Melatonin and Nighttime Blood Pressure in African Americans

非裔美国人的褪黑激素和夜间血压

• 批准号: 7661116
• 负责人: JEROME L. ABRAMSON
• 金额: $ 23.25万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7661116
• 关键词: Adult; Adverse effects; Affect; African American; Blood Pressure; Cardiovascular Diseases; Clinical Trials; Coronary heart disease; Cross-Over Studies; Data; Double-Blind Method; Electrocardiogram; Ethnic group; Goals; Hypertension; Hypotension; Incidence; Kidney Diseases; Light; Measurement; Melatonin; Methods; Norepinephrine; Placebo Control; Plasma; Polysomnography; Public Health; Randomized; Recruitment Activity; Risk Factors; Skin Temperature; Sleep; Stroke; Supplementation; Ultrasonography; United States; Vasodilation; brachial artery; heart rate variability; high risk; mortality; novel; pilot trial; public health relevance; racial and ethnic

DESCRIPTION (provided by applicant): Elevated nighttime blood pressure (BP) is an important risk factor for cardiovascular disease (CVD). Indeed, recent data suggest that elevated nighttime BP may be a stronger risk factor for CVD than elevated daytime BP. African Americans are more likely than other racial/ethnic groups to suffer from elevated nighttime BP, which may partially explain why African Americans are at higher risk of mortality from coronary heart disease and stroke, and have a higher incidence of renal disease, than other racial/ethnic groups in the United States. Thus, investigating methods of reducing nighttime BP in African Americans should be considered an important public health goal. Evidence suggests that melatonin supplementation may help lower nighttime BP. However, randomized studies of melatonin supplementation and nighttime BP in African Americans have not been conducted. The long term goal of this proposal is to examine whether melatonin supplementation helps reduce nighttime BP in African Americans with elevated nighttime BP, and to explore potential mechanisms by which this BP lowering effect might occur. We plan to conduct a pilot randomized, double blind, placebo- controlled, crossover clinical trial (n = 40) examining the effect of melatonin supplementation on nighttime BP in African Americans. The specific aims of the pilot trial are as follows: (i) obtain preliminary data on the efficacy of 4 weeks of nightly melatonin supplementation on nighttime BP in African-American subjects suffering from elevated nighttime BP; (ii) explore sleep factors, sympathetic drive, and vasorelaxation as potential mechanisms by which melatonin may lower nighttime BP; (iii) determine the feasibility of recruiting and randomizing African American subjects with elevated nighttime BP for a melatonin supplementation trial; and (iv) estimate whether melatonin supplementation has any adverse side effects when taken nightly for four weeks in African-American adults with elevated nighttime BP. Results from the proposed trial should help provide important preliminary data that could be used to guide a larger, more definitive trial. PUBLIC HEALTH RELEVANCE: This project is relevant to public health because it will help shed light on whether melatonin supplementation can lower nighttime blood pressure in African Americans who suffer from elevated nighttime blood pressure.

描述（由申请人提供）：夜间血压（BP）升高是心血管疾病（CVD）的重要风险因素。事实上，最近的数据表明，夜间血压升高可能是比白天血压升高更强的CVD风险因素。非裔美国人比其他种族/族裔群体更有可能遭受夜间血压升高，这可能部分解释了为什么非裔美国人比美国其他种族/族裔群体冠心病和中风的死亡风险更高，肾脏疾病的发病率更高。因此，研究降低非裔美国人夜间血压的方法应被视为一个重要的公共卫生目标。有证据表明，补充褪黑激素可能有助于降低夜间血压。然而，尚未对非裔美国人补充褪黑激素和夜间血压进行随机研究。该提案的长期目标是研究褪黑激素补充剂是否有助于降低夜间血压升高的非裔美国人的夜间血压，并探索这种血压降低效应可能发生的潜在机制。我们计划进行一项试验性随机、双盲、安慰剂对照、交叉临床试验（n = 40），检查褪黑激素补充对非裔美国人夜间血压的影响。初步试验的具体目的如下：（i）获得关于每晚补充褪黑激素4周对患有夜间血压升高的非裔美国人受试者的夜间血压的疗效的初步数据;（ii）探索睡眠因素、交感神经驱动和血管舒张作为褪黑激素可能降低夜间血压的潜在机制;（iii）确定招募和随机分配夜间血压升高的非裔美国人受试者进行褪黑激素补充试验的可行性;以及（iv）估计在夜间血压升高的非裔美国成年人中每晚服用褪黑激素补充剂四周是否有任何不良副作用。拟议试验的结果应有助于提供重要的初步数据，可用于指导更大，更明确的试验。 公共卫生相关性：该项目与公共卫生有关，因为它将有助于阐明褪黑激素补充剂是否可以降低患有夜间血压升高的非裔美国人的夜间血压。