot ulcers, knee replacements and brain injury (TBI).

See footnote for image credit.

See footnote for image credit.

The body has an innate process for defending itself from ischemic disorders, which can be activated by a procedure called Remote Ischemic Conditioning (RIC).  RIC is believed to signal through one or both of two potential pathways:  a humoral pathway, involving a blood-borne messenger molecule, and, a neural, parasympathetic pathway mediated by acetylcholine. Each pathway leads to the activation of cell-surface receptors that in turn leads to the activation of cytoprotective signaling. (1) 

Remote Ischemic Conditioning (RIC) has been shown to trigger natural protection from ischemic disorders but still requires pivotal studies.  In addition, manual delivery is problematic for widespread use, and automation will be needed for the therapy to become widely available.

Ischemic Conditioning

Ischemia is inadequate blood supply to an organ. It causes a shortage of the oxygen needed to keep tissue alive. Without immediate intervention, the result is frequently debilitating disease and death. RIC therapy means four cycles of alternately stopping and restoring blood flow in an arm or leg for five minutes at a time in order to activate an innate process that makes remote tissues and organs resistant to ischemia.


5 minutes on
5 minutes off
For 40 minutes


Produces resistance to ischemic damage throughout the body

Safety & Efficacy

A 2015 PubMed article states: “RIC is safe and effective, noninvasive, easily feasible, and inexpensive.” (2)

Clinical evidence is overwhelmingly positive.

  • 64 of 70 RIC studies with 5,769 patients were positive. No studies had negative results. The 8 studies that showed no effect involved the use of anesthesia known to counteract RIC.
  • Clinical trials – 30 years of more than 100 completed and ongoing trials with more than 20,000 patients throughout the world and zero negative results.

Click here to see a partial bibliography.

Click here to see selected published clinical studies and analyses. 

Key End Points Achieved




(2) Reproduced from Robert M. Bell et al. Remote Ischaemic Conditioning: Building Evidence of Efficacy. EHJ (2014) 35 (3): 138-140 (Fig. 1). By permission of Oxford University Press on behalf of the European Society of Cardiology. Published at