HypertensionHAPI-CHINCT02761603
Healthy Aging Practice-centered Instruction Cardiovascular Health Investigation (HAPI-CHI)
A study testing Healthy Aging Practice-centered Instruction (HAPI) and Tai Chi (CHI) in people with Hypertension and Prehypertension, run by University of California, San Diego.
Trial summary
Over 30% of American adults have hypertension (HTN) (high blood pressure), and the rate increases considerably with age; 64% of men and 78% of women over 65 have HTN. High blood pressure associated with HTN can force of the blood against artery walls with enough pressure that it can eventually cause health problems… Read more about this study
- Who is it for?
- Ages 60 years and older
- Conditions the study is for
- Hypertension, Prehypertension
- What is being tested?
- Healthy Aging Practice-centered Instruction (HAPI) and Tai Chi (CHI)
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 250 participants
- Where
- No sites listed yet
- Study dates
- Apr 2015to Dec 2022
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 60 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- 1. SBP≥130 but overall BP ≤ 170/110;
- Able to perform light to moderate exercise;
- Able to give informed consent;
- Able to complete study assessments as described;
- Understand study procedures and to comply with them for the entire length of the study;
- 5. 60+ years;
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- Able to complete written questionnaires without assistance (reading devices okay);
- Have not had a fall in that resulted in hospitalization in the past 12 months;
- Willing to be randomized to TC or HAP-E;
- Able to attend regular study activities at the center and/or UCSD.
Who cannot join
- Currently performing meditation for more than 15 minutes at a time 2X/week or more);
- Currently performing moderate exercise (enough to work up a sweat) for more than 15 minutes 2X/week or more.
- Oxygen-dependent COPD;
- Stroke, cerebral neurologic impairment, cardiac surgery or MI within the past year;
- Current use of mood stabilizers, or antipsychotics;
- Medications (steroids) and conditions affecting our immune assays or our physiological measures of vascular function (anti-cholinergics);
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- Severe kidney disease;
- Current cancer diagnosis or treatment;
- Insulin-dependent diabetes mellitus;
- Meets criteria for bipolar disorder, schizophrenia, substance use disorder;
- Suicidality;
- Inability to read and write in English;
- Inability to provide written informed consent;
- Inability to adequately answer questions on the post-consent assessment;
- Current smoker;
- Body Mass Index > 40 kg/m2;
- Currently meets criteria for major depressive episode (per patient self-report of clinical diagnosis by a professional);
About this study
Official title: Autonomic and Immuno-Vascular Mechanisms of Antihypertensive Effects of Tai Chi
Over 30% of American adults have hypertension (HTN) (high blood pressure), and the rate increases considerably with age; 64% of men and 78% of women over 65 have HTN. High blood pressure associated with HTN can force of the blood against artery walls with enough pressure that it can eventually cause health problems, such as heart disease and stroke. HTN is one of the most significant causes of early death worldwide and one of the most preventable causes of death. Many studies reveal that lowering blood pressure (BP) reduces the incidence of diseases of the heart and blood vessels. Non-drug related treatments are known to reduce BP which can have a great effect on public health. Research suggests that Tai Chi (TC) is effective in lowering BP in patients with HTN, but because of the low quality of existing studies there is no definite proof. Also, it is not known how TC reduces BP. One possibility is that TC practice, which is shown to reduce psychological distress such as anxiety and depression and reduce the body's responses to stress, can improve the balance of the autonomic nervous system (the part of your nervous system that controls beating of the heart and the widening or narrowing of blood vessels). This may lead to lower BP. The investigators plan to investigate the pathways among autonomic, blood vessel, immune and psychological factors in relation to BP changes in response to 12-weeks of TC compared with Healthy Aging Practice-centered Education (HAP-E). 250 older adults (60+ years old) with mild HTN will be enrolled, and the investigators will take several measurements of heart and nervous system functioning. The investigators hypothesize that performing TC for 12 weeks will result in autonomic "re-regulation" which will improve BP and blood vessel health (Aim 1) and sympathetic nervous system (part of the nervous system that serves to speed up heart rate, contract blood vessels, and raise blood pressure) regulation of the immune system (Aim 2). Lastly, the investigators hypothesize that psychological factors will be related to TC effects on autonomic regulation (Aim 3). Findings from the investigators study will hopefully shed light on the pathways by which TC reduces BP. Also, the particular effects of TC ("meditative movement") in an older, "hard-to-treat" hypertensive population will be better understood.
- Conditions
- Hypertension, Prehypertension
- Being tested
- Healthy Aging Practice-centered Instruction (HAPI), Tai Chi (CHI)
- Medical subject headings
- Hypertension, Prehypertension
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Healthy Aging Practice-centered Instruction (HAPI)Behavioural
Sessions will include interactive activities derived from the CDC's "Program to Encourage Active and Rewarding LiveS (PEARLS)" and will include lectures based on health-related topics from presentations given by experts as part of the UC San Diego Stein Institute of Aging's Successful Aging project. The PEARLS Problem Solving Treatment (PST) group discussions will be facilitated by a trained instructor in order for participants to identify problems or barriers they have in engaging in healthy behaviors relevant to each of 12 topic areas (e.g. sleep, nutrition, mental health, social support, bone health, diabetes prevention, cognitive wellness, and resilience). Each session will be composed of: Successful Aging video (45 min), discussion (40 min), and identifying problem solving strategies (25 min) with a homework assignment each week, for a total of 24 hours of in-class instruction and discussion.
Tai Chi (CHI)Behavioural
Sessions will include expert instruction in the brief Yang-style 8-form Tai Chi meditative movements. Each class will include a 10-minute warm-up and cool-down plus 40 minutes of Tai Chi instruction and or practice, for a total of 24 hours of in-class instruction
| Study group | Role | What they receive |
|---|---|---|
| Healthy Aging Practice-centered Instruction (HAPI) | Active comparator | 24 hours of group instruction in which experts present on a variety of health-related topics followed by class discussion, goal-setting, and goal review. Themes will include: sleep, nutrition, mental health, social support, bone-health, diabetes prevention, cognitive wellness, and resilience. Receives: Behavioral: Healthy Aging Practice-centered Instruction (HAPI) |
| Tai Chi (CHI) | Experimental | 24 hours of group instruction in 8 meditative Tai Chi movements. Receives: Behavioral: Tai Chi (CHI) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Blood Pressure
Change From Pre-intervention to Post-intervention in Blood Pressure (mmHg)
Measured: Pre- to post-intervention (12 weeks)
Secondary outcomes (6)
Stroke Volume
Change From Pre-intervention to Post-intervention in Stroke Volume (mL)
Measured: Pre- to post-intervention (12 weeks)
Cardiac Output
Change From Pre-intervention to Post-intervention in Cardiac Output (mL/min)
Measured: Pre- to post-intervention (12 weeks)
Total Peripheral Resistance (TPR)
Change From Pre-intervention to Post-intervention in TPR (mmHg·min/l)
Measured: Pre- to post-intervention (12 weeks)
Ejection Fraction (EF)
Change From Pre-intervention to Post-intervention in EF (%)
Measured: Pre- to post-intervention (12 weeks)
Pulse Wave Velocity (PWV)
Change From Pre-intervention to Post-intervention in PWV
Measured: Pre- to post-intervention (12 weeks)
Heart Rate Variability (HRV)
Change From Pre-intervention to Post-intervention in HRV
Measured: Pre- to post-intervention (12 weeks)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 May 2016 (estimated)
- Study startApr 2015
- Primary completionMay 2021
- Study completionDec 2022 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for HypertensionStudies of the same condition, open and under way.
- More trials run by University of California, San DiegoThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 250 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of California, San Diego
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Laura S. Redwine, PhD, University of California, San Diego
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02761603
- Sponsor's protocol ID
- R01HL126056
- Acronym
- HAPI-CHI
- Status last verified
- Jan 2022
- First submitted
- 29 Apr 2016
- Last updated
- 21 Jan 2022
- Results posted
- No
- Data monitoring committee
- Yes
- Individual data sharing
- No
Publications
Kohn JN, Lobo JD, Troyer EA, Wilson KL, Ang G, Walker AL, Pruitt C, Pung MA, Redwine LS, Hong S. Tai chi or health education for older adults with hypertension: effects on mental health and psychological resilience to COVID-19. Aging Ment Health. 2023 Mar;27(3):496-504. doi: 10.1080/13607863.2022.2053836. Epub 2022 Mar 21.
PubMed 35311437
Study at a glance
From the registry record, last updated by the sponsor on 21 Jan 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Autonomic and Immuno-Vascular Mechanisms of Antihypertensive Effects of Tai Chi
- ClinicalTrials.gov ID
- NCT02761603
- Acronym / sponsor ID
- HAPI-CHI / R01HL126056
- Conditions
- Hypertension, Prehypertension
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 250 participants (estimated)
- Lead sponsor
- University of California, San DiegoUniversity, hospital or other
- Study start
- Apr 2015
- Primary completion
- May 2021 (actual)
- Study completion
- Dec 2022 (estimated)
- First posted
- 4 May 2016 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Over 30% of American adults have hypertension (HTN) (high blood pressure), and the rate increases considerably with age; 64% of men and 78% of women over 65 have HTN. High blood pressure associated with HTN can force of the blood against artery walls with enough pressure that it can eventually cause health problems, such as heart disease and stroke. HTN is one of the most significant causes of early death worldwide and one of the most preventable causes of death. Many studies reveal that lowering blood pressure (BP) reduces the incidence of diseases of the heart and blood vessels. Non-drug related treatments are known to reduce BP which can have a great effect on public health. Research suggests that Tai Chi (TC) is effective in lowering BP in patients with HTN, but because of the low quality of existing studies there is no definite proof. Also, it is not known how TC reduces BP. One possibility is that TC practice, which is shown to reduce psychological distress such as anxiety and depression and reduce the body's responses to stress, can improve the balance of the autonomic nervous system (the part of your nervous system that controls beating of the heart and the widening or narrowing of blood vessels). This may lead to lower BP. The investigators plan to investigate the pathways among autonomic, blood vessel, immune and psychological factors in relation to BP changes in response to 12-weeks of TC compared with Healthy Aging Practice-centered Education (HAP-E). 250 older adults (60+ years old) with mild HTN will be enrolled, and the investigators will take several measurements of heart and nervous system functioning. The investigators hypothesize that performing TC for 12 weeks will result in autonomic "re-regulation" which will improve BP and blood vessel health (Aim 1) and sympathetic nervous system (part of the nervous system that serves to speed up heart rate, contract blood vessels, and raise blood pressure) regulation of the immune system (Aim 2). Lastly, the investigators hypothesize that psychological factors will be related to TC effects on autonomic regulation (Aim 3). Findings from the investigators study will hopefully shed light on the pathways by which TC reduces BP. Also, the particular effects of TC ("meditative movement") in an older, "hard-to-treat" hypertensive population will be better understood.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Healthy Aging Practice-centered Instruction (HAPI) | Active comparator | Behavioral: Healthy Aging Practice-centered Instruction (HAPI)24 hours of group instruction in which experts present on a variety of health-related topics followed by class discussion, goal-setting, and goal review. Themes will include: sleep, nutrition, mental health, social support, bone-health, diabetes prevention, cognitive wellness, and resilience. |
| Tai Chi (CHI) | Experimental | Behavioral: Tai Chi (CHI)24 hours of group instruction in 8 meditative Tai Chi movements. |
Who may qualify
- Ages
- 60 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (10 listed)
- 1. SBP≥130 but overall BP ≤ 170/110;
- Able to perform light to moderate exercise;
- Able to give informed consent;
- Able to complete study assessments as described;
- Understand study procedures and to comply with them for the entire length of the study;
Key exclusion criteria (17 listed)
- Currently performing meditation for more than 15 minutes at a time 2X/week or more);
- Currently performing moderate exercise (enough to work up a sweat) for more than 15 minutes 2X/week or more.
- Oxygen-dependent COPD;
- Stroke, cerebral neurologic impairment, cardiac surgery or MI within the past year;
- Current use of mood stabilizers, or antipsychotics;
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Healthy Aging Practice-centered Instruction (HAPI)Sessions will include interactive activities derived from the CDC's "Program to Encourage Active and Rewarding LiveS (PEARLS)" and will include lectures based on health-related topics from presentations given by experts as part of the UC San Diego Stein Institute of Aging's Successful Aging project. The PEARLS Problem Solving Treatment (PST) group discussions will be facilitated by a trained instructor in order for participants to identify problems or barriers they have in engaging in healthy behaviors relevant to each of 12 topic areas (e.g. sleep, nutrition, mental health, social support, bone health, diabetes prevention, cognitive wellness, and resilience). Each session will be composed of: Successful Aging video (45 min), discussion (40 min), and identifying problem solving strategies (25 min) with a homework assignment each week, for a total of 24 hours of in-class instruction and discussion. | Behavioural | Healthy Aging Practice-centered Instruction (HAPI) |
| Tai Chi (CHI)Sessions will include expert instruction in the brief Yang-style 8-form Tai Chi meditative movements. Each class will include a 10-minute warm-up and cool-down plus 40 minutes of Tai Chi instruction and or practice, for a total of 24 hours of in-class instruction | Behavioural | Tai Chi (CHI) |
Primary outcome
Blood Pressure
Time frame: Pre- to post-intervention (12 weeks)
Change From Pre-intervention to Post-intervention in Blood Pressure (mmHg)
6 secondary outcomes
Stroke Volume
Time frame: Pre- to post-intervention (12 weeks)
Cardiac Output
Time frame: Pre- to post-intervention (12 weeks)
Total Peripheral Resistance (TPR)
Time frame: Pre- to post-intervention (12 weeks)
Ejection Fraction (EF)
Time frame: Pre- to post-intervention (12 weeks)
Pulse Wave Velocity (PWV)
Time frame: Pre- to post-intervention (12 weeks)
Heart Rate Variability (HRV)
Time frame: Pre- to post-intervention (12 weeks)
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 Jan 2022.
- Derived from this study: PubMed 35311437Kohn JN, Lobo JD, Troyer EA, Wilson KL, Ang G, Walker AL, Pruitt C, Pung MA, Redwine LS, Hong S. Tai chi or health education for older adults with hypertension: effects on mental health and psychological resilience to COVID-19. Aging Ment Health. 2023 Mar;27(3):496-504. doi: 10.1080/13607863.2022.2053836. Epub 2022 Mar 21.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
Questions about this trial
What is this clinical trial studying?
A study testing Healthy Aging Practice-centered Instruction (HAPI) and Tai Chi (CHI) in people with Hypertension and Prehypertension, run by University of California, San Diego.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 10 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 21 Jan 2022. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Blood Pressure (time frame: Pre- to post-intervention (12 weeks)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02761603, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Jan 2022.