Nicotinamide Riboside for Pulmonary Hypertension

This trial explores whether a form of vitamin B3, nicotinamide riboside (NR), can benefit individuals with a specific type of high blood pressure in the lungs and heart, known as combined pre- and post-capillary pulmonary hypertension (CPH). CPH is a challenging condition that often leads to heart failure, and currently, no approved treatments exist. The study compares NR to a placebo to assess its effects on body markers related to cell energy and heart health, rather than directly addressing symptoms. Ideal participants are those diagnosed with CPH who can still walk, indicating that the condition affects but does not severely limit their daily activities. As an unphased trial, this study provides a unique opportunity to contribute to groundbreaking research that could lead to new treatment options for CPH.

The trial does not specify if you need to stop taking your current medications. However, it mentions that participants should have a stable medication regimen for pulmonary hypertension or heart failure, with no more than one diuretic adjustment in the three months before joining the study.

Research has shown that nicotinamide riboside (NR) is generally safe for use. One study demonstrated that taking 2 grams of NR daily for 12 weeks was safe and significantly increased levels of NAD⁺, a key substance for cell energy, in patients with heart failure. Another study found no reports of moderate or severe side effects, even with high doses of NR, suggesting that NR is unlikely to cause serious side effects. As a type of vitamin B3 often used as a dietary supplement, NR's safety is further supported.¹²³⁴⁵

Nicotinamide riboside (NR) is unique because it targets pulmonary hypertension by boosting cellular energy and enhancing mitochondrial function. Unlike standard treatments like endothelin receptor antagonists or phosphodiesterase-5 inhibitors, which primarily work by relaxing blood vessels, NR offers a novel approach by addressing the underlying cellular health and energy production. Researchers are excited about NR because it has the potential to improve overall heart function and energy metabolism, which could lead to better outcomes for patients with pulmonary hypertension.

Research suggests that nicotinamide riboside (NR) might help people with pulmonary hypertension (PH). In animal studies, NR repaired damage to blood vessels and the heart caused by PH by increasing NAD⁺ levels, a compound that helps cells produce energy and function properly. Other studies in humans have found that NR can raise NAD⁺ levels and lower oxidative stress, which can harm cells. Additionally, NR has been reported to lower systolic blood pressure and reduce inflammation, both of which benefit heart and lung health. While these findings are promising, NR is currently only used as a dietary supplement to support normal body functions, not as a proven treatment for PH. In this trial, participants will receive either NR or a placebo to evaluate its potential benefits for PH.¹²⁵⁶⁷