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VasoconstrictionPhase 4STARSNCT05997732

Sympathetic Neurovascular Transduction: Role of Adrenergic Receptors and Sex Differences

A Phase 4 study testing Phenylephrine Hydrochloride, Isoproterenol Hydrochloride and Norepinephrine Bitartrate in people with Vasoconstriction and Vasodilation, run by University of Alberta at 1 site in Canada.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

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. Read more about this study

Who is it for?
Ages 18 to 40 yearsHealthy volunteers can take part
Conditions the study is for
Vasoconstriction, Vasodilation
What is being tested?
Phenylephrine Hydrochloride, Isoproterenol Hydrochloride and Norepinephrine Bitartrate
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteCanada
Study dates
31 Oct 2023to 1 Dec 2027
Phase
Phase 4
Are there results?
Not yet: the study is under way

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 18 to 40 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • 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.

Who cannot join

  • 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.
Show all 11Show fewer
  • 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.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Emily Vanden Berg, MSc contact

(780)-492-5553

ervanden@ualberta.ca

Nicholas Cheung, MSc contact

(780)-492-5553

nkcheung@ualberta.ca

Canada1 site, 1 recruiting
  • University of Alberta

    Edmonton, Alberta, T6G 2R3

    Craig Steinback, PhD, (780)492-5553, craig.steinback@ualberta.ca

    Recruiting

Other trials in Canada

About this study

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?
Read more

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.
Read the detailed description

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.

Being tested
Phenylephrine Hydrochloride, Isoproterenol Hydrochloride, Norepinephrine Bitartrate, Propranolol Hydrochloride, Phentolamine Mesylate
Keywords
sympathetic nerve activity, sex differences, adrenergic receptors, neurovascular transduction
Medical subject headings
Aneurysm

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Phenylephrine HydrochlorideDrug

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

  • Isoproterenol HydrochlorideDrug

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

  • Norepinephrine BitartrateDrug

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

  • Propranolol HydrochlorideDrug

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

  • Phentolamine MesylateDrug

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

  • Phenylephrine HydrochlorideDrug

    Participants will receive one dose via the brachial artery catheter to evaluate the effectiveness of the α-adrenergic blockade.

  • Isoproterenol HydrochlorideDrug

    Participants will receive one dose via the brachial artery catheter to evaluate the effectiveness of the β-adrenergic blockade.

  • Propranolol HydrochlorideDrug

    Propranolol will be continuously co-infused with phentolamine to maintain the β-adrenergic blockade.

Study groups in NCT05997732
Study groupRoleWhat they receive
Control ConditionExperimentalNormal saline will be infused through the brachial artery catheter at the same calculated rate as propranolol + phentolamine in the α+β-blockade condition to control for volumetric effects.
Receives: Drug: Phenylephrine Hydrochloride; Drug: Isoproterenol Hydrochloride; Drug: Norepinephrine Bitartrate
β-Adrenergic BlockadeExperimentalβ-adrenoreceptors will be blocked locally in the forearm using propranolol. Normal saline will be co-infused at the calculated rate of phentolamine in the α+β-blockade condition to control for volumetric effects.
Receives: Drug: Norepinephrine Bitartrate; Drug: Propranolol Hydrochloride
α+β-Adrenergic BlockadeExperimentalα-adrenoreceptors will be blocked locally in the forearm using phentolamine. Propranolol will be co-infused to maintain β-blockade.
Receives: Drug: Phentolamine Mesylate; Drug: Phenylephrine Hydrochloride; Drug: Isoproterenol Hydrochloride; Drug: Propranolol Hydrochloride

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Forearm blood flow

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

    Measured: 10 minutes per condition + 2 minutes per agonist dose = 60 minutes

  2. Forearm vascular resistance

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

    Measured: 10 minutes per condition + 2 minutes per agonist dose = 60 minutes

  3. Forearm vascular conductance

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

    Measured: 10 minutes per condition + 2 minutes per agonist dose = 60 minutes

  4. Arterial blood pressure

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

    Measured: 10 minutes per condition + 2 minutes per agonist dose = 60 minutes

  5. Muscle sympathetic nerve activity

    Resting baseline

    Measured: 10 minutes per condition = 30 minutes

  6. Circulating sex hormone concentrations

    Blood samples

    Measured: 2 minutes

  7. Circulating sympathetic neurotransmitter concentrations

    Blood sample

    Measured: 2 minutes

Secondary outcomes (1)
  1. Arterial-venous blood gas concentrations

    Blood sample during each condition

    Measured: 2 minutes per sample = 6 minutes

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Aug 2023
  2. Study start31 Oct 2023
  3. Primary completion1 Dec 2027 (estimated)
  4. Study completion1 Dec 2027 (estimated)

Resources

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 4
Primary purpose
Basic science
Allocation
Non-randomised
Intervention model
Crossover
Model description
Participants will complete three pharmacological conditions, and serve as their own controls.
Masking
None (open label)
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05997732
Sponsor's protocol ID
Pro00126600
Acronym
STARS
Status last verified
Jan 2026
First submitted
2 Aug 2023
Last updated
8 Jan 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Hart EC, Charkoudian N, Wallin BG, Curry TB, Eisenach JH, Joyner MJ. Sex differences in sympathetic neural-hemodynamic balance: implications for human blood pressure regulation. Hypertension. 2009 Mar;53(3):571-6. doi: 10.1161/HYPERTENSIONAHA.108.126391. Epub 2009 Jan 26.

    PubMed 19171792
  • Steinback CD, Fraser GM, Usselman CW, Reyes LM, Julian CG, Stickland MK, Chari RS, Khurana R, Davidge ST, Davenport MH. Blunted sympathetic neurovascular transduction during normotensive pregnancy. J Physiol. 2019 Jul;597(14):3687-3696. doi: 10.1113/JP277714. Epub 2019 Jun 13.

    PubMed 31106429
  • Fairfax ST, Holwerda SW, Credeur DP, Zuidema MY, Medley JH, Dyke PC 2nd, Wray DW, Davis MJ, Fadel PJ. The role of alpha-adrenergic receptors in mediating beat-by-beat sympathetic vascular transduction in the forearm of resting man. J Physiol. 2013 Jul 15;591(14):3637-49. doi: 10.1113/jphysiol.2013.250894. Epub 2013 May 7.

    PubMed 23652594
  • Dinenno FA, Eisenach JH, Dietz NM, Joyner MJ. Post-junctional alpha-adrenoceptors and basal limb vascular tone in healthy men. J Physiol. 2002 May 1;540(Pt 3):1103-10. doi: 10.1113/jphysiol.2001.015297.

    PubMed 11986395
  • Hissen SL, Taylor CE. Sex differences in vascular transduction of sympathetic nerve activity. Clin Auton Res. 2020 Oct;30(5):381-392. doi: 10.1007/s10286-020-00722-0. Epub 2020 Aug 31.

    PubMed 32865664

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Phenylephrine Hydrochloride, Isoproterenol Hydrochloride and Norepinephrine Bitartrate in people with Vasoconstriction and Vasodilation, run by University of Alberta at 1 site in Canada.

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 4 inclusion and 11 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: looking for participants now, as of the sponsor's last update on 8 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

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.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Emily Vanden Berg, MSc ((780)-492-5553, ervanden@ualberta.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Forearm blood flow (time frame: 10 minutes per condition + 2 minutes per agonist dose = 60 minutes). The study lists 7 primary outcomes in all. 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 NCT05997732, which also lists 5 linked publications.

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 8 Jan 2026.

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