Nicotinamide Riboside for Treating Elevated Systolic Blood Pressure and Arterial Stiffness in Middle-aged and Older Adults
| Status: | Not yet recruiting |
|---|---|
| Conditions: | Healthy Studies, High Blood Pressure (Hypertension) |
| Therapuetic Areas: | Cardiology / Vascular Diseases, Other |
| Healthy: | No |
| Age Range: | 50 - 79 |
| Updated: | 2/2/2019 |
| Start Date: | April 2019 |
| End Date: | December 2023 |
| Contact: | Daniel H Craighead, PhD |
| Email: | daniel.craighead@colorado.edu |
| Phone: | 303-492-7702 |
Nicotinamide Riboside Supplementation for Treating Elevated Systolic Blood Pressure and Arterial Stiffness in Middle-aged and Older Adults
Aging is the primary risk factor for cardiovascular diseases (CVD), the number one cause of
death in developed societies. Systolic blood pressure (SBP) increase with age and is a key
intermediary factor linking aging to increased CVD risk. The primary mechanisms underlying
the age-associated increase in SBP is stiffening of the large elastic arteries, which is
mediated by increases in oxidative stress, inflammation, and vascular smooth muscle tone.
Regular caloric restriction is effective at lowering SBP in middle-aged and older adults;
however, adherence to caloric restriction is poor and may be detrimental to normal weight
older adults due to reduced skeletal muscle mass and bone mineral density. Therefore,
identification of more practical alternative interventions that mimic the beneficial effects
of caloric restriction, with stronger adherence and less risk of adverse consequences, is of
significant biomedical importance.
Nicotinamide riboside is a naturally occurring precursor of nicotinamide adenine dinucleotide
(NAD+), a critical mediator of the beneficial effects of caloric restriction, and therefore a
novel caloric restriction mimetic compound. We recently completed the first pilot study of
nicotinamide riboside supplementation in healthy middle-aged and older adults and
demonstrated that 6 weeks of supplementation decreased systolic blood pressure (SBP) by 8
mmHg in individuals with baseline SBP of 120-139 mmHg (elevated SBP/stage 1 hypertension)
compared with placebo, and lowered arterial stiffness, a strong independent predictor of CVD
and related morbidity and mortality.
As a next translational step, we will conduct a randomized, placebo-controlled, double-blind
clinical trial to further assess the safety and efficacy of oral nicotinamide riboside (3
months vs placebo) for decreasing SBP and arterial stiffness in middle-aged and older men and
women with SBP between 120 and 139 mmHg at baseline.
death in developed societies. Systolic blood pressure (SBP) increase with age and is a key
intermediary factor linking aging to increased CVD risk. The primary mechanisms underlying
the age-associated increase in SBP is stiffening of the large elastic arteries, which is
mediated by increases in oxidative stress, inflammation, and vascular smooth muscle tone.
Regular caloric restriction is effective at lowering SBP in middle-aged and older adults;
however, adherence to caloric restriction is poor and may be detrimental to normal weight
older adults due to reduced skeletal muscle mass and bone mineral density. Therefore,
identification of more practical alternative interventions that mimic the beneficial effects
of caloric restriction, with stronger adherence and less risk of adverse consequences, is of
significant biomedical importance.
Nicotinamide riboside is a naturally occurring precursor of nicotinamide adenine dinucleotide
(NAD+), a critical mediator of the beneficial effects of caloric restriction, and therefore a
novel caloric restriction mimetic compound. We recently completed the first pilot study of
nicotinamide riboside supplementation in healthy middle-aged and older adults and
demonstrated that 6 weeks of supplementation decreased systolic blood pressure (SBP) by 8
mmHg in individuals with baseline SBP of 120-139 mmHg (elevated SBP/stage 1 hypertension)
compared with placebo, and lowered arterial stiffness, a strong independent predictor of CVD
and related morbidity and mortality.
As a next translational step, we will conduct a randomized, placebo-controlled, double-blind
clinical trial to further assess the safety and efficacy of oral nicotinamide riboside (3
months vs placebo) for decreasing SBP and arterial stiffness in middle-aged and older men and
women with SBP between 120 and 139 mmHg at baseline.
Inclusion Criteria:
- Ability to provide informed consent
- Willing to accept random assignment to condition
- Systolic blood pressure between 120 and 139 mmHg
- Body mass index <40 kg/m2
- Weight stable in the prior 3 months (<2 kg weight change) and willing to remain weight
stable throughout the study
- Absence of other clinical disease as determined by medical history, physical
examination, blood chemistries, ankle-brachial index, and 12-lead ECG at rest and
during graded treadmill exercise
- Ankle-brachial index >0.7
- Total cholesterol <240 mg/dL
- Fasting plasma glucose <126 mg/dL
- Normal 12-lead ECG at rest and during graded treadmill exercise to fatigue
Exclusion Criteria:
- Systolic blood pressure <120 or >/= 140 mmHg
- Currently taking antihypertensive medications
- Other chronic medical condition (e.g., diabetes, chronic kidney disease, cancer)
- Current smoker
- Alcohol dependence or abuse
- Uncontrolled thyroid disease or change in thyroid medication within previous 3 months
- Abnormal blood pressure response to exercise (drop in SBP below resting pressure or
SBP >160 mmHg or DBP >115 mmHg)
- Regular vigorous aerobic/endurance exercise (>4 bouts/weeks, >30 min/bout at a
workload >6 METS)
We found this trial at
1
site
354 UCB
Boulder, Colorado 80309
Boulder, Colorado 80309
Principal Investigator: Douglas R Seals, PhD
Phone: 303-492-2485
Click here to add this to my saved trials
