Remote Ischemic Conditioning: Challenges and Opportunities

Remote ischemic conditioning (RIC) has been investigated as a promising, safe, and well-tolerated nonpharmacological therapy for cardio-cerebrovascular disease over the past 3 decades; variable results have been found when it is used in cerebrovascular versus cardiovascular disease. For patients with cardiovascular disease, milestone studies suggest that the roles of RIC may be limited. Recently, however, 2 large trials investigating RIC in patients with cerebrovascular disease found promising results, which may reignite the field's research prospects after its setbacks in the cardiovascular field. This perspectives article highlights several important clinical trials of RIC in the cardio-cerebrovascular disease and describes the many challenges of RIC in clinical translation. Finally, based on the available evidence, several promising research directions such as chronic RIC, early initiation in target population, improvement of compliance, better understanding of dosing, and identification of specific biomarkers are proposed and should be investigated before RIC can become applied into clinical practice for patient benefit.

Automated summary

Remote ischemic conditioning (RIC) has shown variable results in the treatment of cerebrovascular and cardiovascular disease. While milestone studies suggest limited roles for RIC in cardiovascular disease patients, recent large trials found promising results in cerebrovascular disease patients. This article discusses important clinical trials of RIC in cardio-cerebrovascular disease and highlights the challenges of clinical translation. It proposes several promising research directions that should be investigated before RIC can be applied in clinical practice.