Heart care

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Businessman Tony Rutledge gets EECP treatment in Newmarket for angina and arrhythmia. Photo / Janna Dixon

Sports stars and clients hoping to improve their health are paying up to $10,000 for a controversial health treatment in Auckland. Some swear by it while others are sceptical. Sally Webster investigates.

All Black Ali Williams has been treated. So has former All Black Tana Umaga, boxer Shane Cameron and entertainer Ray Columbus.

Known as EECP (enhanced external counter pulsation) therapy, the treatment is claimed to have several benefits, including improving the quality and capacity of the circulatory system, lowering blood pressure and blood sugar, relieving stable angina and improving body condition.

The treatment has its own entry on Wikipedia, giving it credibility with internet surfers, and it is United States Food and Drug Administration-approved.

But New Zealand Medical Association chairman Paul Ockleford has never heard of it.

Nevertheless, patients are forking out $300 a session for the therapy. Many are being recommended a course of 35 treatments at a cost of $10,500.

Director Will Hinchcliff set up Primary Heart Care in 2007, using US parent body Global Cardio Care's brand of EECP clinics.

Hanging on the wall of the Newmarket clinic's waiting room are a collection of signed photographs. "Thanks for everything," writes Tana Umaga, and from the US comes endorsement from Mohammed Ali's daughters.

Justifying the $300 charge, Hinchcliff says the beds alone cost $250,000. He has three beds in use and another two in storage for when the five-bed clinic increases its patient numbers. And there lies the challenge. To get enough patients, Hinchcliff has to make the treatment affordable.

Attempts to persuade district health boards and health insurer Southern Cross to include the clinic as a bona-fide service provider have been unsuccessful. Instead, Hinchcliff is forming a new charitable trust, The Primary Heart Care Foundation, which will discount the treatment of patients who can't afford the fees. And, he says, the foundation will fund research to prove EECP's effectiveness.

Hinchcliff won't say whose funding will pad the foundation coffers. Board members include his father and Auckland councillor, Dr John Hinchcliff, as well as Dr Gerard Lewis, known for breakthrough research into the treatment of hypertension. Ray Columbus will chair the board.

But whether EECP is worth the money is still up for debate. Patients lie on a bed for an hour while fitted with inflatable cuffs wrapped around each leg from the ankle to the buttocks, much like those strapped to the upper arm to read blood pressure.

Electrodes on the chest monitor the heart. In the heart's rest phase, the cuffs inflate. They squeeze the blood up from the legs with a gusto usually only produced by the clenching lower ventricles of a healthy heart. Thus, the organ can use available energy to pump the blood out and supposedly reach long-forgotten parts of the body.

Ockleford says the treatment reminds him of the "very simplified theory behind compression stockings used to stop venous pooling".

"But, of course, the placebo effect could be at work here," he says.

"It's not uncommon for fringe therapies - especially when expensive - to attract patients who really want to believe that therapy is working.

"Bear in mind, too, that testimonials are understood to affect a 30 per cent placebo effect before the treatment has even begun."

Columbus and his wife, Lynda, are sold on the treatment. Both have been treated with EECP. Lynda suffered post-polio syndrome, had "the heartbeat of a sparrow" and had metal plates in her face after a near-fatal car accident.

"She claimed that after 13 sessions of EECP her face was no longer prey to barometric changes that pained her daily," says Ray Columbus. "She finally got her smile back."

Encouraged by his wife's feedback, Columbus tried the treatment to see if he could improve his health after a heart attack and three stent procedures. "My recovery and return to a normal life was so impressive that, some months later in the [US], a specialist said my symptoms of cardiovascular disease appeared to have been reversed."

The couple are happy to be advertisements for EECP. Their testimonials persuaded Auckland retiree Professor Ray Bradley to give it a go. Bradley endorsed a testimonial that after treatment last year, EECP lowered his blood pressure "by 40 points and, as a diabetic, he no longer needed insulin".

Ali Williams had treatment before his Tri Nations inclusion in July, reportedly to quickly mend lingering shoulder and Achilles tendon injuries. Boxer Shane Cameron heard about the therapy from runner Lisa Tamati. He mixed treatments with rigorous training to increase his chances against Dominic Vea in July's Sydney fight.

"I was incredibly sceptical to start with but it really improved my conditioning and even helped my hand injury," he says.

Hinchcliff still hopes Primary Heart Care will be added to the list of Southern Cross providers. But Southern Cross Health Society chief executive Peter Tynan indicated the application was unsuccessful partly because Primary Heart Care was not a "registered medical provider or a member of a recognised professional body".

Also, studies of a reasonable clinical size and longevity are lacking, he says.

Heart Foundation medical director Professor Norman Sharpe agrees, saying that is why the foundation turned down any involvement. He says the available clinical research data is "very interesting" and he is widely read on the subject. "Something is definitely happening. Most studies published on the internet point in the right direction but they use small groups. To be conclusive with something like this you'd need hundreds of people to take part. That's expensive."

Proof of long-term results is also lacking. "I'm aware that many people feel they're enjoying a better quality of life after EECP treatment, but for how long and for how much? Frankly, it's just too expensive for us to endorse."

Nevertheless, patients keep coming. One former company director, who did not want her name used, said that after eight months of treatment, incidents of atrial fibrillation were considerably reduced, even though EECP isn't known for overcoming this condition with the same success attributed to reducing angina.

Twins Elanie Pakea and Lynette Kake said their father, Wana Ruarangi Paikea, was recovering from a triple bypass and a stroke earlier this year and could barely walk. But after his fourth treatment, he left his walker at home and could walk a short distance.

Bradley said although his blood pressure was initially lowered after EECP therapy, the treatment couldn't save him from another stroke.

"At first I ... was even prepared to drive from Omaha every day, but the cost was almost impossible to manage. [Hinchcliff] generously offered me a discount and I was able to continue once a week. But in December last year, I had a stroke and was hospitalised for five days." Bradley says his blood pressure has crept up to the same level as before the stroke. He stopped the therapy two months ago.

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