The antihypertensive effect of fermented milk in individuals with prehypertension or borderline hypertension

Abstract

Fermented milk (FM) with putative antihypertensive effect in humans could be an easy applicable lifestyle intervention against hypertension. The mode of action is supposed to be through active milk peptides, shown to possess in vitro ACE-inhibitory effect. Blood pressure (BP) reductions upto 23 mm Hg have been reported in spontaneously hypertensive rats fed FM. Results from human studies of the antihypertensive effect are inconsistent. However, many studies suffer from methodological weaknesses, as insufficient blinding and the use of office BP measurements. We conducted a randomised, double-blind placebo-controlled study of the antihypertensive effect of Lactobacillus helveticus FM in 94 prehypertensive and borderline hypertensive subjects. The participants were randomised into three treatment groups with a daily intake of 150 ml of FM, 300 ml of FM or placebo (chemically acidified milk). The primary outcome was repeated 24-h ambulatory BP measurements. There were no statistically significant differences in the outcome between the groups (systolic BP (SBP), P ¼ 0.9; diastolic BP (DBP), P ¼ 0.2). However, the group receiving 300 ml FM had reduced BP across the 8-week period in several readings, which could be compatible with a minor antihypertensive effect. Heart rate and lipids remained unchanged between groups. Hence, our study does not support earlier studies measuring office BP-measurements, reporting antihypertensive effect of FM. Based on straight performed 24-h ambulatory BP measurements, milk fermented with Lactobacillus helveticus does not posses significant antihypertensive effect.

Effects of 12 weeks of treatment with fermented milk on blood pressure, glucose metabolism and markers of cardiovascular risk in patients with type 2 diabetes: a randomised double-blind placebo-controlled study

“…This is in accordance with the findings by Usinger et al (13) who reported no significant effect of a similar amount of Cardi04 yogurt on 24-h BP measurements in a group with prehypertension or borderline hypertension. Our result is also supported by two other studies investigating at the effect of lactotripeptides on 24-h AMBP monitoring (ABPM) without finding any significant effect (14,15).…”

Scientific Opinion on the substantiation of health claims related to isoleucine‐proline‐proline (IPP) and valine‐proline‐proline (VPP) and maintenance of normal blood pressure (ID 661, 1831, 1832, 2891, further assessment) pursuant to Article 13(1) of Regulation (EC) No 1924/2006

“…The Panel notes that 15 RCTs Cicero et al, 2010;De Leeuw et al, 2009;Engberink et al, 2008;Itakura et al, 2001;Mizushima et al, 2004;Seppo et al, 2003;Tuomilehto et al, 2004;Turpeinen et al, 2009;Usinger et al, 2010a;Van der Zander et al, 2008a;Van der Zander et al, 2008b;Van Mierlo et al, 2009 two studies;Yoshizawa et al, 2010), of which seven were designed to detect small (3-9 mm Hg) differences in SBP De Leeuw et al, 2009;Usinger et al, 2010a;Van der Zander et al, 2008a;Van der Zander et al, 2008b;Van Mierlo et al, 2009 two studies), did not observe an effect of IPP and VPP on SBP or DBP.…”

“…In seven of the human intervention studies (one reported in two publications) described above Cicero et al, 2010;De Leeuw et al, 2009;Engberink et al, 2008;Mizushima et al, 2004;Usinger et al, 2010a;2010b;Van der Zander et al, 2008b) the effects of IPP and VPP on the activity of the renin-angiotensin-aldosterone system II were assessed by measuring ACE activity or changes in plasma concentrations of renin, aldosterone, angiotensin I or angiotensin. None of these studies showed a statistically significant effect between groups of IPP and VPP on parameters measured which could indicate an inhibition of ACE in vivo in humans.…”

“…In the framework of further assessment, two additional meta-analyses (Aubin, 2011, unpublished;Cicero et al, 2011) and six RCTs (Cicero et al, 2010;Ishida et al, 2007;Nakamura et al, 2011;Turpeinen et al, 2009;Usinger et al, 2010a;Yoshizawa et al, 2010) were provided as pertinent to the claim.…”

“…The Panel considers that these two studies powered to detect small (3 mm Hg) differences in SBP do not show an effect of IPP and VPP on office or 24 h ambulatory SBP or DBP. Usinger et al (2010a;2010b) enrolled 94 hypertensive subjects into a randomised, double-blind, placebo controlled parallel eight-week study. Subjects were randomised into four groups: one group receiving fermented milk providing 3.6 mg/day IPP and VPP (n=32), a second group which received 1.8 mg/day IPP and VPP (n=32), and two placebo groups which received either 150 ml/day (n=15) or 300 ml/day (n=15) acidified milk devoid of IPP and VPP.…”