The overall goal of the K01 will be to gain mentored career development to enhance Dr. Laddu's ability to become an independent researcher in chronic disease prevention with a focus on developing pragmatic and scalable interventions to lower or control blood pressure (BP) by preventing highly prevalent aging conditions (i.e., sarcopenia and hypertension). The knowledge and experience acquired through (1) clinical trial design and conduct, and (2) behavioral health promotion intervention conduct, including qualitative and quantitative methodologies, will make Dr. Laddu well-equipped to design multifactorial interventions that target behavioral risk factors and influence health status. This premise of this K01 proposal is to address current gaps in the literature regarding the understanding of high BP due to sarcopenia, and provide new evidence for the discernable relationship between low muscle strength and BP in sarcopenia, and effective non-pharmaceutical treatment approaches. In the most scientifically rigorous manner, Dr. Laddu will evaluate the feasibility of recruitment, retention, implementation and adherence to an empirically-based progressive resistance training (PRT) intervention to test its effect on BP in a targeted population of older adults with sarcopenia who are randomized (via block permuted scheme) to the PRT intervention. Built within this randomized control intervention design, Dr. Laddu will further explore reversibility to examine whether muscle strength serves as an intervention target for BP control in sarcopenic adults, which will be more appropriately tested in subsequently well-powered R-level intervention studies. Physiologically plausible mechanisms by which the PRT impacts changes in BP will also be explored through learned techniques by her mentor. Through this practical experience, Dr. Laddu will acquire insights relative to the intra- and inter-personal behaviors and barriers associated with physical activity and health promotion, and learn how to promote actionable, and scalable lifestyle and behavior strategies that are applicable to and older, high-risk population. Experience will be complemented with cross- disciplinary training which will be accomplished through an integrated career development plan that consists of formal coursework and seminars, guidance from her highly skilled senior mentors and guaranteed protected time to gain practical research experience, and leverages the rich environment for research with older adults at the University of Illinois at Chicago. The training and skills acquired through the K01 career development application will strengthen her research trajectory in health promotion and successfully transition to a fully independent investigator. Importantly, this K01 will set the foundation for Dr. Laddu to build a research portfolio focused on identifying solutions that inform current health care guidelines on effective and practical solutions for the prevention, treatment, and management of BP, and BP-related cardiovascular diseases (CVD) among those suffering from muscular deficits or similar debilitating conditions that affect the growing geriatric population.
Current prevention and treatment of high blood pressure (BP) in sarcopenia, by non-pharmacological approaches remain limited and are far from optimal. This randomized control intervention pilot study will provide new evidence of the unexplored relationship between muscle strength and high BP in sarcopenia, and experimentally test the effects of an evidence-based progressive resistance training intervention on BP, while also examining reversibility to identify muscle strength as a non-pharmacological target for BP control in older sarcopenic adults. Knowledge gained from this study will serve as the basis a definitively powered R01-funded clinical trial that will evaluate the effectiveness of a PRT versus aerobic intervention on BP, predicted CVD risk and survival, and further explore muscle strength as a novel intervention target for BP control in sarcopenic adults.
