Creatine and creatine analogues in hypertension and cardiovascular disease

Horjus, Deborah L; Oudman, Inge; Montfrans, Gert A. van; Brewster, Lizzy M.

doi:10.1002/14651858.cd005184.pub2

Cited by 27 publications

(19 citation statements)

References 9 publications

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“…We screened 493 reviews after removal of duplicates. Based on their titles and abstracts, a total of 82 reviews met the inclusion criteria and made up the data set 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 . The 82 relevant CSRs included 1177 RCTs.…”

Section: Resultsmentioning

confidence: 99%

An assessment of randomized controlled trials (RCTs) for non-communicable diseases (NCDs): more and higher quality research is required in less developed countries

Hong

2015

Sci Rep

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Research is crucial to implement evidence-based health interventions for control of non-communicable diseases (NCDs). This study aims to assess main features of randomized controlled trials (RCTs) for control of NCDs, and to identify gaps in clinical research on NCDs between high-income and less developed countries. The study included 1177 RCTs in 82 Cochrane Systematic reviews (CSRs) and evaluated interventions for adults with hypertension, diabetes, stroke, or heart diseases. Multivariate logistic regression analyses were conducted to explore factors associated with risk of bias in included RCTs. We found that 78.2% of RCTs of interventions for major NCDs recruited patients in high-income countries. The number of RCTs included in the CSRs was increasing over time, and the increasing speed was more noticeable for RCTs conducted in middle-income countries. RCTs conducted in less developed countries tended to be more recently published, less likely to be published in English, with smaller sample sizes, and at a higher risk of bias. In conclusion, there is still a lack of research evidence for control of NCDs in less developed countries. To brace for rising NCDs and avoid waste of scarce research resources, not only more but also higher quality clinical trials are required in low-and-middle-income countries.

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Section: Resultsmentioning

confidence: 99%

An assessment of randomized controlled trials (RCTs) for non-communicable diseases (NCDs): more and higher quality research is required in less developed countries

Hong

2015

Sci Rep

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“…In animal studies it has been demonstrated that inhibition of the CK system leads to a shift from type II to type I fiber predominance, with mitochondrial proliferation and increased oxidative phosphorylation, weight loss, and increased insulin sensitivity . However, a recent review evaluating existing therapeutic strategies that target the CK system in hypertension and cardiovascular diseases was inconclusive . Given the heterogeneity and small sample size of the trials, the authors stated that larger clinical studies are needed to confirm these observations.…”

Section: Discussionmentioning

confidence: 99%

“…[30][31][32] However, a recent review evaluating existing therapeutic strategies that target the CK system in hypertension and cardiovascular diseases was inconclusive. 33 Given the heterogeneity and small sample size of the trials, the authors stated that larger clinical studies are needed to confirm these observations.…”

Section: Discussionmentioning

confidence: 99%

Creatine Kinase as Predictor of Blood Pressure and Hypertension. Is It All About Body Mass Index? A Follow‐Up Study of 250 Patients

Johnsen

Lilleng

Bekkelund

2014

J of Clinical Hypertension

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2The correlation between creatine kinase (CK) and blood pressure (BP) was examined prospectively in 120 patients with persistent high CK and 130 individuals with normal CK. Hypertension was defined as systolic BP (SBP) ≥140 mm Hg or diastolic BP (DBP) ≥90 mm Hg or current use of antihypertensive medication. Baseline CK was weakly correlated with SBP (r=0.11, P=.07) and DBP (r=0.16, P=.01) at follow-up. Persons with persistent high CK had higher SBP (140.8 mm Hg vs 138.2 mm Hg) and DBP (83.2 mm Hg vs 81.0 mm Hg, P=.06) values and were more likely to have hypertension (66.7% vs 55.5%, P=.05) than individuals with normal CK. In age-and sex-adjusted analysis, a 1-unit change in logCK was associated with a 4.9-mm Hg higher SBP, a 3.3-mm Hg higher DBP, and a 2.2-higher odds for having hypertension at follow-up (P=.1, .07, and .06, respectively). When including body mass index (BMI) to the model, BMI was a strong and independent predictor for SBP, DBP, and hypertension at follow-up and the CK effect on blood pressure was substantially attenuated. This study showed that the CK effect on blood pressure is clearly modified by BMI. J Clin Hypertens (Greenwich). 2014;16:820-826. ª 2014 Wiley Periodicals, Inc.Hypertension is a global burden, affecting more than a quarter of the adult population worldwide, which often goes undiagnosed.1 It has been hypothesized, in a biological plausible manner, that high creatine kinase (CK) activity could be a genetic factor responsible for primary hypertension.2 Two large cross-sectional, population-based studies have demonstrated an independent dose-response association between CK and blood pressure (BP).3,4 High CK has also been associated with failure of antihypertensive therapy. 5 In addition, a low CK level was associated with lower BP and an increased prevalence of fainting.6 Cross-sectional studies, however, make causal inferences impossible because of the lack of temporality between exposure and outcome. Whether the observed relationship between CK and BP is causal or confounded is still unresolved. 7,8 In the present prospective study, we measured CK and BP simultaneously at two points in time and examined whether BP at follow-up was correlated with CK at baseline. In addition, we examined CK in persons with and without hypertension at follow-up and whether CK was a long-term predictor of hypertension. Figure 1 shows a diagram of the flow of participants. All study participants were recruited from the sixth survey of the Tromsø Study in [2007][2008]. 9 CK and BP were analyzed cross-sectionally in 12,828 participants aged 30 to 87 years (mean 58 years), 6834 women and 5994 men, 65% of those eligible. A total of 686 participants had high CK according to references given by the Nordic Reference Interval Project (NORIP) 10 and were invited to a second visit for CK control. Of the 686 persons with high CK, 562 attended the second visit (baseline), and CK was measured after 3 days of refraining from alcohol and muscular load, leisure physical activity, muscular training, physiotherapy, ...

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“…However, our finding is consistent with no reported blood pressure effect in three published male only placebo-controlled trials with creatine [ 160 , 161 , 162 ] and one mix-sex study [ 144 ]. There has been one systematic review on the use of creatine and creatine analogues in hypertension and cardiovascular disease, which also concluded no change in blood pressure with creatine supplementation in myocardial infarction or heart failure trials [ 163 ]. Overall, more thorough investigations are required to definitively rule in or out adverse cardiovascular effects of creatine supplementation in both male and female populations.…”

Section: Discussionmentioning

confidence: 99%

Risk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis

et al. 2020

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Creatine Monohydrate (CrM) is a dietary supplement routinely used as an ergogenic aid for sport and training, and as a potential therapeutic aid to augment different disease processes. Despite its increased use in recent years, studies reporting potential adverse outcomes of CrM have been mostly derived from male or mixed sex populations. A systematic search was conducted, which included female participants on CrM, where adverse outcomes were reported, with meta-analysis performed where appropriate. Six hundred and fifty-six studies were identified where creatine supplementation was the primary intervention; fifty-eight were female only studies (9%). Twenty-nine studies monitored for adverse outcomes, with 951 participants. There were no deaths or serious adverse outcomes reported. There were no significant differences in total adverse events, (risk ratio (RR) 1.24 (95% CI 0.51, 2.98)), gastrointestinal events, (RR 1.09 (95% CI 0.53, 2.24)), or weight gain, (mean difference (MD) 1.24 kg pre-intervention, (95% CI −0.34, 2.82)) to 1.37 kg post-intervention (95% CI −0.50, 3.23)), in CrM supplemented females, when stratified by dosing regimen and subject to meta-analysis. No statistically significant difference was reported in measures of renal or hepatic function. In conclusion, mortality and serious adverse events are not associated with CrM supplementation in females. Nor does the use of creatine supplementation increase the risk of total adverse outcomes, weight gain or renal and hepatic complications in females. However, all future studies of creatine supplementation in females should consider surveillance and comprehensive reporting of adverse outcomes to better inform participants and health professionals involved in future trials.

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Creatine and creatine analogues in hypertension and cardiovascular disease

Cited by 27 publications

References 9 publications

An assessment of randomized controlled trials (RCTs) for non-communicable diseases (NCDs): more and higher quality research is required in less developed countries

An assessment of randomized controlled trials (RCTs) for non-communicable diseases (NCDs): more and higher quality research is required in less developed countries

Creatine Kinase as Predictor of Blood Pressure and Hypertension. Is It All About Body Mass Index? A Follow‐Up Study of 250 Patients

Risk of Adverse Outcomes in Females Taking Oral Creatine Monohydrate: A Systematic Review and Meta-Analysis

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