Study Overview: This research is testing a new device called the ARC-IM System to help manage blood pressure problems in people who have had a spinal cord injury for over a year. Blood pressure instability can be uncomfortable or dangerous, especially when sitting or standing. Study Process: Participants will undergo surgery for the ARC-IM System implant and will be divided into two groups. One group will receive active treatment, while the other will receive a placebo-like treatment. After three months, all participants will receive the active treatment. Eligibility: Participants must be 18-75 years old and have specific blood pressure issues due to a spinal cord injury that occurred at least a year ago.

• Participation involves a surgical implant and follow-up visits to monitor progress.
• Subjects will need to manage without certain blood pressure medications for 30 days before joining.
• If you need daily help from a caregiver, they must be present during study visits.

Safety Note: Some conditions, like heart problems or pregnancy, mean you cannot join. Check with your doctor if you are eligible and consider the commitment before participating.