Dietary nitrate prevents progression of carotid subclinical atherosclerosis through blood pressure-independent mechanisms in patients with or at risk of type 2 diabetes mellitus
Morselli F, Faconti L, Mills CE, Morant S, Chowienczyk PJ, Yeung JA, Cavarape A, Cruickshank JK, Webb AJ
British journal of clinical pharmacology · 7 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
- Consumo medido con
- No se indica
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Institute for Health and Care Research
- Organización sin fines de lucro
- British Heart Foundation
- Universidad u hospital
- King's College London
Según 3 financiadores declarados.
Publicación
- Publicado
- 2021-05-13 · Br J Clin Pharmacol · vol. 87 · número 12 · págs. 4726–4736
- Editorial
- Wiley
- Citado
- 10 citas · más que el 72% de estudios similares · 0.8× el promedio de su campo
- Referencias
- 49 trabajos
- Acceso
- Acceso abierto (revista híbrida) · CC-BY-NC
- Áreas de investigación
- Cardiovascular Health and Disease Prevention · Nitric Oxide and Endothelin Effects · Blood Pressure and Hypertension Studies
- Palabras clave
- dietary nitrate, beetroot juice, intima-media thickness, carotid artery diameter, carotid artery stiffness, spironolactone, doxazosin, hypertension, type 2 diabetes, vascular remodeling, pulse pressure
- MeSH
- humans, beta vulgaris, diabetes mellitus, type 2, nitrates, double-blind method, blood pressure, atherosclerosis, carotid intima-media thickness
9 autores
- Franca Morselli🇮🇹🇬🇧University of Udine; St Thomas' Hospital; King's College London; Guy's and St Thomas' NHS Foundation Trust; British Heart Foundation
- Luca Faconti🇬🇧St Thomas' Hospital; King's College London; Guy's and St Thomas' NHS Foundation Trust; British Heart Foundation
- Charlotte Elizabeth Mills🇬🇧St Thomas' Hospital; King's College London; Guy's and St Thomas' NHS Foundation Trust; University of Reading
- S. V. Morant🇬🇧University of Dundee
- Phil Chowienczyk🇬🇧St Thomas' Hospital; King's College London; Guy's and St Thomas' NHS Foundation Trust; British Heart Foundation
- Joshua Au Yeung🇬🇧St Thomas' Hospital; King's College London; Guy's and St Thomas' NHS Foundation Trust; British Heart Foundation
- Alessandro Cavarape🇮🇹University of Udine
- J. Kennedy Cruickshank🇬🇧St Thomas' Hospital; King's College London; Guy's and St Thomas' NHS Foundation Trust
- Andrew J. Webb🇬🇧 · autor de correspondenciaSt Thomas' Hospital; King's College London; Guy's and St Thomas' NHS Foundation Trust; British Heart Foundation
Resumen
El texto original del estudio, en el idioma en que se publicó.
Aims
To test if 6 months' intervention with dietary nitrate and spironolactone could affect carotid subclinical atherosclerosis and stiffness, respectively, vs. placebo/doxazosin, to control for blood pressure (BP).
Methods
A subgroup of participants in our double-blind, randomized-controlled, factorial VaSera trial had carotid imaging. Patients with hypertension and with/at risk of type 2 diabetes were randomized to active nitrate-containing beetroot juice or placebo nitrate-depleted juice, and spironolactone or doxazosin. Vascular ultrasound for carotid diameter (CD, mm) and intima-media thickness (CIMT, mm) was performed at baseline, 3- and 6-months. Carotid local stiffness (CS, m/s) was estimated from aortic pulse pressure (Arteriograph) and carotid lumen area. Data were analysed by modified intention to treat and using mixed-model effect, adjusted for confounders.
Results
In total, 93 subjects had a baseline evaluation and 86% had follow-up data. No statistical interactions occurred between the juice and drug arms and BP was similar between the juices and between the drugs. Nitrate-containing vs. placebo juice significantly lowered CIMT (-0.06 [95% confidence interval -0.12, -0.01], P = .034), an overall difference of ~8% relative to baseline; but had no effect on CD or CS. Doxazosin appeared to reduce CS from baseline (-0.34 [-0.62, -0.06]) however, no difference was detected vs. spironolactone (-0.15 [-0.46, 0.16]). No differences were detected between spironolactone or doxazosin on CIMT and CD.
Conclusions
Our results show that 6 months' intervention with dietary nitrate influences vascular remodelling, but not carotid stiffness or diameter. Neither spironolactone nor doxazosin had a BP-independent effect on carotid structure and function.
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