Impact of Nutrition on Pulmonary Arterial Hypertension

Abstract

Pulmonary arterial hypertension (PAH) is characterized by sustained vasoconstriction, vascular remodeling, inflammation, and in situ thrombosis. Although there have been important advances in the knowledge of the pathophysiology of PAH, it remains a debilitating, limiting, and rapidly progressive disease. Vitamin D and iron deficiency are worldwide health problems of pandemic proportions. Notably, these nutritional alterations are largely more prevalent in PAH patients than in the general population and there are several pieces of evidence suggesting that they may trigger or aggravate disease progression. There are also several case reports associating scurvy, due to severe vitamin C deficiency, with PAH. Flavonoids such as quercetin, isoflavonoids such as genistein, and other dietary polyphenols including resveratrol slow the progression of the disease in animal models of PAH. Finally, the role of the gut microbiota and its interplay with the diet, host immune system, and energy metabolism is emerging in multiple cardiovascular diseases. The alteration of the gut microbiota has also been reported in animal models of PAH. It is thus possible that in the near future interventions targeting the nutritional status and the gut dysbiosis will improve the outcome of these patients.

Effects of Different Types of Exercise Training on Pulmonary Arterial Hypertension: A Systematic Review

“…For the treatment, pharmaceutical therapies are often used primarily to result in an improvement and possibly a cure. However, the aspect of non-pharmaceutical therapy, such as exercise therapy and/or restrictive diets [34], takes an equally important contribution and is of increasing interest in current disease management [10]. Regarding other chronic diseases, physical activity was found beneficial, which was reinforced by Chia et al [35] in topical research for PAH.…”

A Step Closer to the “Fourth 90”: A Practical Narrative Review of Diagnosis and Management of Nutritional Issues of People Living with HIV

“…In addition, another condition linked to inflammation, thrombosis, endothelial alterations, and HIV infections, which can itself benefit from a nutritional intervention, is pulmonary hypertension. In particular, vitamin D, vitamin C, and iron deficiency have been observed in patients with this disease, while a diet rich in flavonoids, isoflavones, and resveratrol is associated with a slower progression of this disorder in animal models [64].…”

Nutrition as potential treatment strategy in pulmonary arterial hypertension

“…Nutrition has also gained attention as a factor potentially influencing the Moreover, it was found that the gut microbiota is changed in a rat model of PAH (Callejo et al, 2018). This would merit further elucidation of the potential role of gut microbiota and its interplay with the diet, immune function and energy metabolism in the context of PAH (Callejo, Barberá, et al, 2020). As described in chapter 3 of this thesis, drugs can also influence gut microbiota, so the interplay between the gut and often used drugs in PAH might be an interesting topic for future research.…”

“…Other authors that reviewed studies on the presence of micronutrient deficiencies in PAH also found that iron and vitamin D deficiencies are highly prevalent in PAH patients (Callejo, Barberá, et al, 2020;Semen & Bast, 2019). However, for vitamin D there are only a few studies available with a with a small sample size.…”

“…However, for vitamin D there are only a few studies available with a with a small sample size. There have been some studies on vitamin C deficiency and the development of PAH (Callejo, Barberá, et al, 2020;Kupari & Rapola, 2012), as vitamin C impacts mechanisms involved in the PAH pathophysiology, such as the NO pathway (Taddei et al, 1998).…”