Christopher Hearon

The University of Texas Southwestern Medical Center

The hemodynamic and autonomic determinants of elevated blood pressure in obesity-associated hypertension - a potential role for neuropeptide Y

#Cardiovascular

How will the SphygmoCor® technology enable, enhance, or accelerate your research?

Our project plans to assess the neural mechanisms of high blood pressure in obesity-associated hypertension. The inclusion of SphygmoCor technology would advance our research by adding the assessment of the hemodynamic (pressure-flow relations) determinants of high blood pressure. Coupling the assessments of central arterial stiffness and its consequences for central and peripheral blood pressure will provide high-resolution assessments of the causes of high blood pressure in obesity, hypertension and obesity-associated hypertension. Previous studies have typically focused on either sympathetic neural control or arterial structure/function. The provision of SphygmoCor equipment will facilitate an investigation into whether elevated NPY during stress mediates the link between elevated sympathetic nervous system activity, elevated arterial stiffness and abnormal central hemodynamics. Specifically, participants will perform at home blood pressure monitoring using the CONNEQT Pulse and will upload their vascular biometric data to the server so investigators can access a 14-day report. The home blood pressure assessments will engage individuals with their blood pressure and via consultation with our clinical staff further their understanding of its importance for their heart and other major organs. The SphgmoCor Xcel will be used to conduct pulse wave analysis and velocity (PWA/V) measurements in the laboratory. The combined assessments of at home central and peripheral blood pressure and measurements of (PWA/V) will provide comprehensive of assessment of each participants blood pressure. These data will add significantly to our research program but most importantly provide unique and novel information to each participant and their primary care physician to aid in their care.

Executive Summary

Obesity and hypertension are associated with heightened sympathetic nervous system activity, central arterial stiffening, and peripheral vascular dysfunction. Our ongoing NIH-funded project aims to describe the role of the sympathetic neurotransmitter neuropeptide Y (NPY) in the control of blood pressure in obesity-associated hypertension with a focus on the vasoconstrictor effects of NPY in the microcirculation. Recent reports also indicate that elevated sympathetic nervous system activity is associated with arterial stiffness, though the mechanisms remain unclear. NPY may be a critical link between sympathetic nervous system activity and arterial stiffness as NPY regulates vascular cell proliferation and inflammation. The proposed project will 1) assess high-resolution measures of microvascular and macrovascular function in obesity-associated hypertension and 2) identify the role of NPY in obesity-associated hypertension.

Research Setting

The proposed study will be conducted at the Institute for Exercise and Environmental Medicine (IEEM), a unique Human Physiology Research Institute affiliated with The University of Texas Southwestern Medical Center and Texas Health Presbyterian Hospital Dallas. The IEEM has 12 clinical and scientific faculty working in 10 major laboratories supported by approximately 40 technical staff focused upon defining the limits to human functional capacity in health and disease. The primary laboratory supporting this project will be the Integrative Cardiovascular Physiology Laboratory (PI: Christopher M. Hearon, Ph.D.). The co-investigators on this project are Denis J. Wakeham, Ph.D., a post-doctoral research fellow focused on the assessment of aortic hemodynamics, Professor Joshua A. Beckman, M.D., Director of Vascular Medicine and Medical Director of the Aortic Disease Center at UT Southwestern. The laboratory is staffed by one research scientist, two post-doctoral fellows, two research nurses, two systems engineers and one senior research associate. Prospective study participants with obesity-associated hypertension will be contacted via the hypertension clinics at UT Southwestern. The proposed research studies are in the recruitment phase and are funded by an NIH R00 (NIH R00HL153777). If awarded, the equipment will also be used to support ongoing and future studies. Specifically, Dr. Wakeham is submitting early-career grants to support the high-resolution assessment of hemodynamic regulation at rest and during exercise in healthy adults and those before and after thoracic aortic aneurysm repair. The assessment of office blood pressure and central hemodynamics will be key outcomes for these studies.