Mechanisms underlying blood pressure reduction by dietary inorganic nitrate

Carlström, Mattias; Lundberg, Jon O.; Weitzberg, Eddie

doi:10.1111/apha.13080

Cited by 72 publications

(68 citation statements)

References 264 publications

(321 reference statements)

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“…However, there was no reduction in diastolic BP after BRJ supplementation compared to PLA supplementation. A lowering of blood pressure after BRJ ingestion is consistent with previous reports 4,27 , with the mechanisms that underpin this effect likely to be multifaceted, but are largely believed to be NO-mediated 28 . The magnitude of BP reduction in the current study is likely to be of clinical relevance 29,30 .…”

Section: Discussionsupporting

confidence: 89%

No Effect of Beetroot Juice Supplementation on 100-m and 200-m Swimming Performance in Moderately Trained Swimmers

Esen¹,

Nicholas²,

Morris³

et al. 2019

International Journal of Sports Physiology and Performance

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Purpose: Dietary nitrate supplementation has been reported to improve performance in kayaking and rowing exercise, which mandate significant recruitment of the upper-body musculature. Because the effect of dietary nitrate supplementation on swimming performance is unclear, the purpose of this study was to assess the effect of dietary nitrate supplementation on 100-m and 200-m swimming freestyle time-trial (TT) performance. Methods: In a double-blind, randomized crossover design, 10 moderately trained swimmers underwent 2 separate 3-d supplementation periods, with a daily dose of either 140 mL nitrate-rich (∼800 mg/d nitrate) or nitrate-depleted (PLA) beetroot juice (BRJ). After blood sampling on day 3, the swimmers performed both 200-m and 100-m freestyle swimming TTs, with 30 min recovery between trials. Results: Plasma nitrite concentration was greater after BRJ relative to PLA consumption (432 [203] nmol/L, 111 [56] nmol/L, respectively, P = .001). Systolic blood pressure was lowered after BRJ compared with PLA supplementation (114 [10], 120 [10] mm Hg, respectively P = .001), but time to complete the 200-m (BRJ 152.6 [14.1] s, PLA 152.5 [14.1] s) and 100-m (BRJ 69.5 [7.2] s, PLA 69.4 [7.4] s) freestyle swimming TTs was not different between BRJ and PLA (P > .05). Conclusions: Although 3 d of BRJ supplementation increased plasma nitrite concentration and lowered blood pressure, it did not improve 100-m and 200-m swimming TT performance. These results do not support an ergogenic effect of nitrate supplementation in moderately trained swimmers, at least for 100-m and 200-m freestyle swimming performance.

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Section: Discussionsupporting

confidence: 89%

No Effect of Beetroot Juice Supplementation on 100-m and 200-m Swimming Performance in Moderately Trained Swimmers

Esen¹,

Nicholas²,

Morris³

et al. 2019

International Journal of Sports Physiology and Performance

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“…In support, several human studies have reported a significant contribution of NO to reactive hyperemia in the microvasculature . Another possible explanation for the positive effects of BRJ on microvascular reactivity in hypertensives may be the inhibition of vascular NADPH oxidase by increased

{normalNO}_{3}^{-}

, resulting in reduced generation of free oxygen species and less scavenging of shear stress‐induced NO …”

Section: Discussionmentioning

confidence: 80%

Dietary nitrate improves muscle microvascular reactivity and lowers blood pressure at rest and during isometric exercise in untreated hypertensives

et al. 2019

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Objective: This double-blind, cross-over study examined in drug-naïve hypertensives the effects of a single dose of dietary nitrate (beetroot juice, BRJ) on (a) office/ambulatory BP and arterial stiffness, (b) muscle microvascular function, and (c) hemodynamic responses and cardiovagal baroreceptor sensitivity (cBRS) at rest and during isometric exercise.Methods: Eighteen untreated hypertensives (44.0 ± 2.6 years) consumed randomly, a nitrate-rich (8.1 mmol-BRJ nitrate ) and a nitrate-depleted (BRJ placebo ) BRJ. Office BP and pulse wave velocity were assessed before/after BRJ. An occlusion-reperfusion maneuver with continuous monitoring of muscle oxygenated hemoglobin (O 2 Hb) and total hemoglobin (tHb), via NIRS, followed. Participants performed submaximal isometric handgrip with beat-by-beat monitoring of hemodynamics and cBRS.Ambulatory BP assessment followed.Results: During reperfusion, following arterial occlusion, the magnitude and rate of muscle microvascular reoxygenation (O 2 Hb) and red blood cell content (tHb) were higher in BRJ nitrate vs BRJ placebo (P < 0.05), suggesting improved microvascular reactivity. Office/ambulatory BP were lower following BRJ nitrate vs BRJ placebo (P < 0.05); pulse-wave-velocity was not altered. During isometric handgrip, BP and peripheral resistance rise were smaller in BRJ nitrate vs BRJ placebo (P < 0.01-0.05), with no differences in cBRS. Conclusions:In drug-naïve hypertensives, a single dose of BRJ induces (a) short-term reductions in resting/ambulatory BP, (b) acute improvements in muscle microvascular function, and (c) attenuation in BP and peripheral resistance responses during isometric exercise.

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“…However, the outcomes of this sub-study were defined post-hoc, hence there were no measures taken to ensure a consistent and comparable lifestyle (physical activity and dietary habits) from baseline to follow-up. Components of the NO pathway are sensitive to dietary intake of arginine (5), nitrite and especially nitrate (25), which is found in high levels in certain vegetables and is known to lower blood pressure (9).…”

Section: Limitations and Methodological Considerationsmentioning

confidence: 99%

Effect of spironolactone for 1 yr on endothelial function and vascular inflammation biomarkers in renal transplant recipients

Mortensen

Bistrup

Stubbe

et al. 2019

American Journal of Physiology-Renal Physiology

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Kidney transplantation is associated with increased cardiovascular risk. Endothelial dysfunction and vascular inflammation contribute to negative outcome. In experimental models, mineralocorticoid receptor antagonists improved endothelial function and reduced inflammation. The present study tested the hypothesis that the mineralocorticoid receptor antagonist spironolactone improves endothelial function and reduces vascular inflammation in renal transplant patients. Eighty prevalent renal transplant patients from an ongoing, double-blind randomized placebo-controlled trial were included. Paired plasma samples before and after 1 yr of treatment ( n = 39 in the spironolactone-treated group and 41 in the placebo-treated group) were used to determine markers of endothelial dysfunction (nitrite, nitrate, cGMP, arginine, citrulline, ornithine, asymmetric dimethylarginine, symmetric dimethylarginine, NG-monomethyl-l-arginine, von Willebrand factor, tissue-type plasminogen activator antigen, and plasminogen activator inhibitor 1 antigen) and markers of inflammation (intercellular adhesion molecule, vascular adhesion molecule, high-sensitivity C-reactive protein, and serum amyloid protein A). The median time since the transplantation was 4.6 (0.12–22.3) yr in the spironolactone-treated group and 2.1 (0.17–13.9) yr in the placebo-treated group ( P > 0.05). Spironolactone increased plasma aldosterone ( P < 0.001) and K+ ( P < 0.001). Blood pressure did not change significantly. No significant differences were detected between groups in any of the measured markers of endothelial dysfunction or inflammation except in the subgroup analysis of patients with diabetes, where spironolactone decreased nitrite compared with placebo. In this study, mineralocorticoid receptor antagonism did not improve biomarkers of endothelial dysfunction or vascular inflammation in prevalent renal transplant patients. Further studies are needed to evaluate the potential beneficial effect of early or late mineralocorticoid receptor antagonism on vascular outcomes in renal transplant patients.

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Mechanisms underlying blood pressure reduction by dietary inorganic nitrate

Cited by 72 publications

References 264 publications

No Effect of Beetroot Juice Supplementation on 100-m and 200-m Swimming Performance in Moderately Trained Swimmers

No Effect of Beetroot Juice Supplementation on 100-m and 200-m Swimming Performance in Moderately Trained Swimmers

Dietary nitrate improves muscle microvascular reactivity and lowers blood pressure at rest and during isometric exercise in untreated hypertensives

Effect of spironolactone for 1 yr on endothelial function and vascular inflammation biomarkers in renal transplant recipients

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