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Intra-aortic balloon pump (IABP) therapy primarily functions to improve coronary artery perfusion. This is achieved through the mechanism of the balloon inflating during diastole, which subsequently increases coronary blood flow to the heart muscle when the aortic valve is closed. By inflating the balloon at this specific time, it creates a temporary increase in the diastolic pressure within the aorta, thus enhancing blood flow to the coronary arteries.

Additionally, the device's inflation and deflation cycles help to reduce left ventricular workload by decreasing afterload when the balloon is deflated prior to ventricular contraction. This dual effect—improved coronary perfusion and decreased work of the heart—makes the IABP particularly useful in cases of heart failure or in patients undergoing high-risk cardiac procedures.

While blood pressure regulation and cardiac output are important physiological parameters influenced by various interventions, they are secondary effects rather than the primary function of the IABP. This distinction emphasizes the central role of enhancing coronary artery perfusion in the therapy's intended outcomes.