Lin Yi, Zeidan Rola S, Lapierre-Nguyen Stephanie, Costello Hannah M, Anton Stephen D, Buford Thomas W, Christou Demetra D, Gumz Michelle L, Leeuwenburgh Christiaan, Martens Christopher R, McDermott Mary M, Migaud Marie E, Sandesara Bhanuprasad, Seals Douglas R, Qiu Peihua, Wang Yipeng, Mankowski Robert T
Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Physiology and Aging, University of Florida, Gainesville, FL, USA.
Geroscience. 2025 Aug 7. doi: 10.1007/s11357-025-01815-2.
Aerobic exercise lowers blood pressure (BP) with varying effects in hypertensive adults, potentially due to age-related nicotinamide adenine dinucleotide (NAD) metabolism dysregulation. This pilot randomized clinical trial (RCT) tested the efficacy of combining aerobic exercise with the NAD booster nicotinamide riboside (NR) to enhance BP control. In this double-blinded RCT, 54 sedentary adults (≥ 55 years) with mean daytime systolic BP (SBP) ≥ 130 mmHg were randomized to 6 weeks of 1000 mg/day of NR combined with 3 days/week of supervised 30-min walking exercise (NR + Ex), Placebo combined with the same exercise regimen (PL + Ex), or NR alone (NR). The primary outcome was daytime SBP. Other outcomes included pulse wave velocity (PWV), NAD catabolites, and nighttime BP. The primary comparison was between NR + Ex and PL + Ex. Of 54 participants (mean age 67 years, 61% female), 49 (NR + Ex: n = 15, PL + Ex: n = 16, NR: n = 18) completed all study visits (93% adherence to exercise and 90% to supplementation). NR + Ex (mean change = 5.19 ± 13.2 mmHg) did not reduce SBP more than PL + Ex (- 2.71 ± 10.5 mmHg). NR + Ex (- 0.31 ± 0.77 m/s) showed a trend toward a greater reduction in PWV. Levels of NAD catabolites were higher in NR groups. In a post hoc analysis, NR + Ex showed a trend toward greater nighttime BP reductions (systolic: - 9.6 ± 9.22; diastolic: - 4.51 ± 7.12 mmHg) in participants without antihypertensive medications. NR + Ex was not superior to PL + Ex in reducing BP in hypertensive middle-aged and older. However, trends toward greater nighttime BP reduction in NR + Ex in participants without antihypertensive medication warrant further investigation in a Phase IIb RCT.
有氧运动可降低高血压成年人的血压（BP），但效果因人而异，这可能是由于与年龄相关的烟酰胺腺嘌呤二核苷酸（NAD）代谢失调所致。这项初步随机临床试验（RCT）测试了将有氧运动与NAD增强剂烟酰胺核糖（NR）相结合以加强血压控制的疗效。在这项双盲RCT中，54名久坐不动的成年人（≥55岁），平均日间收缩压（SBP）≥130mmHg，被随机分为三组，分别接受为期6周的每日1000mg NR联合每周3天、每次30分钟的有监督步行运动（NR+Ex），安慰剂联合相同运动方案（PL+Ex），或单独使用NR（NR）。主要结局指标是日间SBP。其他结局指标包括脉搏波速度（PWV）、NAD分解代谢物和夜间血压。主要比较对象是NR+Ex组和PL+Ex组。54名参与者（平均年龄67岁，61%为女性）中，49名（NR+Ex组：n = 15，PL+Ex组：n = 16，NR组：n = 18）完成了所有研究访视（运动依从性为93%，补充剂依从性为90%）。NR+Ex组（平均变化=5.19±13.2mmHg）降低SBP的幅度并不比PL+Ex组（-2.71±10.5mmHg）更大。NR+Ex组（-0.31±0.77m/s）显示出PWV降幅更大的趋势。NR组的NAD分解代谢物水平更高。在一项事后分析中，NR+Ex组在未服用抗高血压药物的参与者中显示出夜间血压降幅更大的趋势（收缩压：-9.6±9.22；舒张压：-4.51±7.12mmHg）。在降低高血压中老年患者血压方面，NR+Ex组并不优于PL+Ex组。然而，未服用抗高血压药物的参与者中NR+Ex组夜间血压降幅更大的趋势值得在IIb期RCT中进一步研究。
