Biobehavioral Mechanisms of Blood Pressure Regulation

Hypertension Clinical Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00005366
• Other study ID #: 4253
• Secondary ID: R01HL049427
• Status: Completed
• Phase: N/A
• First received: May 25, 2000
• Last updated: February 17, 2016
• Start date: September 1993
• Est. completion date: August 1998

Study information

• Verified date: April 2001
• Source: National Heart, Lung, and Blood Institute (NHLBI)
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Federal Government
• Study type: Observational

Clinical Trial Summary

To investigate the role of biobehavioral factors in the pathogenesis of concentric left ventricular hypertrophy.

Description:

BACKGROUND:

Hypertension is more prevalent in Black than white men, and is more prevalent in men than women. Furthermore, even controlling for blood pressure, concentric left ventricular hypertrophy, an early structural adaptation of hypertension, is more prevalent in Black than white men, and more prevalent in men than women. Concentric left ventricular hypertrophy is the strongest predictor, other than age, of the cardiovascular morbidity associated with high blood pressure.

DESIGN NARRATIVE:

In a biracial sample, concentric left ventricular hypertrophy and concentric remodelling were assessed by echocardiographic measures of left ventricular mass and relative wall thickness. Laboratory procedures were used to: (i) assess hemodynamic and neurohumoral responses during exposure to a diverse battery of physical and psychological stressors, and; (ii) evaluate alpha and beta adrenergic receptor responsiveness, baroreceptor reflex gain and minimal forearm vascular resistance. Since blood pressure during a typical workday was an established predictor of left ventricular hypertrophy, it was also assessed. A new biobehavioral model was tested that implicated the hemodynamic pattern of behaviorally-evoked pressor responses in the pathogenesis of concentric left ventricular hypertrophy. One prediction of this model was that a predisposition to exhibit increased vascular resistance during stress (characteristic of black men) would favor the development of concentric hypertrophy. Thus, systemic vascular resistance responses, evaluated in the laboratory, were hypothesized to independently predict left ventricular mass and relative wall thickness, even after controlling for established risk factors, including workday blood pressure. Sympathetic nervous system function was examined to test hypothesized mechanisms responsible for race and gender differences in the hemodynamic patterns of blood pressure regulation. The results of these studies emphasized the importance of race and gender in prescribing pharmacological and/or behavioral treatment for hypertensive heart disease.

The study completion date listed in this record was obtained from the "End Date" entered in the Protocol Registration and Results System (PRS) record.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 0
• Est. completion date: August 1998
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 25 Years to 39 Years
• Eligibility: No eligibility criteria

Study Design

N/A

Related Conditions & MeSH terms

• Cardiovascular Diseases
• Heart Diseases
• Hypertension

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
National Heart, Lung, and Blood Institute (NHLBI)

References & Publications (10)

Blumenthal JA, Thyrum ET, Gullette ED, Sherwood A, Waugh R. Do exercise and weight loss reduce blood pressure in patients with mild hypertension? N C Med J. 1995 Feb;56(2):92-5. Review. — View Citation

Carels RA, Blumenthal JA, Sherwood A. Emotional responsivity during daily life: relationship to psychosocial functioning and ambulatory blood pressure. Int J Psychophysiol. 2000 Apr;36(1):25-33. — View Citation

Carels RA, Sherwood A, Blumenthal JA. Psychosocial influences on blood pressure during daily life. Int J Psychophysiol. 1998 Mar;28(2):117-29. Review. — View Citation

Carels RA, Sherwood A, Szczepanski R, Blumenthal JA. Ambulatory blood pressure and marital distress in employed women. Behav Med. 2000 Summer;26(2):80-5. — View Citation

Carels RA, Szczepanski R, Blumenthal JA, Sherwood A. Blood pressure reactivity and marital distress in employed women. Psychosom Med. 1998 Sep-Oct;60(5):639-43. — View Citation

Sherwood A, Hinderliter AL, Light KC. Physiological determinants of hyperreactivity to stress in borderline hypertension. Hypertension. 1995 Mar;25(3):384-90. — View Citation

Sherwood A, Johnson K, Blumenthal JA, Hinderliter AL. Endothelial function and hemodynamic responses during mental stress. Psychosom Med. 1999 May-Jun;61(3):365-70. — View Citation

Sherwood A, May CW, Siegel WC, Blumenthal JA. Ethnic differences in hemodynamic responses to stress in hypertensive men and women. Am J Hypertens. 1995 Jun;8(6):552-7. — View Citation

Watkins LL, Grossman P, Krishnan R, Sherwood A. Anxiety and vagal control of heart rate. Psychosom Med. 1998 Jul-Aug;60(4):498-502. — View Citation

Watkins LL, Grossman P, Sherwood A. Noninvasive assessment of baroreflex control in borderline hypertension. Comparison with the phenylephrine method. Hypertension. 1996 Aug;28(2):238-43. — View Citation