NR and Exercise for Blood Pressure

ConditionHypertension (HTN)

Trial statusNot yet recruiting

Trial phaseNot applicable

Trial typeInterventional

Biological sexFemale

Age55-80

SponsorZHANG Jiaqi

About this trial

Hypertension continues to pose a significant global health challenge, with rates of optimal blood pressure control remaining low - particularly in China, where fewer than 5% of individuals with hypertension achieve guideline-recommended targets.

Age-associated endothelial dysfunction and arterial stiffness are recognized as the key contributors to the development of hypertension and the unique role of nicotinamide adenine dinucleotide (NAD) depletion in the pathogenesis of vascular dysfunction has been recently discovered. Treatment with nicotinamide riboside (NR), an NAD precursor, has shown promise in preliminary clinical trials for improving blood pressure and vascular health in at-risk populations.

In parallel, aerobic exercise is a well-established non-pharmacologic intervention known to improve cardiovascular outcomes. Emerging studies suggest that exercise may modulate NAD biosynthesis pathways, pointing toward a synergistic potential when combined with NAD-boosting strategies. However, clinical data evaluating the combined effects of NR supplementation and aerobic exercise remain scarce.

Our randomized, placebo-controlled, four-arm, parallel-group design seeks to address this gap. The investigators will investigate the independent and combined effects of 10-week NR supplementation and brisk walking on blood pressure and vascular health in post-menopausal women with elevated/stage I hypertension. This population is specifically targeted due to their heightened risk for vascular dysfunction post-menopause and the observed responsiveness to NR-based interventions in prior studies.

The investigators believe the findings from this trial will provide insight into the feasibility, safety, and efficacy of combining NAD-boosting supplementation with structured exercise in a uniquely vulnerable and previously understudied population. The potential to identify a low-risk, non-pharmaceutical therapeutic approach holds strong implications for public health, particularly in aging women with early-stage hypertension.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

women absent of menstruation for over one year,

Chinese, and

fulfill the criteria of elevated/stage I hypertension according to 2025 American College of Cardiology/American Heart Association Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults (i.e., blood pressure ≥120/80 mmHg based on an average of ≥2 readings obtained on ≥2 occasions)

Disqualifiers

presence of health conditions that contraindicate participation in exercise training, such as a history of cardiovascular disease, cancer, or musculoskeletal disorders,

a history of hysterectomy,

current use of vitamin B supplements and/or NAD precursors,

ongoing hormone replacement therapy within the past six months,

Trial design

Design model

Parallel

Treatments tested in this trial

Brisk walking
Behavioral
Brisk walking twice per week
Nicotinamide Riboside 1000 mg
Dietary supplement
Nicotinamide Riboside supplementation 1000 mg per day
Placebo
Other intervention
Placebo

Treatment groups

112 Participants

are divided into 4 treatment groups

Group A: NR + BWExperimental treatment 2 interventions

Group B: PL + BWPlacebo comparator 2 interventions

Group C: NRActive comparator 1 intervention

Group D: PLPlacebo comparator 1 intervention

Trial outcomes

Primary outcomes

Blood pressure

Blood pressure will be measured using an automated sphygmomanometer that meets the standards from the Association for the Advancement of Medical Instrumentation and the European Society for Hypertension and following standardized procedures. Two measurements will be taken after 5 min sitting rest in a quiet room with comfortable temperature. During assessments, participants will be seated with their back supported, feet flat on the floor, legs uncrossed, and their arm resting on a table with the midpoint of the upper arm aligned at heart level. Two readings of systolic and diastolic blood pressures will be obtained, spaced 2 minutes apart, and the average of the two measurements will be recorded as the final blood pressure reading. If the difference between the two measurements exceeds 5 mmHg, an additional reading will be taken, and the average of all three readings will be used as the final measurement.

Time frame