Effects of Antihypertensive Drug Treatment on Brain Blood Flow, Cognition, and Regulation of Nervous System in Older Adults With Hypertension.

Early Phase 1CompletedNCT06287580

University of Texas Southwestern Medical Center27 enrolled

Overview

High blood pressure (BP) is a public health problem worldwide. Nearly three-quarters of older adults (age \~60 years) in the United States have high BP. High BP links to many health problems, like stroke. Drug treatments are typically used in clinics to reduce high BP and the risk of associated health problems. However, these drug treatments may not always benefit brain health. For example, drug treatment may reduce brain blood flow, which may reduce cognitive function in older adults with high BP. Alternatively, reduced brain blood flow may cause high BP due to increased nervous system activity (the so-called "fight or flight response"). Thus, monitoring brain blood flow may help to manage high BP during drug treatment. It is unknown if brain blood flow and its control will be altered by drug treatment in older high BP patients. Therefore, study team will recruit older adults with high BP, who receive either drug treatment or a placebo for 1 to 2 weeks and will assess brain blood flow, cognitive function, and nervous system control before and after treatment. Results from this study will provide novel and clinically relevant information on the impact of drug treatment for high BP on brain health. Investigators expect these results will suggest that it is crucial to measure brain blood flow, which may be a therapeutic new target for BP control and brain health.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

TRIPLE

Enrollment

Conditions

Essential Hypertension

Eligibility

Sex: ALLMin age: 60 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Older men and women with prehypertension or mild-to-moderate essential hypertension (clinic systolic blood pressure 120-169 and/or diastolic blood pressure 80-109 mmHg). Exclusion Criteria: * Any evidence of cardiovascular or pulmonary disease by medical history or by physical examination * Severe hypertension (systolic BP ≥170 and/or diastolic BP ≥110 mmHg; for safety reasons) or secondary hypertension * Being on ≥3 antihypertensive agents * Chronic kidney disease (an estimated glomerular filtration rate \>45 mL/min) or renal failure * Diabetes mellitus (fasting glucose ≥126 mg/dL or 2-hour oral glucose tolerance test, glucose level ≥200 mg/dL) or other systemic illness * Any history of substance abuse (other than tobacco) * Current cigarette smokers * History of gouty arthritis * Taking hormonal replacement therapy * Endurance-trained athletes * Diagnosed Alzheimer's disease and related dementias

Outcomes

Primary Outcomes

Change in Muscle sympathetic nerve activity (MSNA) from baseline at post intervention

Muscle sympathetic nerve activity will be measured using microneurography at the peroneal nerve. Muscle sympathetic nerve activity will be quantified by identification and measurement of sympathetic bursts in the integrated neurogram and expressed as burst frequency (mean number of bursts per unit time)

Time frame: Baseline, post intervention

Change in cognitive performance from baseline at post intervention via Stroop Color and Word Test

Change in cognitive performance is measured by Stroop Color and Word Test. Accuracy and reaction time in the Stroop Color and Word test are computed to assess cognitive performance.

Time frame: Baseline, post intervention

Change in Cerebral blood flow from baseline at post intervention

A probe will be placed over an artery in participant's neck and temple. Total cerebral blood flow is calculated as a sum of blood flow from the four arteries of the internal carotid artery and vertebral artery. The distribution of cardiac output to the brain is calculated as the percentage of total cerebral blood flow to cardiac output.

Time frame: Baseline, post intervention

Effects of Antihypertensive Drug Treatment on Brain Blood Flow, Cognition, and Regulation of Nervous System in Older Adults With Hypertension.

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes