Sleep and Circadian Mechanisms Contributing to Nocturnal Non-dipping Blood Pressure
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Hypertension
- Sponsor
- Oregon Health and Science University
- Enrollment
- 30
- Locations
- 1
- Primary Endpoint
- Blood pressure
- Status
- Completed
- Last Updated
- 11 months ago
Overview
Brief Summary
This study will be the first to distinguish the relative contributions of sleep, circadian and behavioral mechanisms to the non-dipping BP profile in Black adults and will lay the groundwork for optimizing therapies dependent on mechanisms, such as targeting sleep, targeting circadian rhythmicity, or targeting behaviors, and raising the possibility that ideal therapy for hypertension (HTN) may differ by race. This research will ultimately help to improve health and survival in black populations with HTN.
Detailed Description
By studying standardized behaviors and regulators of BP during sleep and behavioral stresses across all circadian phases, this protocol will allow us specifically to: 1. To determine if poor sleep, while controlling for circadian phase, contributes to the higher overall BP and reduced nocturnal drop in BP in Blacks compared to Whites. 2. To determine if reduced BP responses to standardized behavioral changes across the day and night contribute to the higher overall BP and reduced nocturnal drop in BP in Blacks compared to Whites. 3. To determine if reduced circadian amplitude of BP contributes to the higher overall BP and reduced nocturnal drop in BP in Blacks compared to Whites.
Investigators
Steven A. Shea
Director
Oregon Health and Science University
Eligibility Criteria
Inclusion Criteria
- •Self-identified Black or White
- •'normotensive' (resting systolic blood pressure (SBP) \<140/90 mmHg) or uncomplicated stage 1 'hypertensive' (systolic BP between 140 and 160 mmHg or a diastolic (DBP) between 90 and 100 mmHg).
- •free of all prescription and non-prescription drugs (including caffeine, nicotine, alcohol and herbal medications)
Exclusion Criteria
- •Currently treated with pharmacologic agents for hypertension
- •Blood pressure \>160/100 mmHg
- •Smoked within the last year
- •Regular night work or rotating shift work for the three months prior to the study
- •Travel across more than three time zones during the three months prior to the study.
- •Any acute, chronic or debilitating medical conditions, other than mild hypertension (140\<SBP\<160 or 90\<DBP\<100 mmHg) and severe renal disease (glomerular filtration rate \<30)
- •Moderate to severe obstructive sleep apnea (OSA)
- •History of severe psychiatric illnesses or psychiatric disorders will be excluded, including alcoholism, drug dependency, major depression, manic depressive illness, schizophrenic disorders, panic disorder, generalized anxiety disorder, post-traumatic stress disorder, agoraphobia, claustrophobia, paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder, borderline personality disorder, and antisocial personality disorder.
Outcomes
Primary Outcomes
Blood pressure
Time Frame: 7-day lab stay
Blood pressure will be measured via automatic and manual-operated sphygmomanometer. Readings will be recorded in units of mmHg.
Heart rate variability
Time Frame: 7-day lab stay
Two channel ECG will be recorded for heart rate variability analysis.
Secondary Outcomes
- saliva cortisol(7-day lab stay)
- venous norepinephrine(7-day lab stay)
- venous aldosterone(7-day lab stay)
- venous endocannabinoids(7-day lab stay)
- venous epinephrine(7-day lab stay)
- saliva melatonin(7-day lab stay)
- beat-by-beat blood pressure(7-day lab stay)
- 24-hr ambulatory blood pressure(2 day ambulatory period)
- flow mediated dilation(7-day lab stay)