ACES - ACE inhibitors Combined with Exercise for hypertensive Seniors

ACES - ACE 抑制剂与运动相结合治疗高血压老年人

• 批准号: 10670590
• 负责人: Thomas W Buford
• 金额: $ 51.55万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10670590
• 关键词: Adjuvant; Aerobic Exercise; American; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Attenuated; Blood Pressure; Blood capillaries; Cardiac Surgery procedures; Cardiovascular system; Cessation of life; Cholesterol; Chronic; Cities; Clinical; Clinical Practice Guideline; Data; Dose; Drug Prescriptions; Dual-Energy X-Ray Absorptiometry; E-Selectin; Elderly; Endocrine; Epidemiology; Event; Exercise; FDA approved; Gait speed; Geography; Glucose; Heart; Hydrochlorothiazide; Hypertension; Individual; Inflammation; Interleukin-6; Intervention; Intervention Studies; Life Style; Losartan; Masks; Measures; Messenger RNA; Muscle; Muscle Fibers; Outcome; Oxidative Regulation; Oxidative Stress; Participant; Perindopril; Pharmaceutical Preparations; Pharmacology; Phase; Physical Exercise; Physical Performance; Physiological; Population; Proteins; Protocols documentation; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Renin-Angiotensin System; Reporting; Risk; Risk Reduction; Signal Transduction; Site; Skeletal Muscle; Structure; TNF gene; Target Populations; Testing; Thiazide Diuretics; Vascular Cell Adhesion Molecule-1; Walking; angiogenesis; antagonist; base; blood pressure control; cardiovascular health; cardiovascular risk factor; clinical practice; clinically relevant; clinically significant; disability; exercise capacity; exercise intervention; exercise program; exercise training; experience; functional decline; functional improvement; functional outcomes; functional status; high risk; high risk population; hypertensive; improved; indexing; member; normotensive; oxidized low density lipoprotein; peer; pre-clinical; preservation; prevent; primary outcome; public health priorities; public health relevance; receptor; recruit; response; safety and feasibility; secondary outcome; sedentary; surgical risk; systemic inflammatory response; vascular inflammation; walking speed

The purpose of this project is to conduct a randomized, controlled trial (RCT) to determine if choice of antihypertensive medication influences changes in functional status and other cardiovascular risk factors among older persons with hypertension. Functional status, determined by measures of physical performance, is an important predictor of cardiovascular outcomes in older adults. Seniors with compromised function experience more CV events, have a higher risk of undergoing cardiac surgery and higher risk of CVD-related death than higher-functioning peers. Seniors with hypertension experience accelerated declines in function, and presently physical exercise is the primary strategy for preventing this decline. However, functional responses to exercise are highly variable and appear to be influenced by the type of antihypertensive medication(s) utilized to control blood pressure. Preliminary evidence suggests that, compared to other first- line antihypertensive agents, angiotensin converting enzyme (ACE) inhibitors enhance exercise-derived improvements in functional status among hypertensive seniors. This RCT will test this hypothesis. Sedentary older adults with functional limitations and hypertension will be recruited from two sites to participate in a randomized clinical trial in which they will be randomly assigned to one of three first-line antihypertensive agents: (1) the ACE inhibitor perindopril, (2) AT1 receptor antagonist losartan, or (3) the thiazide diuretic hydrochlorothiazide. All participants will also participate in a structured aerobic exercise intervention. This trial will evaluate whether, compared to losartan and HCTZ, perindopril improves indices of functional status and cardiovascular risk when combined with physical exercise. This study is expected to differentiate beneficial effects of three FDA-approved antihypertensive medications on an emerging cardiovascular risk factor in a clinically-relevant population. Thus the study has important implications for expeditiously influencing clinical practice guidelines in the prescription of antihypertensive drugs to millions of Americans.

该项目的目的是进行一项随机对照试验 (RCT)，以确定是否选择 抗高血压药物会影响功能状态和其他心血管危险因素的变化 患有高血压的老年人中。功能状态，由身体表现测量确定， 是老年人心血管结局的重要预测因素。功能受损的老年人 经历更多的心血管事件、接受心脏手术的风险更高以及心血管疾病相关的风险更高 死亡人数高于功能较高的同龄人。患有高血压的老年人会经历功能加速衰退， 目前，体育锻炼是防止这种下降的主要策略。然而，功能性 对运动的反应差异很大，并且似乎受到抗高血压药物类型的影响 用于控制血压的药物。初步证据表明，与其他第一 一线抗高血压药、血管紧张素转换酶（ACE）抑制剂增强运动源性 高血压老年人的功能状态得到改善。该随机对照试验将检验这一假设。久坐 将从两个地点招募患有功能障碍和高血压的老年人参加 随机临床试验，他们将被随机分配到三种一线抗高血压药物中的一种 药物：(1) ACE 抑制剂培哚普利，(2) AT1 受体拮抗剂氯沙坦，或 (3) 噻嗪类利尿剂 氢氯噻嗪。所有参与者还将参加结构化的有氧运动干预。本次审判 将评估与氯沙坦和 HCTZ 相比，培哚普利是否改善功能状态指数和 与体育锻炼相结合时的心血管风险。这项研究预计将区分有益的 FDA 批准的三种抗高血压药物对新兴心血管危险因素的影响 临床相关人群。因此，该研究对于迅速影响临床具有重要意义。 为数百万美国人提供抗高血压药物处方实践指南。

项目成果

The role of exercise in the reversal of IGF-1 deficiencies in microvascular rarefaction and hypertension.

运动在逆转 IGF-1 缺乏导致的微血管稀疏和高血压中的作用。

• 发表时间: 2020
• 影响因子: 5.6
• 作者: Norling, Amani M;Gerstenecker, Adam T;Buford, Thomas W;Khan, Bilal;Oparil, Suzanne;Lazar, Ronald M
• 通讯作者: Lazar, Ronald M