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Sex Differences in Sympathetic Activity and Vascular Reactivity During Acute and Chronic Hypoxia.

Primary Purpose

Vasodilation, Vasoconstriction

Status
Completed
Phase
Not Applicable
Locations
Canada
Study Type
Interventional
Intervention
Phenylephrine Hydrochloride
Cold Pressor Test
Isocapnic Acute Hypoxia
Hyperoxia
Sponsored by
University of Alberta
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Vasodilation

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Between ages of 18-50
  • No medical history of cardiovascular, respiratory, nervous system, or metabolic disease
  • Females must be pre-menopausal

Exclusion Criteria:

  • Any known cardiovascular, respiratory, nervous system, or metabolic disease (however, participants with controlled arterial hypertension will not be excluded)
  • Having travelled above 2,000m within 1 month of testing at low and high altitude
  • Females who are pregnant, confirmed by a pregnancy test
  • Females who are post-menopausal
  • Participants that are classified as obese (body mass index > 30kg⋅m²)
  • Have a history of smoking regularly in the last 6 months (but nicotine substitutes (patch, gum) not an exclusion criteria)
  • Those with a known allergy to sulfites
  • Participants taking monoamine oxidase (MAO) inhibitors or tricyclic antidepressants

Sites / Locations

  • Mount Royal University
  • University of Alberta

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Low Altitude

Early Acclimatization to High Altitude

Late Acclimatization to High Altitude

Arm Description

Participants will be assessed at an altitude of <1050m.

Participants will be assessed on day 2 or 3 of a high-altitude expedition at 3,800m.

Participants will be assessed on day 9 or 10 of a high-altitude expedition at 3,800m.

Outcomes

Primary Outcome Measures

Change in blood pressure
Phenylephrine sensitivity
Change in arterial blood flow
Phenylephrine sensitivity
Cold pressor test reactivity

Secondary Outcome Measures

Full Information

First Posted
August 4, 2021
Last Updated
October 27, 2022
Sponsor
University of Alberta
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1. Study Identification

Unique Protocol Identification Number
NCT05001048
Brief Title
Sex Differences in Sympathetic Activity and Vascular Reactivity During Acute and Chronic Hypoxia.
Official Title
Sex Differences in Sympathetic Activity and Vascular Reactivity During Acute and Chronic Hypoxia.
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Completed
Study Start Date
August 4, 2019 (Actual)
Primary Completion Date
December 7, 2021 (Actual)
Study Completion Date
September 9, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Alberta

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study aims to investigate sex differences in blood pressure control associated with exposure to acute hypoxia (low oxygen), and short term acclimatization to hypoxia at high altitude.
Detailed Description
About 200 million people worldwide live at high altitudes. Millions of others travel to high altitude every year for work or travel. The low oxygen (or hypoxia) experienced at high altitudes causes considerable physiological stress, and the body adapts in order to maintain adequate oxygen delivery to its tissues. One of these adaptations is an increase in the activity of the sympathetic nervous system. This system is responsible for the "fight or flight" response. Sympathetic activity regulates the size of the blood vessels, which will affect blood pressure. Previous studies suggest that males and females regulate their blood pressure in different ways. Females tend to have lower resting sympathetic activity, and less vasoconstriction in response to stressors than males. Blood pressure changes are also influenced by levels of sex hormones; for example, estrogen may cause opposing vasodilation. Therefore, it is important to understand the differences in how males and females respond to low oxygen. The main purpose of this study is to examine the differences between males and females in control of blood vessels during exposure to low oxygen. To study this question, we will test vasoreactivity to set physiological stressors in both males and females. Participants will be recruited at the Canadian sites, and we will test them while they breathe low oxygen for a short amount of time at low altitude. We will also perform assessments on the same participants during a two week stay at high altitude at White Mountain, CA, which is at an altitude of 3,800m. These data will have implications in the basic understanding of differences between male and female physiology. Specifically, to males and females living or travelling to high altitude.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Vasodilation, Vasoconstriction

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Model Description
Participants will partake in all three arms of the study, which include: 1) low altitude, 2) early acclimatization, and 3) late acclimatization to high altitude assessments.
Masking
None (Open Label)
Masking Description
Due to the study design, masking is not possible. The time points and dosages of the study drug will be known to the participant. Further, due to the wash-out time of the acute hypoxia/hyperoxia interventions, these will always be completed second to the interventions breathing room air.
Allocation
Non-Randomized
Enrollment
14 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Low Altitude
Arm Type
Experimental
Arm Description
Participants will be assessed at an altitude of <1050m.
Arm Title
Early Acclimatization to High Altitude
Arm Type
Experimental
Arm Description
Participants will be assessed on day 2 or 3 of a high-altitude expedition at 3,800m.
Arm Title
Late Acclimatization to High Altitude
Arm Type
Experimental
Arm Description
Participants will be assessed on day 9 or 10 of a high-altitude expedition at 3,800m.
Intervention Type
Drug
Intervention Name(s)
Phenylephrine Hydrochloride
Other Intervention Name(s)
Neo-Synephrine
Intervention Description
Series of three incremental bolus injections to observe α1-adrenoreceptor mediated vasoconstriction.
Intervention Type
Other
Intervention Name(s)
Cold Pressor Test
Intervention Description
Standardized sympathetic stressor involving submersion of the hand in ice-cold water for 3-minutes, aiming to elicit endogenous neurotransmitter release and blood pressure increases.
Intervention Type
Other
Intervention Name(s)
Isocapnic Acute Hypoxia
Intervention Description
During low altitude assessment, participants will be exposed to isocapnic hypoxia equivalent to 3,800m to assess responses to acute exposure.
Intervention Type
Other
Intervention Name(s)
Hyperoxia
Intervention Description
During high altitude assessments, participants will breathe an oxygen concentration comparable to their end-tidal values at low altitude for the assessment of the influences of acclimatization.
Primary Outcome Measure Information:
Title
Change in blood pressure
Description
Phenylephrine sensitivity
Time Frame
18 minutes
Title
Change in arterial blood flow
Description
Phenylephrine sensitivity
Time Frame
18 minutes
Title
Cold pressor test reactivity
Time Frame
4 minutes

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Between ages of 18-50 No medical history of cardiovascular, respiratory, nervous system, or metabolic disease Females must be pre-menopausal Exclusion Criteria: Any known cardiovascular, respiratory, nervous system, or metabolic disease (however, participants with controlled arterial hypertension will not be excluded) Having travelled above 2,000m within 1 month of testing at low and high altitude Females who are pregnant, confirmed by a pregnancy test Females who are post-menopausal Participants that are classified as obese (body mass index > 30kg⋅m²) Have a history of smoking regularly in the last 6 months (but nicotine substitutes (patch, gum) not an exclusion criteria) Those with a known allergy to sulfites Participants taking monoamine oxidase (MAO) inhibitors or tricyclic antidepressants
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sean van Diepen, MD, MSc
Organizational Affiliation
University of Alberta
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Craig Steinback, PhD
Organizational Affiliation
University of Alberta
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mount Royal University
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T3E 6K6
Country
Canada
Facility Name
University of Alberta
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
T6G 2R3
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
19171792
Citation
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.
Results Reference
background
PubMed Identifier
9516178
Citation
Mazzeo RS, Child A, Butterfield GE, Mawson JT, Zamudio S, Moore LG. Catecholamine response during 12 days of high-altitude exposure (4, 300 m) in women. J Appl Physiol (1985). 1998 Apr;84(4):1151-7. doi: 10.1152/jappl.1998.84.4.1151.
Results Reference
background
PubMed Identifier
30462566
Citation
Purdy GM, James MA, Rees JL, Ondrus P, Keess JL, Day TA, Steinback CD. Spleen reactivity during incremental ascent to altitude. J Appl Physiol (1985). 2019 Jan 1;126(1):152-159. doi: 10.1152/japplphysiol.00753.2018. Epub 2018 Nov 21.
Results Reference
background
PubMed Identifier
25527774
Citation
Usselman CW, Gimon TI, Nielson CA, Luchyshyn TA, Coverdale NS, Van Uum SH, Shoemaker JK. Menstrual cycle and sex effects on sympathetic responses to acute chemoreflex stress. Am J Physiol Heart Circ Physiol. 2015 Mar 15;308(6):H664-71. doi: 10.1152/ajpheart.00345.2014. Epub 2014 Dec 19.
Results Reference
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Sex Differences in Sympathetic Activity and Vascular Reactivity During Acute and Chronic Hypoxia.

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