Angiotensin-(1-7) Cardiovascular Effects in Aging

Aging Clinical Trial

Official title:

Angiotensin-(1-7) Cardiovascular Effects in Aging

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05301192
• Other study ID #: STUDY 17401
• Secondary ID: K99HL159272
• Status: Recruiting
• Phase: Early Phase 1
• Start date: December 9, 2022
• Est. completion date: December 1, 2024

Study information

• Verified date: May 2024
• Source: Milton S. Hershey Medical Center
• Contact: Aimee Cauffman, RN
• Phone: 717-531-1617
• Email: acauffman[@]pennstatehealth.psu.edu
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Aging is an independent risk factor for developing hypertension and cardiovascular disease; however, the mechanisms underlying age-related cardiovascular disease remain poorly understood. One hallmark of aging is an increase in sympathetic nervous system activity, which can decrease the number and/or sensitivity of β2 adrenergic receptors to reduce dilation of blood vessels and increase blood pressure. Identifying new targets to restore vascular β2 adrenergic receptor signaling may help reduce cardiovascular risk in aging. This study will test the hypothesis that angiotensin-(1-7), a protective hormone of the renin-angiotensin system, can reduce cardiovascular sympathetic outflow and blood pressure and improve endothelial function in older healthy humans.

Description:

A randomized, double blind, placebo-controlled, crossover study will be conducted to determine if acute intravenous angiotensin-(1-7) infusion can reduce cardiovascular sympathetic tone and blood pressure and improve the function of blood vessels in older healthy individuals. This is an outpatient study that requires a screening visit, and if eligible, two study visits separated by at least one week in the Clinical Research Center within the Penn State Milton S. Hershey Medical Center. The study visits will include intravenous infusion of angiotensin-(1-7) or saline for approximately two hours, starting with increasing doses and holding at a steady-state dose. Endothelial function will be measured and blood samples and endothelial cells collected at baseline and at the end of infusions. Blood pressure, heart rate, and muscle sympathetic nerve activity via microneurography will be measured throughout the study. Each study visit will last approximately 4 hours.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 26
• Est. completion date: December 1, 2024
• Est. primary completion date: June 1, 2024
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 65 Years to 80 Years

Eligibility

Inclusion Criteria:

• Men and women of all races and ethnicities

• Capable of giving informed consent

• Fluent in written and spoken English

• Age 65-80 years

• Body mass index (BMI) between 18.5 and 30 kg/m2

• Normotensive defined as seated blood pressure <130/80 mmHg and without hypertensive medications

• Satisfactory history and physical exam

Exclusion Criteria:

• Age < 65 or > 80 years

• Women who are pregnant, nursing, or taking hormone replacement therapy

• Decisional impairment

• Prisoners

• Current or recent (less than 6 months) recreational drug history or excessive alcohol abuse history (greater than 14 drinks per week)

• Current smokers

• Highly trained athletes

• Evidence of type I or type II diabetes (fasting glucose > 126 mg/dL or use of anti-diabetic medications)

• Hypertension or history of serious cardiovascular disease (e.g., myocardial infarction within 6 months, symptomatic coronary artery disease, presence of angina pectoris, significant arrhythmia, congestive heart failure, deep vein thrombosis, pulmonary embolism, second or third degree heart block, mitral valve stenosis, aortic stenosis, hypertrophic cardiomyopathy) or cerebrovascular disease (e.g., cerebral hemorrhage, stroke, transient ischemic attack).

• History or presence of immunological or hematological disorders

• Impaired hepatic function [aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels >2 times upper limit of normal range]

• Impaired renal function (serum creatinine >2.0 mg/dl)

• Anemia

• Taking drugs known to influence sympathetic activity (e.g. serotonin-norepinephrine reuptake inhibitors, norepinephrine transporter inhibitors, stimulants).

• Treatment with anticoagulants (e.g. warfarin)

• Treatment with chronic systemic glucocorticoid therapy (>7 consecutive days in 1 month in the 1-month preceding the study)

• Treatment with any investigational drug in the 1-month preceding the study

• Known allergy or contraindication to angiotensin converting enzyme inhibitors or angiotensin receptor blockers, both of which increase endogenous angiotensin-(1-7) levels as part of their mechanism of action

• Inability to give, or withdraw, informed consent

Related Conditions & MeSH terms

• Aging

Intervention

Drug:
• Angiotensin-(1-7)
This is a biologically active endogenous angiotensin peptide that may play an important role in regulation of blood pressure.
• Saline
Saline will be used as the placebo comparator.

Locations

Country	Name	City	State
United States	Penn State Milton S. Hershey Medical Center	Hershey	Pennsylvania

Sponsors (2)

Lead Sponsor	Collaborator
Milton S. Hershey Medical Center	National Heart, Lung, and Blood Institute (NHLBI)

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Change in Angiotensin II	Plasma angiotensin II levels will be measured in blood samples obtained at baseline and at the end of angiotensin-(1-7) versus saline infusion.	110 minutes
Other	Change in Angiotensin-(1-7)	Plasma angiotensin-(1-7) levels will be measured in blood samples obtained at baseline and at the end of angiotensin-(1-7) versus saline infusion.	110 minutes
Other	Change in Renin Activity	Plasma renin activity will be measured in blood samples obtained at baseline and at the end of angiotensin-(1-7) versus saline infusion.	110 minutes
Other	Change in Aldosterone	Plasma or serum aldosterone levels will be measured in blood samples obtained at baseline and at the end of angiotensin-(1-7) versus saline infusion.	110 minutes
Primary	Change in Muscle Sympathetic Nerve Burst Rate	Muscle sympathetic nerve burst rate will be measured continuously using peroneal nerve microneurography during angiotensin-(1-7) versus saline infusion.	110 minutes
Secondary	Change in Muscle Sympathetic Nerve Burst Incidence	Muscle sympathetic nerve burst incidence will be measured continuously using peroneal nerve microneurography during angiotensin-(1-7) versus saline infusion.	110 minutes
Secondary	Change in Muscle Sympathetic Nerve Amplitude	Muscle sympathetic nerve amplitude will be measured continuously using peroneal nerve microneurography during angiotensin-(1-7) versus saline infusion.	110 minutes
Secondary	Change in Muscle Sympathetic Nerve Total Activity	Muscle sympathetic nerve total activity will be measured continuously using peroneal nerve microneurography during angiotensin-(1-7) versus saline infusion.	110 minutes
Secondary	Change in Brachial Artery Diameter	A blood pressure cuff will be inflated to a suprasystolic pressure for 5 minutes then deflated. Brachial artery diameter will be measured continuously before, during, and after cuff inflation using duplex ultrasound at baseline and at the end of angiotensin-(1-7) versus saline infusion.	110 minutes
Secondary	Change in Systolic and Diastolic Blood Pressure	Blood pressure will be measured continuously with a finger and arm cuff during angiotensin-(1-7) versus saline infusion.	110 minutes
Secondary	Change in Heart Rate	Heart rate will be measured continuously by electrocardiogram during angiotensin-(1-7) versus saline infusion.	110 minutes
Secondary	Change in Heart Rate Variability	Heart rate variability will be calculated from the continuous electrocardiogram recordings obtained during angiotensin-(1-7) versus saline infusion.	110 minutes
Secondary	Change in Plasma Catecholamines	Circulating catecholamine levels will be measured in blood samples obtained at baseline and at the end of angiotensin-(1-7) versus saline infusion.	110 minutes