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Completed

NCT Number: NCT05227781

8 Weeks of L-CIT Supplementation and LIRET on Vascular Function in Hypertensive Postmenopausal Women

The overall objective of this project is to bring forth evidence that L-Citrulline (L-CIT) supplementation and low intensity resistance exercise training (LIRET) alone and combined will improve vascular function and muscle fitness (mass, strength, and exercise performance) in postmenopausal women with hypertension. The investigators' central hypothesis is that adjuvant L-CIT supplementation may synergistically enhance vascular (arterial stiffness, BP, muscle oxygenation, blood flow) and muscular (strength, exercise performance) responses to LIRET in postmenopausal women with hypertension by improving endothelial vasodilatory function.

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Key information

Age range

50 year–75 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Texas Tech University

Lubbock, Texas, 79409, United States

About this study

Individuals who are on medications will refrain from use the morning of all laboratory visits. Participants will be asked to bring medications with them, and will be allowed to ingest it after the vascular measurements have been obtained.

There will be a total of 7 laboratory visits. The 1st visit will be approximately 1 hr and 45 minutes. The 2nd and 3rd visit will be approximately 2 hrs. The 4th and 6th visit will total about 2 hrs and 15 minutes and finally, the 5th and 7th visit will total about 1hr and 15 minutes. This means the total participant time for laboratory visits will be approximately 12 hours. In addition to this, the second 4 weeks of the 8 week study period will involve coming to the Kinesiology and Sport Management building at Texas Tech University main campus 3 times per week to perform the low-intensity resistance training intervention. These visits should last no more than 30-45 minutes.

The first 3 visits will be separated by 48-72 hrs. Visits 3 and 4 will be separated by 4 weeks (first 4 weeks of LCIT or Placebo supplementation). Visits 4 and 5 will be separated by 48-72 hours. Visits 5 and 6 will again be separated by 4 weeks (Second 4 weeks of LCIT or Placebo supplementation with the addition of Low-intensity resistance exercise in both groups).

Approximately 12 hours total for each of the 7 laboratory visits, as well as 30-45 minutes 3 times per week during the last 4 weeks of the 8 week study.

Using a parallel placebo-controlled design, postmenopausal women with elevated blood pressure or hypertension will be randomized to receive L-CIT supplementation (10g/day) alone for 4 weeks, followed by 4 weeks of L-CIT supplementation in combination with low-intensity resistance training or placebo (maltodextrin) alone for 4 weeks, followed by 4 weeks of placebo in combination with low-intensity resistance training.

Differences between conditions (Citrulline vs Placebo) will be analyzed with independent samples t-test. Two-way ANOVA with repeated measures with Bonferroni adjustments will be used to analyze group (CIT vs. PL) by time (baseline, post-supplementation only, supplement + low-intensity resistance exercise training) interactions between the outcome variables. If group-by-time interactions are detected, post-hoc comparisons will be performed via paired or independent t-tests.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Women aged 50-75 years
  • Resting systolic BP 120-159 mmHg
  • Sedentary (< 60 min of exercise/week)
  • Body mass index of 18.5-39.9 kg/m2)
  • Fasting glucose < 126 mg/dL
  • HbA1c < 6.4%.

Exclusion criteria

  • Body mass index ≥ 40 or < 18.5 kg/m2
  • Diagnosed with type 1 or 2 diabetes mellitus
  • Cardiovascular diseases
  • Systolic blood pressure > 170 mmHg or on more than two anti-hypertensive medication
  • Other chronic diseases such as cancer, asthma, glaucoma, thyroid, kidney, liver and pancreatic disease
  • Individuals incorporated in a weight loss program and aerobic or resistance training program
  • Heavy smokers (> 20 cigarettes per day)
  • Heavy drinkers (> 12 alcoholic drinks per week)

Treatment and study plan

L-citrulline

Dietary Supplement

8 weeks of L-Citrulline supplementation (10 grams/day)

Placebo

Dietary Supplement

8 weeks of Placebo (maltodextrin; 10 grams/day)

Primary outcomes

  1. Changes in endothelial function via brachial artery flow-mediated dilation (effects of L-Citrulline only)

    Time frame: 4 weeks

    Endothelial function will be assessed at baseline and after 4 weeks of L-Citrulline supplementation alone using brachial artery flow-mediated dilation. All measurements will be performed using Doppler ultrasound.

  2. Changes in endothelial function via superficial femoral artery flow-mediated dilation (effects of L-Citrulline only)

    Time frame: 4 weeks

    Endothelial function will be assessed at baseline and after 4 weeks of L-Citrulline supplementation alone using superficial femoral artery flow-mediated dilation. All measurements will be performed using Doppler ultrasound.

  3. Changes in endothelial function via brachial artery flow-mediated dilation (effects of L-Citrulline combined with low-intensity resistance exercise training)

    Time frame: 4 weeks

    After the 4-week assessment, endothelial function will be assessed after 4 additional weeks of L-Citrulline supplementation with combined low-intensity resistance exercise training with the legs using brachial artery flow-mediated dilation. All measurements will be performed using Doppler ultrasound.

  4. Changes in endothelial function via superficial femoral artery flow-mediated dilation (effects of L-Citrulline combined with low-intensity resistance exercise training)

    Time frame: 4 weeks

    After the 4-week assessment, endothelial function will be assessed after 4 additional weeks of L-Citrulline supplementation with combined low-intensity resistance exercise training with the legs using superficial femoral artery flow-mediated dilation. All measurements will be performed using Doppler ultrasound.

  5. Changes in arm exercise blood flow (effects of L-Citrulline only)

    Time frame: 4 weeks

    Blood flow will be measured in the brachial artery during low intensity arm exercise. All measurements will be performed using Doppler ultrasound.

  6. Changes in leg exercise blood flow (effects of L-Citrulline only)

    Time frame: 4 weeks

    Blood flow will be measured in the superficial femoral arteries during low intensity leg exercise. All measurements will be performed using Doppler ultrasound.

  7. Changes in arm exercise blood flow (effects of L-Citrulline combined with low-intensity resistance exercise training)

    Time frame: 4 weeks

    After the 4-week assessment, blood flow will be measured in the brachial artery during low intensity arm exercise. All measurements will be performed using Doppler ultrasound.

  8. Changes in leg exercise blood flow (effects of L-Citrulline combined with low-intensity resistance exercise training)

    Time frame: 4 weeks

    After the 4-week assessment, blood flow will be measured in the superficial femoral artery during low intensity leg exercise. All measurements will be performed using Doppler ultrasound.

Secondary outcomes

  1. Changes in arterial stiffness via arm, leg, and aortic pulse wave velocity (effects of L-Citrulline only)

    Time frame: 4 weeks

    Arterial stiffness will be assessed using pulse wave velocity of the arm (carotid-radial), leg (femoral-ankle), and aorta (carotid-femoral) at baseline and after 4 weeks of L-Citrulline supplementation alone using applanation tonometry.

  2. Changes in arterial stiffness via arm, leg, and aortic pulse wave velocity (effects of L-Citrulline combined with low-intensity resistance exercise training)

    Time frame: 4 weeks

    Arterial stiffness will be assessed using pulse wave velocity of the arms (carotid-radial), legs (femoral-ankle), and aorta (carotid femoral) using applanation tonometry after 4 additional weeks of L-Citrulline supplementation with combined low-intensity resistance exercise training with the legs.

  3. Changes in aortic hemodynamics using pulse wave analysis (effects of L-Citrulline only)

    Time frame: 4 weeks

    The speed and reflection pressures, both representing aortic hemodynamic parameters, will be assessed using radial artery pulses and a validated transfer function (AtCor Medical) at baseline and after 4 weeks of L-Citrulline supplementation alone.

  4. Changes in aortic hemodynamics using pulse wave analysis (effects of L-Citrulline combined with low-intensity resistance exercise training)

    Time frame: 4 weeks

    The speed and reflection pressures, both representing aortic hemodynamic parameters, will be assessed using radial artery pulses and a validated transfer function (AtCor Medical) after 4 additional weeks of L-Citrulline supplementation with combined low-intensity resistance exercise training with the legs.

  5. Changes in brachial and aortic blood pressure via automated sphygmomanometry (effects of L-Citrulline only)

    Time frame: 4 weeks

    Brachial and aortic blood pressures (systolic and diastolic) will be assessed using an arm cuff at baseline and after 4 weeks of L-Citrulline supplementation alone.

  6. Changes in brachial and aortic blood pressure via automated sphygmomanometry (effects of L-Citrulline combined with low-intensity resistance exercise training)

    Time frame: 4 weeks

    Brachial and aortic blood pressures (systolic and diastolic) will be assessed using an arm cuff after 4 additional weeks of L-Citrulline supplementation with combined low-intensity resistance exercise training with the legs.

  7. Changes in muscle strength (effects of L-Citrulline only)

    Time frame: 4 weeks

    Handgrip and leg strength (leg press, leg extension, leg flexion, calf raises) will be assessed at baseline and after 4 weeks of L-Citrulline supplementation alone.

  8. Changes in muscle strength (effects of L-Citrulline combined with low-intensity resistance exercise training)

    Time frame: 4 weeks

    After the 4-week assessment, handgrip and leg strength (leg press, leg extension, leg flexion, calf raises) will be assessed after 4 additional weeks of L-Citrulline supplementation with combined low-intensity resistance exercise training with the legs. These 4 exercises are to be of focus during the training sessions (3 days/week, 12 total training sessions).

  9. Quantification of L-Arginine (effects of L-Citrulline only)

    Time frame: 4 weeks

    Serum levels of L-Arginine (nmol/ul) will be assessed at baseline and after 4 weeks of L-Citrulline supplementation alone.

  10. Quantification of Arginase (effects of L-Citrulline only)

    Time frame: 4 weeks

    Serum levels ofarginase (pg/mL) will be assessed at baseline and after 4 weeks of L-Citrulline supplementation alone.

  11. Quantification of nitric oxide (effects of L-Citrulline only)

    Time frame: 4 weeks

    Serum levels ofnitric oxide (umol/L) will be assessed at baseline and after 4 weeks of L-Citrulline supplementation alone.

  12. Quantification of Endothelin-1 (effects of L-Citrulline only)

    Time frame: 4 weeks

    Serum levels of endothelin-1 (pg/mL) will be assessed at baseline and after 4 weeks of L-Citrulline supplementation alone.

  13. Quantification of L-Ornithine (effects of L-Citrulline only)

    Time frame: 4 weeks

    Serum levels of L-Ornithine (pmol/ul) will be assessed at baseline and after 4 weeks of L-Citrulline supplementation alone.

  14. Quantification of L-Arginine (effects of L-Citrulline combined with low-intensity resistance exercise training)

    Time frame: 4 weeks

    After the 4-week assessment, serum levels of L-Arginine (nmol/ul) will be assessed after 4 additional weeks of L-Citrulline supplementation with combined low-intensity resistance exercise training with the legs.

  15. Quantification of arginase (effects of L-Citrulline combined with low-intensity resistance exercise training)

    Time frame: 4 weeks

    After the 4-week assessment, serum levels of arginase (pg/mL) will be assessed after 4 additional weeks of L-Citrulline supplementation with combined low-intensity resistance exercise training with the legs.

  16. Quantification of nitric oxide (effects of L-Citrulline combined with low-intensity resistance exercise training)

    Time frame: 4 weeks

    After the 4-week assessment, serum levels of nitric oxide (umol/L) will be assessed after 4 additional weeks of L-Citrulline supplementation with combined low-intensity resistance exercise training with the legs.

  17. Quantification of endothelin-1 (effects of L-Citrulline combined with low-intensity resistance exercise training)

    Time frame: 4 weeks

    After the 4-week assessment, serum levels of endothelin-1 (pg/mL) will be assessed after 4 additional weeks of L-Citrulline supplementation with combined low-intensity resistance exercise training with the legs.

  18. Quantification of L-Ornithine (effects of L-Citrulline combined with low-intensity resistance exercise training)

    Time frame: 4 weeks

    After the 4-week assessment, serum levels of L-Ornithine (pmol/ul) will be assessed after 4 additional weeks of L-Citrulline supplementation with combined low-intensity resistance exercise training with the legs.

Sponsors and collaborators

Lead sponsor

Texas Tech University

Other

Registry information

Official study title

8 Weeks of L-Citrulline Supplementation to Improve Low-intensity Resistance Exercise Training Vascular Adaptations in Postmenopausal Women With Hypertension

Important dates

Study start
2018
Primary completion
2022
Study completion
2022
First posted
Feb 7, 2022
Registry last updated
Feb 7, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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