External Counterpulsation for Non-Cardiac Conditions: Current Evidence from a Rapid Review

External Counterpulsation (ECP) is a non-invasive therapy traditionally used for refractory angina and coronary artery disease. The evidence for non-cardiac applications remains limited, despite the well-established cardiovascular benefits. The objective of this review is to evaluate the efficacy and therapeutic potential of ECP in non-cardiac conditions through a rapid review of current literature. A rapid review was conducted on PubMed for articles published up to December 2025. Eligible articles included clinical trials, observational studies, narrative reviews and systematic reviews that assessed ECP in noncardiac disease populations. Data were extracted based on the study design, patient demographics, intervention protocols, outcomes, side effects, and limitations. From an initial pool of 52 records, 16 articles were ultimately incorporated, encompassing a range of conditions including type 2 diabetes, long COVID, ischaemic stroke, vertebrobasilar insufficiency, retinal artery occlusion, intracranial stenosis, kidney dysfunction, fractures and exercise recovery. Most articles reported improvements in functional capacity, endothelial function, and cerebral and blood biomarkers. Limitations include the heterogeneity of treatment protocols and durations, as well as the lack of long-term follow-up. ECP seems to offer widespread benefits beyond cardiac health, particularly in ameliorating endothelial dysfunction, improving circulation, and enhancing regenerative capacity and neurological function. However, robust trials and disease-specific protocols are essential to validate efficacy and optimise clinical integration.