Effects of Cranberry Juice Supplementation on Cardiovascular Disease Risk Factors in Adults with Elevated Blood Pressure: A Randomized Controlled Trial

Abstract

Emerging cardiovascular disease (CVD) risk factors, including central vascular function and HDL efflux, may be modifiable with food-based interventions such as cranberry juice. A randomized, placebo-controlled, crossover trial was conducted in middle-aged adults with overweight/obesity (n = 40; mean BMI: 28.7 ± 0.8 kg/m2; mean age: 47 ± 2 years) and elevated brachial blood pressure (mean systolic/diastolic BP: 124 ± 2/81 ± 1 mm Hg). Study participants consumed 500 mL/d of cranberry juice (~16 fl oz; 27% cranberry juice) or a matched placebo juice in a randomized order (8-week supplementation periods; 8-week compliance break), with blood samples and vascular measurements obtained at study entry and following each supplementation period. There was no significant treatment effect of cranberry juice supplementation on the primary endpoint of central systolic blood pressure or central or brachial diastolic pressure. Cranberry juice significantly reduced 24-h diastolic ambulatory BP by ~2 mm Hg compared to the placebo (p = 0.05) during daytime hours. Cranberry juice supplementation did not alter LDL-C but significantly changed the composition of the lipoprotein profile compared to the placebo, increasing the concentration of large LDL-C particles (+29.5 vs. −6.7 nmol/L; p = 0.02) and LDL size (+0.073 vs. −0.068 nm; p = 0.001). There was no effect of treatment on ex vivo HDL efflux in the total population, but exploratory subgroup analyses identified an interaction between BMI and global HDL efflux (p = 0.02), with greater effect of cranberry juice in participants who were overweight. Exploratory analyses indicate that baseline C-reactive protein (CRP) values may moderate treatment effects. In this population of adults with elevated blood pressure, cranberry juice supplementation had no significant effect on central systolic blood pressure but did have modest effects on 24-hr diastolic ambulatory BP and the lipoprotein profile. Future studies are needed to verify these findings and the results of our exploratory analyses related to baseline health moderators.

The Role of Berry Consumption on Blood Pressure Regulation and Hypertension: An Overview of the Clinical Evidence

“…In a placebo-controlled, crossover intervention, 40 overweight or obese participants with pre-hypertension, received a daily serving of 500 mL cranberry drink (27% cranberry juice) for 8 weeks. Although no change in SBP or DBP was observed, 24-h ambulatory BP measurement revealed a significant reduction in DBP during daytime hours [81].…”

The effects of blueberry and cranberry supplementation on blood pressure in patients with cardiovascular diseases: A systematic review and meta‐analysis of randomized clinical trials

“…Table 1 shows the characteristics and main findings of the included studies. Of the 17 studies included, nine were from the United States (Basu et al, 2010, 2011; Dohadwala et al, 2011; Hsia et al, 2020; Johnson et al, 2015; Richter et al, 2021; Stote et al, 2020; Stull et al, 2010, 2015). Cardiometabolic diseases ranged from hypertension, myocardial infarction, metabolic syndrome, overweight/obesity, and non‐alcoholic fatty liver disease.…”

“…The sample size ranged from 20 (Lee et al, 2008) to 115 subjects (Curtis et al, 2019). Eight studies used cranberry as an intervention (Basu et al, 2011; Dohadwala et al, 2011; Eftekhari et al, 2016; Hsia et al, 2020; Lee et al, 2008; Masnadi Shirazi et al, 2021; Richter et al, 2021; Ruel et al, 2014), while the other nine used blueberry (Arevström et al, 2019; Basu et al, 2010; Chan et al, 2021; Curtis et al, 2019; Johnson et al, 2015; Rousseau et al, 2021; Stote et al, 2020; Stull et al, 2010. 2015).…”

“…Although our meta‐analysis provided an intriguing result, as we only included patients suffering from cardiometabolic problems and hence BP lowering would be more susceptible, the inclusion of healthy individuals makes the population with great heterogeneity. Importantly, this previous meta‐analysis included studies until 2017, and our meta‐analysis included 3 new RCTs that probably contributed to the neutral effects on SBP and DBP (Hsia et al, 2020; Masnadi Shirazi et al, 2021; Richter et al, 2021).…”

“…Overall, anthocyanin content ranged from 21 mg (Curtis et al, 2019) to 2250 mg (Arevström et al, 2019) for blueberry supplementation and 5 mg (Richter et al, 2021) to 144 mg (Hsia et al, 2020) for cranberry supplementation.…”