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NCT Number: NCT05997732

Sympathetic Neurovascular Transduction: Role of Adrenergic Receptors and Sex Differences

The main purpose of this interventional study is to examine differences in resting blood pressure control between healthy males and females. The main questions it aims to answer are:

1. Are there sex differences in the communication between the sympathetic nervous system (also known as the "fight or flight" response) and peripheral blood vessels (which influence systemic blood pressure)? 2. What is the role of specific vascular receptors that respond to sympathetic signals, and is it different between males and females?

Participants will complete one study visit of approximately 3 hours where they will:

* Have a blood sample taken to measure circulating sex hormone and sympathetic transmitters. * Receive very small doses of medications commonly used to adjust blood pressure through an artery in their arm. The effects of these medications will be short-acting and localized to the forearm. * Have their sympathetic nervous activity directly measured through two very small needles (similar to acupuncture needles) in the side of their leg. * Have their blood pressure and heart rate recorded, and forearm blood flow measured using ultrasound.

Recruiting

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Key information

Age range

18 year–40 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 4

Primary location

University of Alberta

Edmonton, Alberta, T6G 2R3, Canada

Location status: Recruiting

Location contact

Craig Steinback, PhD

CONTACT

[email protected]

(780)492-5553

About this study

Blood pressure is in part regulated by activity of your sympathetic nervous system (also known as your "fight or flight" response). Sympathetic nerve activity affects the size of your blood vessels, which in turn will affect your blood pressure. This communication between sympathetic impulses and the resulting change in vascular resistance is termed "sympathetic neurovascular transduction". In other words, transduction represents the reactivity of the blood vessels in response to individual sympathetic bursts of activity.

Males and females regulate their blood pressure in different ways; for example, females tend to have lower blood pressure and sympathetic nerve activity than males. Females also appear to have less constriction of their blood vessels in response to stress. This may be due to differences in the receptors which are activated by the sympathetic nervous system. These receptors are called α and β-adrenergic receptors and are located on vascular smooth muscle cells. They respond to sympathetic neurotransmitters such as norepinephrine in opposite directions: α-adrenoreceptors cause vasoconstriction (and an increase in vascular resistance), and β-adrenoreceptors cause vasodilation (and a decrease in vascular resistance) in part through the endothelium-dependent nitric oxide pathway.

Current evidence suggests that β-adrenergic receptors are more sensitive in females and contribute to paradoxical vasodilation when α-adrenergic receptors are stimulated by norepinephrine from sympathetic bursts. It has also been suggested that estrogen interacts with adrenergic receptors, contributing to this sex difference. This study will contribute to the understanding of sex differences in cardiovascular physiology and may have implications for clinical cardiovascular conditions.

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Between ages 18-40 years
  • No diagnosed medical history of cardiovascular, respiratory, nervous system, or metabolic disease.
  • Females must be pre-menopausal.
  • Prior to study visit: abstained from caffeine, alcohol, strenuous exercise, and medication not taken regularly for at least 12 hours.

Exclusion criteria

  • Current diagnosis of cardiovascular, respiratory, nervous system, or metabolic disease that may impact blood pressure regulation. This will be assessed on a case-by-case basis by the study physician.
  • Participants with bleeding or clotting disorders, or those currently taking blood thinners.
  • Participants currently taking beta-agonist inhalers i.e. Ventolin (at least not in the last 24 hours).
  • Females who are pregnant, confirmed by a pregnancy test.
  • Females who have are less than 1 year postpartum or are breastfeeding.
  • Females who are post-menopausal.
  • Participants that are classified as obese (body mass index > 30 kg ⋅ m2).
  • Have a history of smoking regularly in the last 6 months (but nicotine substitutes (i.e. patch, gum) are not an exclusion criteria).
  • Those with a known allergy to sulfites, or other components of the supplied solution of study drugs.
  • Participants taking medications that are contraindicated with any of the study drugs, such as monoamine oxidase (MAO) inhibitors or tricyclic antidepressants.
  • Participants who have not adhered to the pre-testing guidelines related to diet, alcohol or exercise will not be excluded, but will be rescheduled for a different day. This is to reduce experimental variability.

Treatment and study plan

Phenylephrine Hydrochloride

Drug

Participants will receive three incremental doses via the brachial artery catheter to assess α1-adrenoreceptor mediated vasoconstriction.

Isoproterenol Hydrochloride

Drug

Participants will receive four incremental doses via the brachial artery catheter to assess β-adrenoreceptor mediated vasodilation.

Norepinephrine Bitartrate

Drug

Participants will receive three incremental doses via the brachial artery catheter to assess nonspecific adrenoreceptor activation.

Propranolol Hydrochloride

Drug

Propranolol will be continuously infused through the brachial artery catheter to induce β-adrenergic blockade locally in the forearm.

Phentolamine Mesylate

Drug

Phentolamine will be continuously infused through the brachial artery catheter to induce α-adrenergic blockade locally in the forearm.

Primary outcomes

  1. Forearm blood flow

    Time frame: 10 minutes per condition + 2 minutes per agonist dose = 60 minutes

    Measured during resting baseline; changes during phenylephrine, isoproterenol, and norepinephrine infusion to determine agonist sensitivity.

  2. Forearm vascular resistance

    Time frame: 10 minutes per condition + 2 minutes per agonist dose = 60 minutes

    Measured during resting baseline; changes during phenylephrine, isoproterenol, and norepinephrine infusion to determine agonist sensitivity.

  3. Forearm vascular conductance

    Time frame: 10 minutes per condition + 2 minutes per agonist dose = 60 minutes

    Measured during resting baseline; changes during phenylephrine, isoproterenol, and norepinephrine infusion to determine agonist sensitivity.

  4. Arterial blood pressure

    Time frame: 10 minutes per condition + 2 minutes per agonist dose = 60 minutes

    Measured during resting baseline; changes during phenylephrine, isoproterenol, and norepinephrine infusion to determine agonist sensitivity.

  5. Muscle sympathetic nerve activity

    Time frame: 10 minutes per condition = 30 minutes

    Resting baseline

  6. Circulating sex hormone concentrations

    Time frame: 2 minutes

    Blood samples

  7. Circulating sympathetic neurotransmitter concentrations

    Time frame: 2 minutes

    Blood sample

Secondary outcomes

  1. Arterial-venous blood gas concentrations

    Time frame: 2 minutes per sample = 6 minutes

    Blood sample during each condition

Study contacts

Contact information is provided by the study sponsor or research team.

Emily Vanden Berg, MSc

CONTACT

[email protected]

(780)-492-5553

Nicholas Cheung, MSc

CONTACT

[email protected]

(780)-492-5553

Sponsors and collaborators

Lead sponsor

University of Alberta

Other

Registry information

Acronym: STARS

Important dates

Study start
2023
Primary completion
2027
Study completion
2027
First posted
Aug 18, 2023
Registry last updated
Jan 8, 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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