Hypertension, Systolic, Stiffness, Aortic
Conditions
Brief summary
Stiffening of your blood vessels, particularly the large vessels from your heart (called the aorta and carotids) you age contributes to the development of cardiovascular disease (CVD) such as heart attack and stroke. Nerve activity from your brain to your body also increases with advancing age but it is unknown if this nerve activity contributes directly to the stiffening on your blood vessels in older adults in addition to high blood pressure. Therefore, successful completion of the proposed aims will have a significant clinical impact by identifying if nerve activity from your brain could be a novel target for therapies that would lower stiffness of the aorta and carotid arteries in older adults.
Interventions
DRUGClonidine
Clonidine 0.2 mg/day oral tablet
DRUGHydrochlorothiazide
Hydrochlorothiazide 37.5 mg/day oral tablet
DRUGPlacebo
Placebo
Sponsors
University of Iowa
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Intervention model description
Randomized, placebo controlled, parallel design
Eligibility
Sex/Gender
ALL
Age
60 Years to 85 Years
Healthy volunteers
Yes
Inclusion criteria
* age 60-85 * non-smoking * clinically healthy * untreated or treated stage 1 isolated systolic hypertension (ISH) (systolic BP 130-139 mmHg; diastolic BP \<90 mmHg) or stage 2 ISH (systolic BP 140-159 mmHg; diastolic BP \<90 mmHg) per 2017 AHA/ACC hypertension guidelines * if subject is on antihypertensive medications, they will stop taking medication for a one-week washout period after Visit 1 before they return for Visit 2. They will come in at day 3 and day 7 of the one-week washout for a BP reading, to confirm that systolic BP is \<160 mmHg.
Exclusion criteria
* no history of cardiovascular disease (e.g., myocardial infarction, bypass surgery, angioplasty/stent, heart failure, cardiomyopathy, pacemaker/defibrillator, peripheral artery disease), pulmonary disease, liver disease, Type I or II diabetes, cancer (treated by chemotherapy and/or radiation), psychiatric illness, on aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs). * aspirin, NSAIDs, vitamins, herbal supplements, omega-3-fatty acids will have to discontinue for at least 1 week before participation and remain discontinued during the study. * blood thinners, serotonin reuptake inhibitors (SSRIs), or PDE5 inhibitors will also be excluded. * Women must be postmenopausal for at least 6 months (surgical or natural) and not currently on hormone replacement therapy. * Subjects not on antihypertensive will not be eligible if their resting clinic systolic BP is \<130 mmHg or \>160 mmHg and diastolic BP \>90 mmHg.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in carotid-femoral pulse wave velocity | Baseline and after 4 weeks | Aortic stiffness |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in carotid distensibility index | Baseline and after 4 weeks | Change in carotid distensibility |
| Change in carotid flow pulsatility index | Baseline and after 4 weeks | Change in carotid flow pulsatility |
| Change in carotid intimal medial thickness (IMT) | Baseline and after 4 weeks | Change in carotid wall thickness |
Countries
United States
Outcome results
None listed