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EFFECT OF KETONE SUPPLEMENTATION ON NOCTURNAL BLOOD PRESSURE AND HEART RATE VARIABILITY IN OLDER ADULTS

Abstract

BACKGROUND: More than half of American adults have high blood pressure (BP; hypertension), which is a major risk factor for cardiovascular disease (CVD), the leading cause of death worldwide. Nighttime BP is superior to daytime BP in predicting CVD-related events and lack of nighttime BP dipping (i.e., non-dipping; ≤10% fall in BP at night) is also associated with CVD morbidities. Advancing age is associated with a decline in the autonomic regulation of BP that contributes to abnormal diurnal BP variations and hypertension. Thus, there is a critical need for effective strategies to mitigate age-related increases in BP, blunted BP dipping, and autonomic dysregulation. Ketone bodies (i.e., β-Hydroxybutyrate) have emerged as important regulators of the cardiovascular system. However, there is limited data regarding ketone supplementation and BP, particulary nighttime BP, and automonic function in humans. Therefore, we will determine whether acute ketone supplementation reduces nighttime BP, increases BP dipping, and enhances autonomic function in middle-aged and older adults. METHODS: We will recruit 24 middle-aged and older adults (≥45 yrs, ~50% females) for a randomized, placebo-controlled, crossover design, acute ketone supplement study (NCT05888506). We will use 24-h ambulatory BP monitoring, electrocardiography, and actigraphy monitoring to assess nighttime BP and BP dipping (nighttime:daytime BP ratio), heart rate variability parameters (HRV, to quantify autonomic function), and sleep characteristics on two separate nights. The only difference between the nights is that 30-min prior to bed participants will ingest either a 60 ml ketone ester supplement (30g β-Hydroxybutyrate) or a taste-matched placebo. Participants will be asked to refrain from exercise, follow comparable dietary patterns, and duplicate in bed and awake times on both trial days. ANTICIPATED RESULTS: We hypothesize that compared with placebo, acute ketone supplementation will reduce nighttime BP and increase BP dipping and HRV.

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