The effects of dietary nitrate on blood pressure and endothelial function: a review of human intervention studies

2013 ◽  
Vol 26 (2) ◽  
pp. 210-222 ◽  
Author(s):  
Ditte A. Hobbs ◽  
Trevor W. George ◽  
Julie A. Lovegrove
Keyword(s):  
Blood Pressure ◽  
Endothelial Function ◽  
Systolic Blood Pressure ◽  
Intervention Studies ◽  
Blood Pressure Reduction ◽  
Oral Bacteria ◽  
Human Intervention ◽  
Dietary Nitrate ◽  
Beneficial Effects ◽  
Healthy Humans

Evidence has accumulated in recent years that suggests that nitrate from the diet, particularly vegetables, is capable of producing bioactive NO in the vasculature, following bioconversion to nitrite by oral bacteria. The aim of the present review was to consider the current body of evidence for potential beneficial effects of dietary nitrate on blood pressure and endothelial function, with emphasis on evidence from acute and chronic human intervention studies. The studies to date suggest that dietary nitrate acutely lowers blood pressure in healthy humans. An inverse relationship was seen between dose of nitrate consumed and corresponding systolic blood pressure reduction, with doses of nitrate as low as 3 mmol of nitrate reducing systolic blood pressure by 3 mmHg. Moreover, the current studies provide some promising evidence on the beneficial effects of dietary nitrate on endothelial function.In vitrostudies suggest a number of potential mechanisms by which dietary nitrate and its sequential reduction to NO may reduce blood pressure and improve endothelial function, such as: acting as a substrate for endothelial NO synthase; increasing vasodilation; inhibiting mitochondrial reactive oxygen species production and platelet aggregation. In conclusion, the evidence for beneficial effects of dietary nitrate on blood pressure and endothelial function is promising. Further long-term randomised controlled human intervention studies assessing the potential effects of dietary nitrate on blood pressure and endothelial function are needed, particularly in individuals with hypertension and at risk of CVD.

scholarly journals The Role of Dietary Nitrate and the Oral Microbiome on Blood Pressure and Vascular tone

2020 ◽  
pp. 1-53
Author(s):  
H.S. Alzahrani ◽  
K.G. Jackson ◽  
D.A. Hobbs ◽  
J.A. Lovegrove
Keyword(s):  
Blood Pressure ◽  
Vascular Function ◽  
Vascular Tone ◽  
Cardiovascular Health ◽  
Oral Bacteria ◽  
Oral Microbiome ◽  
Current Evidence ◽  
Dietary Nitrate ◽  
Beneficial Effects

Abstract There is increasing evidence for the health benefits of dietary nitrates including lowering blood pressure and enhancing cardiovascular health. Although commensal oral bacteria play an important role in converting dietary nitrate to nitrite, very little is known about the potential role of these bacteria in blood pressure regulation and maintenance of vascular tone. The main purpose of this review is to present the current evidence on the involvement of the oral microbiome in mediating the beneficial effects of dietary nitrate on vascular function and to identify sources of inter and intra-individual differences in bacterial composition. A systematic approach was used to identify the relevant articles published on PubMed and Web of Science in English from January 1950 until September 2019 examining the effects of dietary nitrate on oral microbiome composition and association with blood pressure and vascular tone. To date, only a limited number of studies have been conducted, with n=9 in humans and n=3 in animals focusing mainly on blood pressure. In general, elimination of oral bacteria with use of a chlorhexidine based antiseptic mouthwash reduced the conversion of nitrate to nitrite and was accompanied in some studies by an increase in blood pressure in normotensive subjects. In conclusion, our findings suggest that oral bacteria may play an important role in mediating the beneficial effects of nitrate-rich foods on blood pressure. Further human intervention studies assessing the potential effects of dietary nitrate on oral bacteria composition and relationship to real time measures of vascular function are needed, particularly in individuals with hypertension and those at risk of developing cardiovascular diseases.

scholarly journals Systolic blood pressure reduction during the first 24 h in acute heart failure admission: friend or foe?

2017 ◽  
Vol 20 (2) ◽  
pp. 317-322 ◽  
Author(s):  
Gad Cotter ◽  
Marco Metra ◽  
Beth A. Davison ◽  
Guillaume Jondeau ◽  
John G.F. Cleland ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Acute Heart Failure ◽  
Blood Pressure Reduction ◽  
Pressure Reduction ◽  
Heart Failure Admission

scholarly journals Time‐Efficient Inspiratory Muscle Strength Training Lowers Blood Pressure and Improves Endothelial Function, NO Bioavailability, and Oxidative Stress in Midlife/Older Adults With Above‐Normal Blood Pressure

2021 ◽  
Author(s):  
Daniel H. Craighead ◽  
Thomas C. Heinbockel ◽  
Kaitlin A. Freeberg ◽  
Matthew J. Rossman ◽  
Rachel A. Jackman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Muscle Strength ◽  
Arterial Stiffness ◽  
Endothelial Function ◽  
Systolic Blood Pressure ◽  
High Resistance ◽  
Maximal Inspiratory Pressure ◽  
No Bioavailability ◽  
Inspiratory Muscle Strength

Background High‐resistance inspiratory muscle strength training (IMST) is a novel, time‐efficient physical training modality. Methods and Results We performed a double‐blind, randomized, sham‐controlled trial to investigate whether 6 weeks of IMST (30 breaths/day, 6 days/week) improves blood pressure, endothelial function, and arterial stiffness in midlife/older adults (aged 50–79 years) with systolic blood pressure ≥120 mm Hg, while also investigating potential mechanisms and long‐lasting effects. Thirty‐six participants completed high‐resistance IMST (75% maximal inspiratory pressure, n=18) or low‐resistance sham training (15% maximal inspiratory pressure, n=18). IMST was safe, well tolerated, and had excellent adherence (≈95% of training sessions completed). Casual systolic blood pressure decreased from 135±2 mm Hg to 126±3 mm Hg ( P <0.01) with IMST, which was ≈75% sustained 6 weeks after IMST ( P <0.01), whereas IMST modestly decreased casual diastolic blood pressure (79±2 mm Hg to 77±2 mm Hg, P =0.03); blood pressure was unaffected by sham training (all P >0.05). Twenty‐four hour systolic blood pressure was lower after IMST versus sham training ( P =0.01). Brachial artery flow‐mediated dilation improved ≈45% with IMST ( P <0.01) but was unchanged with sham training ( P =0.73). Human umbilical vein endothelial cells cultured with subject serum sampled after versus before IMST exhibited increased NO bioavailability, greater endothelial NO synthase activation, and lower reactive oxygen species bioactivity ( P <0.05). IMST decreased C‐reactive protein ( P =0.05) and altered select circulating metabolites (targeted plasma metabolomics) associated with cardiovascular function. Neither IMST nor sham training influenced arterial stiffness ( P >0.05). Conclusions High‐resistance IMST is a safe, highly adherable lifestyle intervention for improving blood pressure and endothelial function in midlife/older adults with above‐normal initial systolic blood pressure. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03266510.

Abstract WP396: Analysis of Patients With Excessively High Pre-Randomization Systolic Blood Pressure and Effect of Intensive Systolic Blood Pressure Reduction in Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH) 2

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adnan I Qureshi ◽  
Lydia D Foster ◽  
Iryna Lobanova ◽  
Wei Huang ◽  
Jose I Suarez ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Treatment Effect ◽  
Standard Treatment ◽  
Blood Pressure Reduction ◽  
Intensive Treatment ◽  
Hematoma Expansion ◽  
Disability Score ◽  
Modifying Effect ◽  
Current Guidelines

Background: Current guidelines recommend for intracerebral hemorrhage (ICH) patients with the systolic blood pressure (SBP) >220 mmHg, unlike those with initial SBP 150-220 mm, Hg, the efficacy of aggressive reduction of SBP is less well established and further studies are recommended. Methods: We analyzed data from ATACH 2 trial which randomized patients with initial SBP >180 mm Hg to intensive (goal 110-139 mmHg) and standard (goal 140-179 mmHg) SBP reduction using IV nicardipine within 4.5 hours of symptom onset. We compared the characteristics and outcomes between patients with pre- randomization SBP ≥220 mm Hg and those with initial SBP <220 mm Hg. We analyzed the modifying effect (interaction test) of pre-randomization SBP ≥220 mm Hg on treatment effect (intensive versus standard) on death or disability (score 4-6 on modified Rankin scale) at 3-months post-randomization ascertained by a blinded investigator. Results: Of 1000 randomized subjects, 48 subjects had a pre-randomization SBP ≥ 220 mm Hg (mean age 57.8 years, 65% men); 24 were assigned to intensive-treatment and standard-treatment each. The rate of death or disability at 3 months (47.9% versus 37.7%, odds ratio (OR): 1.52, 95% confidence interval (CI): 0.43 to 1.5, 0.85 to 2.72) and hematoma expansion within 24 hours (30.0% versus 21.2%, OR: 1.60; 95% CI: 0.80 to 3.20) was not different among subjects with SBP≥220 mm Hg SBP and those with SBP < 220 mm Hg. Rates of hematoma expansion (19% and 27.3%, OR: 0.63; 95% CI: 0.15 to 2.6) and neurological deterioration (8.7% versus 17.4%, OR: 0.45; 95% CI: 0.07 to 2.8) within 24 hours were not different between those randomized to intensive treatment and those to standard treatment in patients with SBP≥220 mm Hg. The interaction between initial SBP ≥220 mm Hg and treatment effect on death or disability was significant (p=0.0111). Conclusions: Patients with pre-randomization SBP ≥220 mm Hg did not have higher rates of hematoma expansion or death or disability compared to those with SBP <220 mm Hg. The interaction of pre- randomization SBP ≥220 mm Hg with the treatment effect and a non-significantly higher rate of death or disability associated with intensive treatment requires further studies.

Water aerobics is followed by short-time and immediate systolic blood pressure reduction in overweight and obese hypertensive women

2016 ◽  
Vol 10 (7) ◽  
pp. 570-577 ◽  
Author(s):  
Raphael Martins Cunha ◽  
Gisela Arsa ◽  
Eduardo Borba Neves ◽  
Lorena Curado Lopes ◽  
Fabio Santana ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Blood Pressure Reduction ◽  
Pressure Reduction ◽  
Short Time
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