Lower Leg Heat Therapy in Older, Hypertensive Women to Improve Blood Pressure and Cognition

对老年高血压女性进行小腿热疗可改善血压和认知能力

• 批准号: 10749388
• 负责人: John David Akins
• 金额: $ 6.95万
• 依托单位: UT SOUTHWESTERN MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-11 至 2026-09-10
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10749388
• 关键词: Adherence; Alzheimer' s disease related dementia; American Heart Association; Bathing; Biological Assay; Biological Markers; Blood; Blood Pressure; Blood Vessels; Blood flow; Cardiovascular Diseases; Cardiovascular Physiology; Cardiovascular system; Caring; Cerebrum; Chronic; Clinical; Cognition; Cognitive; Combination Drug Therapy; Control Groups; Development; Disease Progression; Doctor of Philosophy; Echocardiography; Epidemiology; Episodic memory; Exhibits; Extramural Activities; Funding; Goals; Guidelines; Health; Health Benefit; Heat shock proteins; Heating; Home; Homeostasis; Hour; Hypertension; Immersion; Interdisciplinary Study; Intervention; Knee; Learning Skill; Leg; Life Style Modification; Measures; Modeling; Morbidity - disease rate; Muscle; National Research Service Awards; Nerve; Perfusion; Peripheral Resistance; Pharmaceutical Preparations; Pharmacotherapy; Physiological; Physiological Adaptation; Population; Prevalence; Public Health; Qi; Recommendation; Regimen; Research; Research Personnel; Rest; Risk; Scientist; Short-Term Memory; Signal Transduction; Systemic blood pressure; Technical Expertise; Techniques; Therapeutic Intervention; Therapeutic heat application; Training; Transcranial Doppler Ultrasonography; Translating; United States; United States National Institutes of Health; Update; Water; Woman; Work; awake; bench to bedside; blood pressure control; blood pressure reduction; blood pressure regulation; cardiovascular disorder risk; cardiovascular health; cerebral hemodynamics; cerebrovascular; cerebrovascular health; clinically relevant; cognitive function; executive function; experience; extracellular; group intervention; heart function; hypertensive; improved; indexing; middle cerebral artery; mortality; neural; neuroregulation; older women; pharmacologic; physiologic stressor; primary outcome; processing speed; protein expression; response; standard care; success; tool; ultrasound

PROJECT SUMMARY/ABSTRACT Hypertension remains a leading contributor to cardiovascular disease-related morbidity and mortality in the United States. Older (i.e., ≥60 y) women are one group more likely to develop hypertension with inadequate blood pressure (BP) control, despite optimal drug regimens. Older women are also at a greater risk for the development of Alzheimer’s disease and related dementias which are exacerbated by hypertension. Accordingly, the prevalence of hypertension and ineffectiveness of drug treatments alone signal the need for non-pharmacological approaches to supplement standard care for BP control in this population. One such approach to achieve this is “heat therapy.” Recent studies have revealed the promising benefits of heat therapy on vascular health, autonomic activity, and cardiac function, which may ultimately reduce BP and the risk for cardiovascular diseases. These physiological adapta- tions may also translate to improvements in cognitive function through improved cerebrovascular func- tion and health. However, no information exists regarding the efficacy of heat therapy to reduce BP, induce meaningful neural-cardiovascular adaptations, and improve cognition in older women. The overall goals of this proposal will be to 1) identify changes in autonomic BP regulation and 2) assess alterations in cerebrovascular and cognitive function in older women with mild hyper- tension following 8 weeks of at-home heat therapy. Specific Aim 1 will investigate chronic lower leg heat therapy's impact on BP control and neural-cardiovascular function in older, hypertensive women using intervention and control groups. The intervention group will perform 8 weeks of at-home lower leg heat therapy using hot water immersion up to the knee (42°C, 45 min/session, 4 sessions/week). The control group will complete the same sessions with thermoneutral water (35°C). We will assess 24-hour ambulatory BP, sympathetic vascular transduction, cardiac function, and heat shock protein expression before and after the interventional period. Specific Aim 2 will measure cerebral hemody- namics and cognitive function responses to chronic lower leg heat therapy in older, hypertensive women. We will use transcranial Doppler ultrasound to assess cerebrovascular function and autoreg- ulation before and after 8 weeks of lower leg heat therapy. Further, we will use the NIH Toolbox Cog- nitive Battery to assess different cognitive function domains. To maximize the clinical relevance of this project and my scientific training, I have assembled a strong interdisciplinary research team comprised of Qi Fu, MD, PhD, Rong Zhang, PhD, Steven Romero, PhD, Heidi Rossetti, PhD, and Satyam Sarma, MD. This team will help me complete the proposed project and master several technical skills (e.g., microneurography, echocardiography, biomolecular assays), while improving my ability to obtain extra- mural research funding (e.g., NIH K99/R00) and become a successful independent clinical researcher.

项目概要/摘要 高血压仍然是心血管疾病相关发病率和死亡率的主要原因 在美国。老年（即 ≥ 60 岁）女性是更容易患高血压的群体 尽管有最佳的药物治疗方案，但血压（BP）控制不足。老年妇女也处于 患阿尔茨海默氏病和相关痴呆症的风险更大，而且病情会加剧 由高血压引起。因此，高血压的患病率和药物治疗的无效性 仅表明需要非药物方法来补充血压控制的标准护理 在这个人群中。实现这一目标的一种方法是“热疗”。最近的研究表明 热疗对血管健康、自主活动和心脏功能的巨大益处， 这可能最终降低血压和心血管疾病的风险。这些生理适应 还可以通过改善脑血管功能转化为认知功能的改善。 化和健康。然而，没有关于热疗降低血压的功效的信息， 诱导有意义的神经心血管适应，并改善老年女性的认知能力。这 该提案的总体目标是 1) 确定自主血压调节的变化以及 2) 评估患有轻度高血压的老年女性脑血管和认知功能的变化 8周的家庭热疗后的紧张。具体目标 1 将调查慢性小腿 热疗对老年高血压女性血压控制和神经心血管功能的影响 使用干预组和对照组。干预组将进行为期8周的在家低强度训练 使用热水浸泡至膝盖的腿部热疗（42°C，每次 45 分钟，每周 4 次）。 对照组将使用热中性水（35°C）完成相同的疗程。我们将评估 24小时动态血压、交感血管转导、心功能、热休克蛋白 干预前后的表达。具体目标 2 将测量脑血流- 老年高血压患者对慢性小腿热疗的运动学和认知功能反应 女性。我们将使用经颅多普勒超声来评估脑血管功能和自动调节 小腿热疗前后 8 周的变化。此外，我们将使用 NIH Toolbox Cog- 用于评估不同认知功能领域的原电池。为了最大限度地发挥该研究的临床意义 项目和我的科学训练，我组建了一个强大的跨学科研究团队，包括 傅奇博士、张荣博士、史蒂文·罗梅罗博士、海蒂·罗塞蒂博士和萨蒂亚姆·萨尔玛， 医学博士。该团队将帮助我完成拟议的项目并掌握多项技术技能（例如， 显微神经造影、超声心动图、生物分子检测），同时提高我获得额外信息的能力 壁画研究资助（例如 NIH K99/R00）并成为一名成功的独立临床研究员。