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NCT Number: NCT07475208

NR and Exercise for Blood Pressure

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.

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Key information

Conditions

Hypertension (HTN) Cardiovascular Diseases Hypertension Vascular Diseases

Age range

55 year–80 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • 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)

Exclusion criteria

  • 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,
  • any changes in antihypertensive medication type or dosage within the last three months, or
  • engagement in regular physical activity, defined as at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week, during the three months prior to enrollment.

Treatment and study plan

Brisk walking

Behavioral

Brisk walking twice per week

Nicotinamide Riboside 1000 mg

Dietary Supplement

Nicotinamide Riboside supplementation 1000 mg per day

Placebo

Other

Placebo

Primary outcomes

  1. Blood pressure

    Time frame: From enrollment to the end of follow-up at 20 weeks

    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.

Secondary outcomes

  1. Whole Blood NAD concentration

    Time frame: From enrollment to the end of follow-up at 20 weeks

    Whole blood NAD concentration will be analyzed with commercially available colorimetric assay kit according to manufacturer's instructions using thawed whole blood samples.

  2. Endothelin 1

    Time frame: From enrollment to the end of follow-up at 20 weeks

    ET-1 will be analyzed with commercially available ELISA kit according to manufacturer's instructions using thawed serum samples and will serve as indicators of vascular function.

  3. Angiotensin

    Time frame: From enrollment to the end of follow-up at 20 weeks

    Angiotensin will be analyzed with commercially available ELISA kit according to manufacturer's instructions using thawed serum samples and will serve as indicators of vascular function.

  4. Body mass

    Time frame: From enrollment to the end of follow-up at 20 weeks

    Measured with bioelectrical impedance analysis (BIA) (MC-780 MA, Tanita, Japan) with participants in minimum clothing and normal hydration status.

  5. Fat mass

    Time frame: From enrollment to the end of follow-up at 20 weeks

    Measured with bioelectrical impedance analysis (BIA) (MC-780 MA, Tanita, Japan) with participants in minimum clothing and normal hydration status

  6. Fat-free mass

    Time frame: From enrollment to the end of follow-up at 20 weeks

    Measured with bioelectrical impedance analysis (BIA) (MC-780 MA, Tanita, Japan) with participants in minimum clothing and normal hydration status.

  7. Fat percentage

    Time frame: From enrollment to the end of follow-up at 20 weeks

    Measured with bioelectrical impedance analysis (BIA) (MC-780 MA, Tanita, Japan) with participants in minimum clothing and normal hydration status.

  8. Height

    Time frame: From enrollment to the end of follow-up at 20 weeks

    Measured using a stadiometer (Seca, Leicester, UK).

  9. BMI

    Time frame: From enrollment to the end of follow-up at 20 weeks

    Calculated as body mass (kg) divided by height squared (m2).

  10. Waist Circumference

    Time frame: From enrollment to the end of follow-up at 20 weeks

    Measured using anthropometric tape.

  11. Seven-day accelerometry

    Time frame: From enrollment to the end of follow-up at 20 weeks

    Participants will be instructed to wear a wrist accelerometer device on their non-dominant wrists 24 hours for 7 days to measure habitual physical activity pattern. Data will be downloaded and saved in raw format, then processed and analyzed with R-package GGIR.

  12. 30-second chair stand test

    Time frame: From enrollment to the end of follow-up at 20 weeks

    Muscle strength of the lower extremities will be assessed using the 30-second chair stand test. During the test, participants will be instructed to stand up to a full standing position and then sit back down as many times as possible within 30 seconds. The number of times participants achieve a full standing position will be recorded as their score.

  13. Handgrip strength

    Time frame: From enrollment to the end of follow-up at 20 weeks

    Measured using a hand-held dynamometer.

Other outcomes

  1. Food diary

    Time frame: From enrollment to the end of follow-up at 20 weeks

    A 24-hour diet log will be used to capture detailed information about the foods and beverages consumed by participants in the past 24 hours from midnight to midnight. Participants will be asked to retain their normal eating habits and will be required to report as detailed information as possible such as the preparation method, ingredients, portion, and size of food, etc. Macronutrients, sodium, and potassium intakes will be estimated using the online dietary assessment software FoodWorks.

  2. Medication usage

    Time frame: From enrollment to the end of follow-up at 20 weeks

    Participants will be instructed to record the dose and frequency associated with the use of any prescribed medications during baseline screening. Data on medication dose and frequency will be presented as the sum of the multiples of lowest recommended dose (LRD). Our project personnel will contact the participants monthly to record any changes in the use of medications.

  3. International Physical Activity Questionnaire (IPAQ)

    Time frame: From enrollment to the end of follow-up at 20 weeks

    IPAQ is a validated questionnaire to measure the physical activity of participants during the past 7 days.

  4. 36-item short-form health survey

    Time frame: From enrollment to the end of follow-up at 20 weeks

    The 36-Item Short Form Health Survey (SF-36) is a set of generic, coherent, and easily administered quality-of-life measures.

  5. Menopause Rating Scale

    Time frame: From enrollment to the end of follow-up at 20 weeks

    The Menopause Rating Scale (MRS) is a validated, 11-item self-assessment tool used globally to measure the severity of menopausal symptoms (somatic, psychological, and urogenital).

  6. Pittsburgh Sleep Quality Index

    Time frame: From enrollment to the end of follow-up at 20 weeks

    The Pittsburgh Sleep Quality Index (PSQI) is a widely used self-report questionnaire that assesses sleep quality over a one-month time interval.

Sponsors and collaborators

Lead sponsor

ZHANG Jiaqi

Other

Registry information

Official study title

Effects of Ten-Week Oral Nicotinamide Riboside Supplementation With Aerobic Exercises on Blood Pressure in Post- Menopausal Women With Elevated/Stage I Hypertension

Important dates

Study start
2026
Primary completion
2026
Study completion
2027
First posted
Mar 16, 2026
Registry last updated
Mar 18, 2026

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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