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The main purpose of this interventional study is to examine differences in resting blood pressure control between healthy males and females. The main questions it aims to answer are:
Participants will complete one study visit of approximately 3 hours where they will:
Blood pressure is in part regulated by activity of your sympathetic nervous system (also known as your "fight or flight" response). Sympathetic nerve activity affects the size of your blood vessels, which in turn will affect your blood pressure. This communication between sympathetic impulses and the resulting change in vascular resistance is termed "sympathetic neurovascular transduction". In other words, transduction represents the reactivity of the blood vessels in response to individual sympathetic bursts of activity.
Males and females regulate their blood pressure in different ways; for example, females tend to have lower blood pressure and sympathetic nerve activity than males. Females also appear to have less constriction of their blood vessels in response to stress. This may be due to differences in the receptors which are activated by the sympathetic nervous system. These receptors are called α and β-adrenergic receptors and are located on vascular smooth muscle cells. They respond to sympathetic neurotransmitters such as norepinephrine in opposite directions: α-adrenoreceptors cause vasoconstriction (and an increase in vascular resistance), and β-adrenoreceptors cause vasodilation (and a decrease in vascular resistance) in part through the endothelium-dependent nitric oxide pathway.
Current evidence suggests that β-adrenergic receptors are more sensitive in females and contribute to paradoxical vasodilation when α-adrenergic receptors are stimulated by norepinephrine from sympathetic bursts. It has also been suggested that estrogen interacts with adrenergic receptors, contributing to this sex difference. This study will contribute to the understanding of sex differences in cardiovascular physiology and may have implications for clinical cardiovascular conditions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control Condition | Experimental | Normal saline will be infused through the brachial artery catheter at the same calculated rate as propranolol + phentolamine in the α+β-blockade condition to control for volumetric effects. |
|
| β-Adrenergic Blockade | Experimental | β-adrenoreceptors will be blocked locally in the forearm using propranolol. Normal saline will be co-infused at the calculated rate of phentolamine in the α+β-blockade condition to control for volumetric effects. |
|
| α+β-Adrenergic Blockade | Experimental | α-adrenoreceptors will be blocked locally in the forearm using phentolamine. Propranolol will be co-infused to maintain β-blockade. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Phenylephrine Hydrochloride | Drug | Participants will receive three incremental doses via the brachial artery catheter to assess α1-adrenoreceptor mediated vasoconstriction. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Forearm blood flow | Measured during resting baseline; changes during phenylephrine, isoproterenol, and norepinephrine infusion to determine agonist sensitivity. | 10 minutes per condition + 2 minutes per agonist dose = 60 minutes |
| Forearm vascular resistance | Measured during resting baseline; changes during phenylephrine, isoproterenol, and norepinephrine infusion to determine agonist sensitivity. | 10 minutes per condition + 2 minutes per agonist dose = 60 minutes |
| Forearm vascular conductance | Measured during resting baseline; changes during phenylephrine, isoproterenol, and norepinephrine infusion to determine agonist sensitivity. | 10 minutes per condition + 2 minutes per agonist dose = 60 minutes |
| Arterial blood pressure | Measured during resting baseline; changes during phenylephrine, isoproterenol, and norepinephrine infusion to determine agonist sensitivity. | 10 minutes per condition + 2 minutes per agonist dose = 60 minutes |
| Muscle sympathetic nerve activity | Resting baseline | 10 minutes per condition = 30 minutes |
| Circulating sex hormone concentrations | Blood samples | 2 minutes |
| Circulating sympathetic neurotransmitter concentrations | Blood sample |
| Measure | Description | Time Frame |
|---|---|---|
| Arterial-venous blood gas concentrations | Blood sample during each condition | 2 minutes per sample = 6 minutes |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Emily Vanden Berg, MSc | Contact | (780)-492-5553 | ervanden@ualberta.ca | |
| Nicholas Cheung, MSc | Contact | (780)-492-5553 | nkcheung@ualberta.ca |
| Name | Affiliation | Role |
|---|---|---|
| Sean van Diepen, MD, MSc | University of Alberta | Principal Investigator |
| Craig Steinback, PhD | University of Alberta | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Alberta | Recruiting | Edmonton | Alberta | T6G 2R3 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19171792 | Background | Hart EC, Charkoudian N, Wallin BG, Curry TB, Eisenach JH, Joyner MJ. Sex differences in sympathetic neural-hemodynamic balance: implications for human blood pressure regulation. Hypertension. 2009 Mar;53(3):571-6. doi: 10.1161/HYPERTENSIONAHA.108.126391. Epub 2009 Jan 26. | |
| 31106429 | Background | Steinback CD, Fraser GM, Usselman CW, Reyes LM, Julian CG, Stickland MK, Chari RS, Khurana R, Davidge ST, Davenport MH. Blunted sympathetic neurovascular transduction during normotensive pregnancy. J Physiol. 2019 Jul;597(14):3687-3696. doi: 10.1113/JP277714. Epub 2019 Jun 13. |
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Participants will complete three pharmacological conditions, and serve as their own controls.
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| Isoproterenol Hydrochloride | Drug | Participants will receive four incremental doses via the brachial artery catheter to assess β-adrenoreceptor mediated vasodilation. |
|
| Norepinephrine Bitartrate | Drug | Participants will receive three incremental doses via the brachial artery catheter to assess nonspecific adrenoreceptor activation. |
|
| Propranolol Hydrochloride | Drug | Propranolol will be continuously infused through the brachial artery catheter to induce β-adrenergic blockade locally in the forearm. |
|
| Phentolamine Mesylate | Drug | Phentolamine will be continuously infused through the brachial artery catheter to induce α-adrenergic blockade locally in the forearm. |
|
| Phenylephrine Hydrochloride | Drug | Participants will receive one dose via the brachial artery catheter to evaluate the effectiveness of the α-adrenergic blockade. |
|
| Isoproterenol Hydrochloride | Drug | Participants will receive one dose via the brachial artery catheter to evaluate the effectiveness of the β-adrenergic blockade. |
|
| Propranolol Hydrochloride | Drug | Propranolol will be continuously co-infused with phentolamine to maintain the β-adrenergic blockade. |
|
| 2 minutes |
| 23652594 | Background | Fairfax ST, Holwerda SW, Credeur DP, Zuidema MY, Medley JH, Dyke PC 2nd, Wray DW, Davis MJ, Fadel PJ. The role of alpha-adrenergic receptors in mediating beat-by-beat sympathetic vascular transduction in the forearm of resting man. J Physiol. 2013 Jul 15;591(14):3637-49. doi: 10.1113/jphysiol.2013.250894. Epub 2013 May 7. |
| 11986395 | Background | Dinenno FA, Eisenach JH, Dietz NM, Joyner MJ. Post-junctional alpha-adrenoceptors and basal limb vascular tone in healthy men. J Physiol. 2002 May 1;540(Pt 3):1103-10. doi: 10.1113/jphysiol.2001.015297. |
| 32865664 | Background | Hissen SL, Taylor CE. Sex differences in vascular transduction of sympathetic nerve activity. Clin Auton Res. 2020 Oct;30(5):381-392. doi: 10.1007/s10286-020-00722-0. Epub 2020 Aug 31. |
| ID | Term |
|---|---|
| D000783 | Aneurysm |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D010656 | Phenylephrine |
| D007545 | Isoproterenol |
| D009638 | Norepinephrine |
| D011433 | Propranolol |
| D010646 | Phentolamine |
| ID | Term |
|---|---|
| D004983 | Ethanolamines |
| D000605 | Amino Alcohols |
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
| D000588 | Amines |
| D002395 | Catecholamines |
| D002396 | Catechols |
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D015306 | Biogenic Monoamines |
| D001679 | Biogenic Amines |
| D050198 | Phenoxypropanolamines |
| D011412 | Propanolamines |
| D020005 | Propanols |
| D009281 | Naphthalenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D011083 | Polycyclic Compounds |
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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