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Tappia PS, Shah AK, Dhalla NS. The Efficacy of Vitamins in the Prevention and Treatment of Cardiovascular Disease. Int J Mol Sci 2024; 25:9761. [PMID: 39337248 PMCID: PMC11432297 DOI: 10.3390/ijms25189761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2024] [Revised: 09/04/2024] [Accepted: 09/06/2024] [Indexed: 09/30/2024] Open
Abstract
Vitamins are known to affect the regulation of several biochemical and metabolic pathways that influence cellular function. Adequate amounts of both hydrophilic and lipophilic vitamins are required for maintaining normal cardiac and vascular function, but their deficiencies can contribute to cardiovascular abnormalities. In this regard, a deficiency in the lipophilic vitamins, such as vitamins A, D, and E, as well as in the hydrophilic vitamins, such as vitamin C and B, has been associated with suboptimal cardiovascular function, whereas additional intakes have been suggested to reduce the risk of atherosclerosis, hypertension, ischemic heart disease, arrhythmias, and heart failure. Here, we have attempted to describe the association between low vitamin status and cardiovascular disease, and to offer a discussion on the efficacy of vitamins. While there are inconsistencies in the impact of a deficiency in vitamins on the development of cardiovascular disease and the benefits associated with supplementation, this review proposes that specific vitamins may contribute to the prevention of cardiovascular disease in individuals at risk rather than serve as an adjunct therapy.
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Affiliation(s)
- Paramjit S Tappia
- Asper Clinical Research Institute, St. Boniface Hospital, Winnipeg, MB R2H 2A6, Canada
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB R2H 2A6, Canada
| | - Anureet K Shah
- Department of Nutrition and Food Science, California State University Los Angeles, Los Angeles, CA 90032, USA
| | - Naranjan S Dhalla
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB R2H 2A6, Canada
- Department of Physiology and Pathophysiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R2E 0J9, Canada
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2
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Camargo LL, Rios FJ, Montezano AC, Touyz RM. Reactive oxygen species in hypertension. Nat Rev Cardiol 2024:10.1038/s41569-024-01062-6. [PMID: 39048744 DOI: 10.1038/s41569-024-01062-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 07/27/2024]
Abstract
Hypertension is a leading risk factor for stroke, heart disease and chronic kidney disease. Multiple interacting factors and organ systems increase blood pressure and cause target-organ damage. Among the many molecular elements involved in the development of hypertension are reactive oxygen species (ROS), which influence cellular processes in systems that contribute to blood pressure elevation (such as the cardiovascular, renal, immune and central nervous systems, or the renin-angiotensin-aldosterone system). Dysregulated ROS production (oxidative stress) is a hallmark of hypertension in humans and experimental models. Of the many ROS-generating enzymes, NADPH oxidases are the most important in the development of hypertension. At the cellular level, ROS influence signalling pathways that define cell fate and function. Oxidative stress promotes aberrant redox signalling and cell injury, causing endothelial dysfunction, vascular damage, cardiovascular remodelling, inflammation and renal injury, which are all important in both the causes and consequences of hypertension. ROS scavengers reduce blood pressure in almost all experimental models of hypertension; however, clinical trials of antioxidants have yielded mixed results. In this Review, we highlight the latest advances in the understanding of the role and the clinical implications of ROS in hypertension. We focus on cellular sources of ROS, molecular mechanisms of oxidative stress and alterations in redox signalling in organ systems, and their contributions to hypertension.
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Affiliation(s)
- Livia L Camargo
- Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Quebec, Canada.
| | - Francisco J Rios
- Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Quebec, Canada
| | - Augusto C Montezano
- Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Quebec, Canada
| | - Rhian M Touyz
- Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Quebec, Canada.
- Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
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3
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Lbban E, Kwon K, Ashor A, Stephan B, Idris I, Tsintzas K, Siervo M. Vitamin C supplementation showed greater effects on systolic blood pressure in hypertensive and diabetic patients: an updated systematic review and meta-analysis of randomised clinical trials. Int J Food Sci Nutr 2023; 74:814-825. [PMID: 37791386 DOI: 10.1080/09637486.2023.2264549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 09/25/2023] [Indexed: 10/05/2023]
Abstract
Results from randomised controlled trials (RCTs) testing the effect of vitamin C supplementation on blood pressure (BP) have been inconsistent. This systematic review evaluated the effects of vitamin C supplementation on BP and included RCTs testing the effects of vitamin C supplementation alone, on systolic and diastolic BP in adult participants (≥18 years). Random-effect models were conducted to estimate the pooled effects of vitamin C supplementation on BP. A total of 20 studies with 890 participants were included. The median dose of vitamin C was 757.5 mg/d, the median duration was 6 weeks. Vitamin C supplementation was found to reduce systolic BP by -3.0 mmHg (95%CI: -4.7, -1.3 mmHg; p = 0.001). Subgroup analysis showed a more pronounced effect on systolic BP in patients with hypertension (-3.2 mmHg, 95%CI -5.2, -1.2 mmHg, p = 0.002) and diabetes (-4.6 mmHg, 95%CI -8.9, -0.3 mmHg, p = 0.03). Further research needs to evaluate the long-term effect of vitamin C on BP in populations with impaired cardio-metabolic health.
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Affiliation(s)
- Eazaz Lbban
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
- Department of Physiology, College of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Kee Kwon
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Ammar Ashor
- College of Medicine, University of Al-Mustansiriyah, Baghdad, Iraq
| | - Blossom Stephan
- Curtin Dementia Centre of Excellence, enAble Institute, Curtin University, Perth, Australia
| | - Iskandar Idris
- School of Medicine, The University of Nottingham Medical School, Derby Hospital, Nottingham, UK
| | - Kostas Tsintzas
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK
| | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
- Curtin Dementia Centre of Excellence, enAble Institute, Curtin University, Perth, Australia
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Shah AK, Dhalla NS. Effectiveness of Some Vitamins in the Prevention of Cardiovascular Disease: A Narrative Review. Front Physiol 2021; 12:729255. [PMID: 34690803 PMCID: PMC8531219 DOI: 10.3389/fphys.2021.729255] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/17/2021] [Indexed: 01/01/2023] Open
Abstract
By virtue of their regulatory role in various metabolic and biosynthetic pathways for energy status and cellular integrity, both hydro-soluble and lipo-soluble vitamins are considered to be involved in maintaining cardiovascular function in health and disease. Deficiency of some vitamins such as vitamin A, B6, folic acid, C, D, and E has been shown to be associated with cardiovascular abnormalities whereas supplementation with these vitamins has been claimed to reduce cardiovascular risk for hypertension, atherosclerosis, myocardial ischemia, arrhythmias, and heart failure. However, the data from several experimental and clinical studies for the pathogenesis of cardiovascular disease due to vitamin deficiency as well as therapy due to different vitamins are conflicting. In this article, we have attempted to review the existing literature on the role of different vitamins in cardiovascular disease with respect to their deficiency and supplementation in addition to examining some issues regarding their involvement in heart disease. Although both epidemiological and observational studies have shown some merit in the use of different antioxidant vitamins for the treatment of cardiovascular disorders, the results are not conclusive. Furthermore, in view of the complexities in the mechanisms of different cardiovascular disorders, no apparent involvement of any particular vitamin was seen in any specific cardiovascular disease. On the other hand, we have reviewed the evidence that deficiency of vitamin B6 promoted KCl-induced Ca2+ entry and reduced ATP-induced Ca2+-entry in cardiomyocytes in addition to decreasing sarcolemmal (SL) ATP binding. The active metabolite of vitamin B6, pyridoxal 5′-phosphate, attenuated arrhythmias due to myocardial infarction (MI) as well as cardiac dysfunction and defects in the sarcoplasmic reticulum (SR) Ca2+-transport in the ischemic-reperfused hearts. These observations indicate that both deficiency of some vitamins as well as pretreatments with different vitamins showing antioxidant activity affect cardiac function, metabolism and cation transport, and support the view that antioxidant vitamins or their metabolites may be involved in the prevention rather than the therapy of cardiovascular disease.
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Affiliation(s)
- Anureet K Shah
- School of Kinesiology, Nutrition and Food Science, California State University, Los Angeles, Los Angeles, CA, United States
| | - Naranjan S Dhalla
- Department of Physiology and Pathophysiology, St. Boniface Hospital Albrechtsen Research Centre, Max Rady College of Medicine, Institute of Cardiovascular Sciences, University of Manitoba, Winnipeg, MB, Canada
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Barteková M, Adameová A, Görbe A, Ferenczyová K, Pecháňová O, Lazou A, Dhalla NS, Ferdinandy P, Giricz Z. Natural and synthetic antioxidants targeting cardiac oxidative stress and redox signaling in cardiometabolic diseases. Free Radic Biol Med 2021; 169:446-477. [PMID: 33905865 DOI: 10.1016/j.freeradbiomed.2021.03.045] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/22/2021] [Accepted: 03/25/2021] [Indexed: 12/12/2022]
Abstract
Cardiometabolic diseases (CMDs) are metabolic diseases (e.g., obesity, diabetes, atherosclerosis, rare genetic metabolic diseases, etc.) associated with cardiac pathologies. Pathophysiology of most CMDs involves increased production of reactive oxygen species and impaired antioxidant defense systems, resulting in cardiac oxidative stress (OxS). To alleviate OxS, various antioxidants have been investigated in several diseases with conflicting results. Here we review the effect of CMDs on cardiac redox homeostasis, the role of OxS in cardiac pathologies, as well as experimental and clinical data on the therapeutic potential of natural antioxidants (including resveratrol, quercetin, curcumin, vitamins A, C, and E, coenzyme Q10, etc.), synthetic antioxidants (including N-acetylcysteine, SOD mimetics, mitoTEMPO, SkQ1, etc.), and promoters of antioxidant enzymes in CMDs. As no antioxidant indicated for the prevention and/or treatment of CMDs has reached the market despite the large number of preclinical and clinical studies, a sizeable translational gap is evident in this field. Thus, we also highlight potential underlying factors that may contribute to the failure of translation of antioxidant therapies in CMDs.
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Affiliation(s)
- Monika Barteková
- Institute for Heart Research, Centre of Experimental Medicine, Slovak Academy of Sciences, 84104 Bratislava, Slovakia; Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, 81372 Bratislava, Slovakia.
| | - Adriana Adameová
- Institute for Heart Research, Centre of Experimental Medicine, Slovak Academy of Sciences, 84104 Bratislava, Slovakia; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University in Bratislava, 83232 Bratislava, Slovakia
| | - Anikó Görbe
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; Pharmahungary Group, 6722 Szeged, Hungary
| | - Kristína Ferenczyová
- Institute for Heart Research, Centre of Experimental Medicine, Slovak Academy of Sciences, 84104 Bratislava, Slovakia
| | - Oľga Pecháňová
- Institute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, 81371 Bratislava, Slovakia
| | - Antigone Lazou
- Laboratory of Animal Physiology, School of Biology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Naranjan S Dhalla
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, And Department of Physiology & Pathophysiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 0W2, Canada
| | - Péter Ferdinandy
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; Pharmahungary Group, 6722 Szeged, Hungary
| | - Zoltán Giricz
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; Pharmahungary Group, 6722 Szeged, Hungary
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Wu B, Chang H, Marini R, Chopra S, Reddivari L. Characterization of Maize Near-Isogenic Lines With Enhanced Flavonoid Expression to Be Used as Tools in Diet-Health Complexity. FRONTIERS IN PLANT SCIENCE 2021; 11:619598. [PMID: 33584759 PMCID: PMC7874058 DOI: 10.3389/fpls.2020.619598] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/21/2020] [Indexed: 06/12/2023]
Abstract
Increasing incidence of chronic diseases in the 21st century has emphasized the importance of developing crops with enhanced nutritional value. Plant-based diets are associated with reduced incidence of many chronic diseases. The growing population and increased food demand have prioritized the development of high-yielding commercial crop varieties at the expense of natural flavors as well as health-benefiting compounds including polyphenols. Flavonoids are a large subfamily of polyphenols abundant in the plant kingdom with known health-promoting effects, making them a promising trait to be re-introduced into elite lines. Given the vast array of flavonoids and the complexity of plant food metabolome interactions, it is difficult to identify with certainty the specific class(es) of flavonoids in the food matrix that are anti-inflammatory. To address this, we have developed four maize near-isogenic lines (NILs); a line that lacked both anthocyanins and phlobaphenes, a second NIL containing phlobaphenes, a third line had anthocyanins, and a fourth line that contained both anthocyanins and phlobaphenes. The phytochemical profiles and the antioxidant potential of the NILs were characterized. The accumulation of anthocyanins and phlobaphenes contributed significantly to antioxidant capacity compared to maize lines that lacked one or both of the compounds (p < 0.05). Pilot study showed that intake of flavonoid-rich maize diets were able to alleviate experimental colitis in mice. These NILs offer novel materials combining anthocyanins and phlobaphenes and can be used as powerful tools to investigate the disease-preventive effects of specific flavonoid compound in diet/feeding experiments.
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Affiliation(s)
- Binning Wu
- Department of Plant Science, The Pennsylvania State University, State College, PA, United States
- Interdisciplinary Graduate Program in Plant Biology, The Pennsylvania State University, State College, PA, United States
- Department of Food Science, Purdue University, West Lafayette, IN, United States
| | - Haotian Chang
- Department of Food Science, Purdue University, West Lafayette, IN, United States
| | - Rich Marini
- Department of Plant Science, The Pennsylvania State University, State College, PA, United States
| | - Surinder Chopra
- Department of Plant Science, The Pennsylvania State University, State College, PA, United States
- Interdisciplinary Graduate Program in Plant Biology, The Pennsylvania State University, State College, PA, United States
| | - Lavanya Reddivari
- Department of Food Science, Purdue University, West Lafayette, IN, United States
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Cuevas S, Villar VAM, Jose PA. Genetic polymorphisms associated with reactive oxygen species and blood pressure regulation. THE PHARMACOGENOMICS JOURNAL 2019; 19:315-336. [PMID: 30723314 PMCID: PMC6650341 DOI: 10.1038/s41397-019-0082-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 10/19/2018] [Accepted: 12/21/2018] [Indexed: 02/08/2023]
Abstract
Hypertension is the most prevalent cause of cardiovascular disease and kidney failure, but only about 50% of patients achieve adequate blood pressure control, in part, due to inter-individual genetic variations in the response to antihypertensive medication. Significant strides have been made toward the understanding of the role of reactive oxygen species (ROS) in the regulation of the cardiovascular system. However, the role of ROS in human hypertension is still unclear. Polymorphisms of some genes involved in the regulation of ROS production are associated with hypertension, suggesting their potential influence on blood pressure control and response to antihypertensive medication. This review provides an update on the genes associated with the regulation of ROS production in hypertension and discusses the controversies on the use of antioxidants in the treatment of hypertension, including the antioxidant effects of antihypertensive drugs.
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Affiliation(s)
- Santiago Cuevas
- Center for Translational Science, Children's National Health System, 111 Michigan Avenue, NW, Washington, DC, 20010, USA.
| | - Van Anthony M Villar
- Department of Medicine, Division of Renal Diseases and Hypertension, The George Washington University School of Medicine and Health Sciences, Walter G. Ross Hall, Suite 738, 2300 I Street, NW, Washington, DC, 20052, USA
| | - Pedro A Jose
- Department of Medicine, Division of Renal Diseases and Hypertension, The George Washington University School of Medicine and Health Sciences, Walter G. Ross Hall, Suite 738, 2300 I Street, NW, Washington, DC, 20052, USA
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8
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Barrows IR, Ramezani A, Raj DS. Inflammation, Immunity, and Oxidative Stress in Hypertension-Partners in Crime? Adv Chronic Kidney Dis 2019; 26:122-130. [PMID: 31023446 DOI: 10.1053/j.ackd.2019.03.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/26/2019] [Accepted: 03/01/2019] [Indexed: 02/07/2023]
Abstract
Hypertension is considered as the most common risk factor for cardiovascular disease. Inflammatory processes link hypertension and cardiovascular disease, and participate in their pathophysiology. In recent years, there has been an increase in research focused on unraveling the role of inflammation and immune activation in development and maintenance of hypertension. Although inflammation is known to be associated with hypertension, whether inflammation is a cause or effect of hypertension remains to be elucidated. This review describes the recent studies that link inflammation and hypertension and demonstrate the involvement of oxidative stress and endothelial dysfunction-two of the key processes in the development of hypertension. Etiology of hypertension, including novel immune cell subtypes, cytokines, toll-like receptors, inflammasomes, and gut microbiome, found to be associated with inflammation and hypertension are summarized and discussed. Most recent findings in this field are presented with special emphasis on potential of anti-inflammatory drugs and statins for treatment of hypertension.
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Mostafa DG, Ahmed SF, Hussein OA. Protective effect of tetrahydrobiopterin on hepatic and renal damage after acute cadmium exposure in male rats. Ultrastruct Pathol 2018; 42:516-531. [PMID: 30595070 DOI: 10.1080/01913123.2018.1559566] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 10/29/2018] [Accepted: 12/08/2018] [Indexed: 12/14/2022]
Abstract
Cadmium (Cd) has been recognized as one of the most important environmental and industrial pollutants. This study investigated the impact of acute exposure to Cd on oxidative stress and the inflammatory marker interleukin-6 (IL-6) in the plasma of rats and the histological picture of liver and kidney, as well as to examine the potential protective effect of tetrahydrobiopterin (BH4). METHODS Rats were divided into control group, Cd group that received a single intraperitoneal (i.p.) dose of 4 mg/kg b.w. of CdCl2 and BH4+ Cd group that received a single dose of BH4 (20 mg/kg, i.p.) and subsequently exposed to a single dose of Cd 24 h after the BH4 treatment. RESULTS Cd increased the plasma levels of hepatic enzymes (ALT and AST), urea, creatinine, malondialdehyde (MDA), and IL-6 and decreased the superoxide dismutase (SOD) activity. Also, it induced histopathological alterations in the liver with severe degeneration, especially in centrilobular zones. Renal tubular epithelium showed vacuolated cytoplasm and dense nuclei. VEGF expression was mild. Ultrastuctural changes were seen in some renal tubules. The nuclei appeared distorted with electron dense chromatin. Mitochondria with destructed cristae were observed. BH4 pretreatment had protective effects, since it significantly reduced the levels of IL-6 and ameliorated the alteration in oxidative status biomarkers induced by Cd. Improvement of histopathological alterations was observed in Cd-groups. The nuclei were vesicular euchromatic, intact mitochondria and normal appearance of the filtration membrane. Moderate expression of VEGF was noted. CONCLUSION This study has provided clear evidence for the protective efficacy of BH4 against experimental Cd toxicity.
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Affiliation(s)
- Dalia G Mostafa
- a Department of Medical Physiology, Faculty of Medicine , Assiut University , Assiut , Egypt
- b Department of Medical Physiology, College of Medicine , King Khalid University , Abha , Saudi Arabia
| | - Salwa Fares Ahmed
- c Department of Histology, Faculty of Medicine , Assiut University , Assiut , Egypt
| | - Ola A Hussein
- c Department of Histology, Faculty of Medicine , Assiut University , Assiut , Egypt
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Yuan X, Li X, Ji Z, Xiao J, Zhang L, Zhang W, Su H, Kaliannan K, Long Y, Shao Z. Effects of vitamin C supplementation on blood pressure and hypertension control in response to ambient temperature changes in patients with essential hypertension. Clin Exp Hypertens 2018; 41:414-421. [DOI: 10.1080/10641963.2018.1501056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Xiaojie Yuan
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi’an, Shaanxi province, China
| | - Xiaochun Li
- Center of disease control of Wuwei, Wuwei, Gansu province, China
| | - Zhaohua Ji
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi’an, Shaanxi province, China
| | - Jing Xiao
- Center of disease control of Wuwei, Wuwei, Gansu province, China
| | - Lei Zhang
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi’an, Shaanxi province, China
| | - Weilu Zhang
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi’an, Shaanxi province, China
| | - Haixiao Su
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi’an, Shaanxi province, China
| | - Kanakaraju Kaliannan
- Laboratory for Lipid Medicine and Technology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Yong Long
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi’an, Shaanxi province, China
| | - Zhongjun Shao
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi’an, Shaanxi province, China
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Çakıcı EK, Eroğlu FK, Yazılıtaş F, Bülbül M, Gür G, Aydoğ Ö, Güngör T, Erel Ö, Alışık M, Elhan AH. Evaluation of the level of dynamic thiol/disulphide homeostasis in adolescent patients with newly diagnosed primary hypertension. Pediatr Nephrol 2018; 33:847-853. [PMID: 29297098 DOI: 10.1007/s00467-017-3865-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 11/29/2017] [Accepted: 11/30/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Thiol/disulphide homeostasis plays a critical role in numerous intracellular enzymatic pathways including antioxidant defense and detoxification. This study was designed to investigate the impact of thiol/disulfide homeostasis in adolescent patients with recently diagnosed primary hypertension (HT) using a novel and automated method. METHODS Native thiol/disulphide levels were measured by a novel spectrophotometric method (Cobasc 501, Roche Diagnostics, Mannheim, Germany) in 30 patients with primary HT together with 30 healthy controls. RESULTS The levels of native thiol, total thiol, and native thiol/total thiol ratios were significantly lower, while the disulphide level, disulphide/native thiol, and disulphide/total thiol ratios were significantly higher in patients with primary HT compared with the control group. There were significant positive correlations between 24-h mean systolic and diastolic blood pressure and disulphide levels, disulphide/native thiol, and disulphide/total thiol ratios. A multiple linear regression model showed that a disulphide/native thiol ratio above 5 and family history of HT are independent predictors of HT. CONCLUSIONS Our study showed that dynamic thiol/disulphide homeostasis shifted towards disulphide formation in adolescent patients with primary HT. Understanding the role of thiol/disulfide homeostasis in primary HT might provide new therapeutic intervention strategies for patients.
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Affiliation(s)
- Evrim Kargın Çakıcı
- Department of Pediatric Nephrology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey.
| | - Fehime Kara Eroğlu
- Department of Pediatric Nephrology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Fatma Yazılıtaş
- Department of Pediatric Nephrology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Mehmet Bülbül
- Department of Pediatric Nephrology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Gökçe Gür
- Department of Pediatric Nephrology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Özlem Aydoğ
- Department of Pediatric Nephrology, 19 Mayis University Medical School, Samsun, Turkey
| | - Tülin Güngör
- Department of Pediatric Nephrology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Özcan Erel
- Department of Biochemistry, Yıldırım Beyazıt University Medical School, Ankara, Turkey
| | - Murat Alışık
- Department of Biochemistry, Yıldırım Beyazıt University Medical School, Ankara, Turkey
| | - Atilla Halil Elhan
- Department of Biostatistics, Ankara University Medical School, Ankara, Turkey
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12
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Dornas WC, Cardoso LM, Silva M, Machado NLS, Chianca DA, Alzamora AC, Lima WG, Lagente V, Silva ME. Oxidative stress causes hypertension and activation of nuclear factor-κB after high-fructose and salt treatments. Sci Rep 2017; 7:46051. [PMID: 28397867 PMCID: PMC5387393 DOI: 10.1038/srep46051] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 02/15/2017] [Indexed: 02/07/2023] Open
Abstract
There is evidence that diets rich in salt or simple sugars as fructose are associated with abnormalities in blood pressure regulation. However, the mechanisms underlying pathogenesis of salt- and fructose-induced kidney damage and/or consequent hypertension yet remain largely unexplored. Here, we tested the role of oxidative state as an essential factor along with high salt and fructose treatment in causing hypertension. Fischer male rats were supplemented with a high-fructose diet (20% in water) for 20 weeks and maintained on high-salt diet (8%) associate in the last 10 weeks. Fructose-fed rats exhibited a salt-dependent hypertension accompanied by decrease in renal superoxide dismutase activity, which is the first footprint of antioxidant inactivation by reactive oxygen species (ROS). Metabolic changes and the hypertensive effect of the combined fructose-salt diet (20 weeks) were markedly reversed by a superoxide scavenger, Tempol (10 mg/kg, gavage); moreover, Tempol (50 mM) potentially reduced ROS production and abolished nuclear factor-kappa B (NF-κB) activation in human embryonic kidney HEK293 cells incubated with L-fructose (30 mM) and NaCl (500 mosmol/kg added). Taken together, our data suggested a possible role of oxygen radicals and ROS-induced activation of NF-κB in the fructose- and salt-induced hypertension associated with the progression of the renal disease.
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Affiliation(s)
- Waleska C Dornas
- Research in Biological Sciences - NUPEB, Universidade Federal de Ouro Preto, Minas Gerais, Brasil.,UMR991, INSERM, Université de Rennes 1, Rennes, France
| | - Leonardo M Cardoso
- Research in Biological Sciences - NUPEB, Universidade Federal de Ouro Preto, Minas Gerais, Brasil.,Department of Biological Sciences, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Minas Gerais, Brasil
| | - Maísa Silva
- Research in Biological Sciences - NUPEB, Universidade Federal de Ouro Preto, Minas Gerais, Brasil
| | - Natália L S Machado
- Research in Biological Sciences - NUPEB, Universidade Federal de Ouro Preto, Minas Gerais, Brasil
| | - Deoclécio A Chianca
- Research in Biological Sciences - NUPEB, Universidade Federal de Ouro Preto, Minas Gerais, Brasil.,Department of Biological Sciences, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Minas Gerais, Brasil
| | - Andréia C Alzamora
- Research in Biological Sciences - NUPEB, Universidade Federal de Ouro Preto, Minas Gerais, Brasil.,Department of Biological Sciences, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Minas Gerais, Brasil
| | - Wanderson G Lima
- Research in Biological Sciences - NUPEB, Universidade Federal de Ouro Preto, Minas Gerais, Brasil.,Department of Biological Sciences, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Minas Gerais, Brasil
| | | | - Marcelo E Silva
- Research in Biological Sciences - NUPEB, Universidade Federal de Ouro Preto, Minas Gerais, Brasil.,Department of Foods, Escola de Nutrição, Universidade Federal de Ouro Preto, Minas Gerais, Brasil
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13
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Ellulu MS. Obesity, cardiovascular disease, and role of vitamin C on inflammation: a review of facts and underlying mechanisms. Inflammopharmacology 2017; 25:313-328. [PMID: 28168552 DOI: 10.1007/s10787-017-0314-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 01/23/2017] [Indexed: 02/07/2023]
Abstract
Obesity means the accumulation of excessive fat that may interfere with the maintenance of optimal state of health. Obesity causes cardiac and vascular disease through well-known mediators such as hypertension, type-2 diabetes mellitus, and dyslipidemia, but there are evidences for other mediators such as chronic inflammation, oxidative stress, and thrombosis. The decreased levels of antioxidants factors and nitric oxide predispose to further cardiovascular adverse events. To reduce the risks, antioxidants can help by neutralizing the free radicals and protecting from damage by donating electrons. Having the capacity, vitamin C protects from oxidative stress, prevention of non-enzymatic glycosylation of proteins, and enhances arterial dilation through its effect on nitric oxide release. It also decreases lipid peroxidation, and alleviates inflammation. The anti-inflammatory property of vitamin C could be attributed to ability to modulate the NF-kB DNA binding activity and down-regulation in the hepatic mRNA expression for the interleukins and tumor factors.
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Affiliation(s)
- Mohammed S Ellulu
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang, Selangor, Malaysia. .,Clinical Nutrition Specialist, Gaza, Palestine.
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14
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Abstract
It has become clear that reactive oxygen species (ROS) contribute to the development of hypertension via myriad effects. ROS are essential for normal cell function; however, they mediate pathologic changes in the brain, the kidney, and blood vessels that contribute to the genesis of chronic hypertension. There is also emerging evidence that ROS contribute to immune activation in hypertension. This article discusses these events and how they coordinate to contribute to hypertension and its consequent end-organ damage.
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Affiliation(s)
- Roxana Loperena
- Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, 2220 Pierce Drive, Room 536 Robinson Research Building, Nashville, TN 37232, USA
| | - David G Harrison
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Vanderbilt University, 2220 Pierce Drive, Room 536 Robinson Research Building, Nashville, TN 37232, USA.
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15
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Upadrasta A, Madempudi RS. Probiotics and blood pressure: current insights. Integr Blood Press Control 2016; 9:33-42. [PMID: 26955291 PMCID: PMC4772943 DOI: 10.2147/ibpc.s73246] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Gut microbiota play a significant role in host metabolic processes, and recent metagenomic surveys have revealed that they are involved in host immune modulation and influence host development and physiology (organ development). Initially, probiotics are identified as potential therapeutics to treat gastrointestinal disorders and to revitalize the disturbed gut ecosystem. Currently, studies are exploring the potential for expanded uses of probiotics for improving the health conditions in metabolic disorders that increase the risk of developing cardiovascular diseases such as hypertension. Further investigations are required to evaluate targeted and effective use of the wide variety of probiotic strains in various metabolic disorders to improve the overall health status of the host. This review addresses the causes of hypertension and the hypotensive effect of probiotics, with a focus on their mechanistic action.
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Affiliation(s)
- Aditya Upadrasta
- Centre for Research and Development, Unique Biotech Limited, Alexandria Knowledge Park, Shamirpet, Hyderabad, India
| | - Ratna Sudha Madempudi
- Centre for Research and Development, Unique Biotech Limited, Alexandria Knowledge Park, Shamirpet, Hyderabad, India
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16
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Association between High Blood Pressure and Intakes of Sodium and Potassium among Korean Adults: Korean National Health and Nutrition Examination Survey, 2007-2012. J Acad Nutr Diet 2015; 115:1950-7. [DOI: 10.1016/j.jand.2015.04.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 04/22/2015] [Indexed: 01/07/2023]
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17
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Wade KH, Forouhi NG, Cook DG, Johnson P, McConnachie A, Morris RW, Rodriguez S, Ye Z, Ebrahim S, Padmanabhan S, Watt G, Bruckdorfer KR, Wareham NJ, Whincup PH, Chanock S, Sattar N, Lawlor DA, Davey Smith G, Timpson NJ. Variation in the SLC23A1 gene does not influence cardiometabolic outcomes to the extent expected given its association with L-ascorbic acid. Am J Clin Nutr 2015; 101:202-9. [PMID: 25527764 PMCID: PMC4266888 DOI: 10.3945/ajcn.114.092981] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 10/20/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Observational studies showed that circulating L-ascorbic acid (vitamin C) is inversely associated with cardiometabolic traits. However, these studies were susceptible to confounding and reverse causation. OBJECTIVES We assessed the relation between L-ascorbic acid and 10 cardiometabolic traits by using a single nucleotide polymorphism in the solute carrier family 23 member 1 (SLC23A1) gene (rs33972313) associated with circulating L-ascorbic acid concentrations. The observed association between rs33972313 and cardiometabolic outcomes was compared with that expected given the rs33972313-L-ascorbic acid and L-ascorbic acid-outcome associations. DESIGN A meta-analysis was performed in the following 5 independent studies: the British Women's Heart and Health Study (n = 1833), the MIDSPAN study (n = 1138), the Ten Towns study (n = 1324), the British Regional Heart Study (n = 2521), and the European Prospective Investigation into Cancer (n = 3737). RESULTS With the use of a meta-analysis of observational estimates, inverse associations were shown between L-ascorbic acid and systolic blood pressure, triglycerides, and the waist-hip ratio [the strongest of which was the waist-hip ratio (-0.13-SD change; 95% CI: -0.20-, -0.07-SD change; P = 0.0001) per SD increase in L-ascorbic acid], and a positive association was shown with high-density lipoprotein (HDL) cholesterol. The variation at rs33972313 was associated with a 0.18-SD (95% CI: 0.10-, 0.25-SD; P = 3.34 × 10⁻⁶) increase in L-ascorbic acid per effect allele. There was no evidence of a relation between the variation at rs33972313 and any cardiometabolic outcome. Although observed estimates were not statistically different from expected associations between rs33972313 and cardiometabolic outcomes, estimates for low-density lipoprotein cholesterol, HDL cholesterol, triglycerides, glucose, and body mass index were in the opposite direction to those expected. CONCLUSIONS The nature of the genetic association exploited in this study led to limited statistical application, but despite this, when all cardiometabolic traits were assessed, there was no evidence of any trend supporting a protective role of L-ascorbic acid. In the context of existing work, these results add to the suggestion that observational relations between L-ascorbic acid and cardiometabolic health may be attributable to confounding and reverse causation.
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Affiliation(s)
- Kaitlin H Wade
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - Nita G Forouhi
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - Derek G Cook
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - Paul Johnson
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - Alex McConnachie
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - Richard W Morris
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - Santiago Rodriguez
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - Zheng Ye
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - Shah Ebrahim
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - Sandosh Padmanabhan
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - Graham Watt
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - K Richard Bruckdorfer
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - Nick J Wareham
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - Peter H Whincup
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - Stephen Chanock
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - Naveed Sattar
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - Debbie A Lawlor
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - George Davey Smith
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
| | - Nicholas J Timpson
- From the Medical Research Council (MRC) Integrative Epidemiology Unit (KHW, DAL, GDS, and NJT) and the School of Social and Community Medicine (KHW, NGF, SR, DAL, GDS, and NJT), University of Bristol, Bristol, United Kingdom; the MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, United Kingdom (NGF, ZY, and NJW); the Division of Community and Health Sciences, St. George's University of London, London, United Kingdom (DGC and PHW); the Robertson Centre for Biostatistics, Glasgow, United Kingdom (PJ and AM); the Department of Primary Care & Population Health (RWM), the Department of Structural and Molecular Biology, University College London (KRB), London, United Kingdom (RWM); the London School of Hygiene and Tropical Medicine, London, United Kingdom (SE); the British Heart Foundation Glasgow Cardiovascular Research Centre, Faculty of Medicine (SP and NS) and General Practice and Primary Care, Division of Community Based Sciences (GW), University of Glasgow, Glasgow, United Kingdom; and the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (SC)
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18
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Nwokocha CR, Baker A, Douglas D, McCalla G, Nwokocha M, Brown PD. Apocynin ameliorates cadmium-induced hypertension through elevation of endothelium nitric oxide synthase. Cardiovasc Toxicol 2014; 13:357-63. [PMID: 23703608 DOI: 10.1007/s12012-013-9216-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Apocynin is reported to have antioxidant and NADPH oxidase inhibitor activities. Cadmium toxicity is reported to causes oxidative damage, resulting in vascular dysfunction, reduced bioavailability of nitric oxide (NO) and hypertension. The study aimed to investigate the protective effects of apocynin in cadmium-induced hypertension. Thirty-six (36) adult male Sprague-Dawley rats were randomly divided into 6 groups. Group 1 served as control, Groups 2 and 3 received 50 and 100 mg/Kg (b.w) apocynin, respectively, Group 4 received 100 ppm CdCl2 in their drinking water, while Group 5 and 6 received 100 ppm CdCl2 in their drinking and 50 and 100 mg/Kg (b.w) apocynin, respectively, for 8 weeks. Blood pressure readings were taken weekly using the tail-cuff method. cGMP, endothelial nitric oxide synthase (eNOS), NO and hematological parameters were analyzed at the end of 8 weeks. Apocynin, although a poor antioxidant, caused a significant reduction (p < 0.05) in systolic and mean arterial pressures in the cadmium-induced elevations in blood pressure and amelioration of altered hematological parameters. However, while cadmium exposures did not alter the cGMP, eNOS and nitrate concentrations in serum, apocynin reduced the cGMP and nitrite values while significantly elevating (p < 0.05) the eNOS concentrations and also improved the cadmium-induced anemia. Apocynin was effective in reducing cadmium-induced elevated blood pressures through elevation of eNOS. Inhibition of NADPH oxidase activity may be a useful strategy for prevention and treatment of cadmium-induced hypertension.
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Affiliation(s)
- Chukwuemeka R Nwokocha
- Physiology Section, Department of Basic Medical Sciences, The University of the West Indies, Mona Campus, Kingston 7, Jamaica,
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19
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Castro Torres Y, Santos Portela AE, Garrido Bősze IM. [Role of renal inflammation in the physiopathology of salt-sensitive hypertension]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2014; 84:211-7. [PMID: 25024004 DOI: 10.1016/j.acmx.2014.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 01/07/2014] [Accepted: 02/10/2014] [Indexed: 11/29/2022] Open
Abstract
Salt-sensitive hypertension is produced by a decrease in salt renal excretion after a salt overload. Over the last few years, a new theory has been developed to explain this condition based on renal tissue inflammation. This process begins with free radicals production in renal tissue due to oxidative metabolism. Then they favor a renal inflammation mechanism with T-lymphocytes infiltration and other immune cells. Essentially, T-lymphocytes determine an increase in angiotensin ii production which raises sodium and water retention. Association among autoimmune diseases and hypertension may be explained, in part, by the relationship between salt-sensitive hypertension and renal inflammation. The use of antioxidant drugs and the development of new medicaments may be a choice for treating patients affected with this condition.
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Affiliation(s)
- Yaniel Castro Torres
- Facultad de Medicina, Universidad de Ciencias Médicas Dr. Serafín Ruiz de Zárate Ruiz, Santa Clara, Villa Clara, Cuba.
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20
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González J, Valls N, Brito R, Rodrigo R. Essential hypertension and oxidative stress: New insights. World J Cardiol 2014; 6:353-366. [PMID: 24976907 PMCID: PMC4072825 DOI: 10.4330/wjc.v6.i6.353] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 03/01/2014] [Accepted: 05/08/2014] [Indexed: 02/06/2023] Open
Abstract
Essential hypertension is a highly prevalent pathological condition that is considered as one of the most relevant cardiovascular risk factors and is an important cause of morbidity and mortality around the world. Despite the fact that mechanisms underlying hypertension are not yet fully elucidated, a large amount of evidence shows that oxidative stress plays a central role in its pathophysiology. Oxidative stress can be defined as an imbalance between oxidant agents, such as superoxide anion, and antioxidant molecules, and leads to a decrease in nitric oxide bioavailability, which is the main factor responsible for maintaining the vascular tone. Several vasoconstrictor peptides, such as angiotensin II, endothelin-1 and urotensin II, act through their receptors to stimulate the production of reactive oxygen species, by activating enzymes like NADPH oxidase and xanthine oxidase. The knowledge of the mechanism described above has allowed generating new therapeutic strategies against hypertension based on the use of antioxidants agents, including vitamin C and E, N-Acetylcysteine, polyphenols and selenium, among others. These substances have different therapeutic targets, but all represent antioxidant reinforcement. Several clinical trials using antioxidants have been made. The aim of the present review is to provide new insights about the key role of oxidative stress in the pathophysiology of essential hypertension and new clinical attempts to demonstrate the usefulness of antioxidant therapy in the treatment of hypertension.
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Abstract
The cellular metabolism of oxygen generates potentially deleterious reactive oxygen species, including superoxide anion, hydrogen peroxide and hydroxyl radical. Under normal physiologic conditions, the rate and magnitude of oxidant formation is balanced by the rate of oxidant elimination. However, an imbalance between pro-oxidants and antioxidants results in oxidative stress, which is the pathogenic outcome of the overproduction of oxidants that overwhelms the cellular antioxidant capacity. There is growing evidence that increased oxidative stress and associated oxidative damage are mediators of vascular injury in cardiovascular pathologies, including hypertension, atherosclerosis and ischemia-reperfusion. This development has evoked considerable interest because of the possibilities that therapies targeted against reactive oxygen intermediates by decreasing the generation of reactive oxygen species and/or by increasing availability of antioxidants may be useful in minimizing vascular injury. This review focuses on the vascular actions of reactive oxygen species, the role of oxidative stress in vascular damage in hypertension and the therapeutic potential of modulating oxygen radical bioavailability in hypertension. In particular, the following topics will be highlighted: chemistry and sources of reactive oxygen species, antioxidant defense mechanisms, signaling events mediated by reactive oxygen species, role of reactive oxygen species in hypertension and the putative therapeutic role of antioxidants in cardiovascular disease.
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Affiliation(s)
- Rhian M Touyz
- Clinical Research Institute of Montreal, Quebec, Canada.
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22
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Abstract
Hypertension affects one in three adults in Turkey and the United States. Only half are treated for this condition and only 10–20% is controlled. Dietary modifications such as salt restriction, moderation of alcohol drinking, and a diet rich in fruits, vegetables, and legumes and low in snacks, sweets, meat, and saturated fat are helpful in the treatment of hypertension. Consumption of dark chocolate is also associated with a drop in systolic blood pressure. Individual dietary factors that may reduce blood pressure include increased intakes of potassium, calcium, fish oil, fiber, and milk-based and vegetable-based protein.
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Affiliation(s)
- Soner Duman
- Department of Internal Medicine, Ege University Medical School , Bornova, İzmir, Turkey
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Ahmad A, Singhal U, Hossain MM, Islam N, Rizvi I. The role of the endogenous antioxidant enzymes and malondialdehyde in essential hypertension. J Clin Diagn Res 2013; 7:987-90. [PMID: 23905086 PMCID: PMC3708256 DOI: 10.7860/jcdr/2013/5829.3091] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 03/26/2013] [Indexed: 02/07/2023]
Abstract
CONTEXT Oxidative Stress is caused by an imbalance between the production of reactive oxygen species and a biological system's ability to readily detoxify the reactive intermediates. AIMS 1. To compare the levels of Malondialdehyde (MDA), in hypertensive and normotensive subjects. 2. To compare the levels of the antioxidant enzymes, namely, Catalase, Glutathione peroxidase (GPX) and Superoxide Dismutase (SOD) in hypertensive and normotensive subjects. 3. To determine the correlation between the MDA levels and the mean arterial pressure (MAP) among hypertensive subjects. 4. To determine the correlation between the antioxidant enzyme levels and MAP among the hypertensive subjects and to evaluate the effect of 6 months of antihypertensive therapy with a tight blood pressure control on the MDA levels. Materials and Methods : In this cross sectional study, 25 normotensive and 40 hypertensive subjects were recruited. The hypertensive subjects were further subdivided into three subgroups: Prehypertensives, Stage I hypertensives and Stage II hypertensives. All the subjects underwent a blood pressure measurement and the markers of oxidative stress in their sera were estimated. The subjects of Stage I hypertension and Stage II hypertension were given antihypertensive treatment for 6 months and their blood pressures were tightly regulated and brought to the normotensive state. After 6 months, the estimations of the markers of oxidative stress were done again. RESULTS The MDA levels were significantly increased in the stage I and stage II hypertension groups as compared to those of the control group (p<0.05). The antioxidant enzymes (SOD, Catalase and GPX) were significantly decreased (p<0.05) in the prehypertension and in the stage I and stage II hypertension groups as compared to those in the control group. There was a significant increase in the levels of the antioxidant enzymes after 6 months of a tight regulation and bringing of the blood pressure to the normotensive state by giving antihypertensive therapy. CONCLUSION On comparison of the present study with other studies in which the use of antioxidants were found to be ineffective in the blood pressure reduction, it can be concluded that oxidative stress is an effect rather than a cause of essential hypertension.
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Affiliation(s)
- Aquil Ahmad
- Department of Physiology, JNMC, AMU, Aligarh, UP-202002, India
| | - Usha Singhal
- Department of Physiology, JNMC, AMU, Aligarh, UP-202002, India
| | | | - Najmul Islam
- Department of Biochemistry, JNMC, AMU, Aligarh, UP-202002, India
| | - Imran Rizvi
- Department of Medicine, JNMC, AMU, Aligarh, UP-202002, India
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24
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Appel LJ. ASH position paper: Dietary approaches to lower blood pressure. ACTA ACUST UNITED AC 2012; 3:321-31. [PMID: 20409975 DOI: 10.1016/j.jash.2009.08.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2008] [Accepted: 11/06/2008] [Indexed: 01/11/2023]
Abstract
A substantial body of evidence has implicated several aspects of diet in the pathogenesis of elevated blood pressure (BP). Well-established risk factors for elevated BP include excess salt intake, low potassium intake, excess weight, high alcohol consumption, and suboptimal dietary pattern. African Americans are especially sensitive to the BP-raising effects of excess salt intake, insufficient potassium intake, and suboptimal diet. In this setting, dietary changes have the potential to substantially reduce racial disparities in BP and its consequences. In view of the age-related rise in BP in both children and adults, the direct, progressive relationship of BP with cardiovascular-renal diseases throughout the usual range of BP, and the worldwide epidemic of BP-related disease, efforts to reduce BP in nonhypertensive as well as hypertensive individuals are warranted. In nonhypertensives, dietary changes can lower BP and delay, if not prevent, hypertension. In uncomplicated stage I hypertension, dietary changes serve as initial treatment before drug therapy. In hypertensive individuals already on drug therapy, lifestyle modifications can further lower BP. The current challenge is designing and implementing effective clinical and public health interventions that lead to sustained dietary changes among individuals and more broadly in the general population.
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Affiliation(s)
- Lawrence J Appel
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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25
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Bruno RM, Ghiadoni L, Seravalle G, Dell'oro R, Taddei S, Grassi G. Sympathetic regulation of vascular function in health and disease. Front Physiol 2012; 3:284. [PMID: 22934037 PMCID: PMC3429057 DOI: 10.3389/fphys.2012.00284] [Citation(s) in RCA: 152] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 06/29/2012] [Indexed: 01/16/2023] Open
Abstract
The sympathetic nervous system (SNS) is known to play a pivotal role in short- and long-term regulation of different functions of the cardiovascular system. In the past decades increasing evidence demonstrated that sympathetic neural control is involved not only in the vasomotor control of small resistance arteries but also in modulation of large artery function. Sympathetic activity and vascular function, both of which are key factors in the development and prognosis of cardiovascular events and disease, are linked at several levels. Evidence from experimental studies indicates that the SNS is critically influenced, at the central and also at the peripheral level, by the most relevant factors regulating vascular function, such as nitric oxide (NO), reactive oxygen species (ROS), endothelin (ET), the renin-angiotensin system. Additionally, there is indirect evidence of a reciprocal relationship between endothelial function and activity of the SNS. A number of cardiovascular risk factors and diseases are characterized both by increased sympathetic outflow and decreased endothelial function. In healthy subjects, muscle sympathetic nerve activity (MSNA) appears to be related to surrogate markers of endothelial function, and an acute increase in sympathetic activity has been associated with a decrease in endothelial function in healthy subjects. However, direct evidence of a cause-effect relationship from human studies is scanty. In humans large artery stiffness has been associated with increased sympathetic discharge, both in healthy subjects and in renal transplant recipients. Peripheral sympathetic discharge is also able to modulate wave reflection. On the other hand, large artery stiffness can interfere with autonomic regulation by impairing carotid baroreflex sensitivity.
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Affiliation(s)
- Rosa M Bruno
- Department of Internal Medicine University of Pisa, Italy
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26
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Mohanlal V, Parsa A, Weir MR. Role of dietary therapies in the prevention and treatment of hypertension. Nat Rev Nephrol 2012; 8:413-22. [PMID: 22585275 DOI: 10.1038/nrneph.2012.91] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Blood pressure naturally rises with increasing age. The rate of change in blood pressure with age is regulated in part by genetic factors, but can also be altered through sustained dietary modification. Dietary approaches to modify blood pressure remain an important part of cardiovascular health promotion, which is especially important given the aging of the general population coupled with the increasing prevalence of obesity and metabolic disturbances. Specific modification of dietary components such as macronutrients and micronutrients could be helpful to lower blood pressure and alter the slope of blood pressure change whereas nutritional supplements are less likely to have a substantial beneficial effect. Population-wide generalizations regarding diet are impractical as individualized strategies are more likely to be successful in facilitating long-term benefits in improving blood-pressure control. Consequently, more effort needs to be focused on evaluating data from large-scale observational and interventional studies and interpreting their information in a clinically relevant manner, which is likely to be helpful for individual patients. Providing education on the relationship between diet and blood pressure from an early age is most likely to produce tangible benefits.
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Affiliation(s)
- Viresh Mohanlal
- Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201, USA
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27
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Harrison DG, Marvar PJ, Titze JM. Vascular inflammatory cells in hypertension. Front Physiol 2012; 3:128. [PMID: 22586409 PMCID: PMC3345946 DOI: 10.3389/fphys.2012.00128] [Citation(s) in RCA: 121] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Accepted: 04/16/2012] [Indexed: 12/11/2022] Open
Abstract
Hypertension is a common disorder with uncertain etiology. In the last several years, it has become evident that components of both the innate and adaptive immune system play an essential role in hypertension. Macrophages and T cells accumulate in the perivascular fat, the heart and the kidney of hypertensive patients, and in animals with experimental hypertension. Various immunosuppressive agents lower blood pressure and prevent end-organ damage. Mice lacking lymphocytes are protected against hypertension, and adoptive transfer of T cells, but not B cells in the animals restores their blood pressure response to stimuli such as angiotensin II or high salt. Recent studies have shown that mice lacking macrophages have blunted hypertension in response to angiotensin II and that genetic deletion of macrophages markedly reduces experimental hypertension. Dendritic cells have also been implicated in this disease. Many hypertensive stimuli have triggering effects on the central nervous system and signals arising from the circumventricular organ seem to promote inflammation. Studies have suggested that central signals activate macrophages and T cells, which home to the kidney and vasculature and release cytokines, including IL-6 and IL-17, which in turn cause renal and vascular dysfunction and lead to blood pressure elevation. These recent discoveries provide a new understanding of hypertension and provide novel therapeutic opportunities for treatment of this serious disease.
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Affiliation(s)
- David G Harrison
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Nashville, TN, USA
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28
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Juraschek SP, Guallar E, Appel LJ, Miller ER. Effects of vitamin C supplementation on blood pressure: a meta-analysis of randomized controlled trials. Am J Clin Nutr 2012; 95:1079-88. [PMID: 22492364 PMCID: PMC3325833 DOI: 10.3945/ajcn.111.027995] [Citation(s) in RCA: 178] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 02/14/2012] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In observational studies, increased vitamin C intake, vitamin C supplementation, and higher blood concentrations of vitamin C are associated with lower blood pressure (BP). However, evidence for blood pressure-lowering effects of vitamin C in clinical trials is inconsistent. OBJECTIVE The objective was to conduct a systematic review and meta-analysis of clinical trials that examined the effects of vitamin C supplementation on BP. DESIGN We searched Medline, EMBASE, and Central databases from 1966 to 2011. Prespecified inclusion criteria were as follows: 1) use of a randomized controlled trial design; 2) trial reported effects on systolic BP (SBP) or diastolic BP (DBP) or both; 3) trial used oral vitamin C and concurrent control groups; and 4) trial had a minimum duration of 2 wk. BP effects were pooled by random-effects models, with trials weighted by inverse variance. RESULTS Twenty-nine trials met eligibility criteria for the primary analysis. The median dose was 500 mg/d, the median duration was 8 wk, and trial sizes ranged from 10 to 120 participants. The pooled changes in SBP and DBP were -3.84 mm Hg (95% CI: -5.29, -2.38 mm Hg; P < 0.01) and -1.48 mm Hg (95% CI: -2.86, -0.10 mm Hg; P = 0.04), respectively. In trials in hypertensive participants, corresponding reductions in SBP and DBP were -4.85 mm Hg (P < 0.01) and -1.67 mm Hg (P = 0.17). After the inclusion of 9 trials with imputed BP effects, BP effects were attenuated but remained significant. CONCLUSIONS In short-term trials, vitamin C supplementation reduced SBP and DBP. Long-term trials on the effects of vitamin C supplementation on BP and clinical events are needed.
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Affiliation(s)
- Stephen P Juraschek
- Johns Hopkins School of Medicine, Johns Hopkins Bloomberg School of Public Health, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA
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Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database Syst Rev 2012; 2012:CD007176. [PMID: 22419320 PMCID: PMC8407395 DOI: 10.1002/14651858.cd007176.pub2] [Citation(s) in RCA: 284] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Our systematic review has demonstrated that antioxidant supplements may increase mortality. We have now updated this review. OBJECTIVES To assess the beneficial and harmful effects of antioxidant supplements for prevention of mortality in adults. SEARCH METHODS We searched The Cochrane Library, MEDLINE, EMBASE, LILACS, the Science Citation Index Expanded, and Conference Proceedings Citation Index-Science to February 2011. We scanned bibliographies of relevant publications and asked pharmaceutical companies for additional trials. SELECTION CRITERIA We included all primary and secondary prevention randomised clinical trials on antioxidant supplements (beta-carotene, vitamin A, vitamin C, vitamin E, and selenium) versus placebo or no intervention. DATA COLLECTION AND ANALYSIS Three authors extracted data. Random-effects and fixed-effect model meta-analyses were conducted. Risk of bias was considered in order to minimise the risk of systematic errors. Trial sequential analyses were conducted to minimise the risk of random errors. Random-effects model meta-regression analyses were performed to assess sources of intertrial heterogeneity. MAIN RESULTS Seventy-eight randomised trials with 296,707 participants were included. Fifty-six trials including 244,056 participants had low risk of bias. Twenty-six trials included 215,900 healthy participants. Fifty-two trials included 80,807 participants with various diseases in a stable phase. The mean age was 63 years (range 18 to 103 years). The mean proportion of women was 46%. Of the 78 trials, 46 used the parallel-group design, 30 the factorial design, and 2 the cross-over design. All antioxidants were administered orally, either alone or in combination with vitamins, minerals, or other interventions. The duration of supplementation varied from 28 days to 12 years (mean duration 3 years; median duration 2 years). Overall, the antioxidant supplements had no significant effect on mortality in a random-effects model meta-analysis (21,484 dead/183,749 (11.7%) versus 11,479 dead/112,958 (10.2%); 78 trials, relative risk (RR) 1.02, 95% confidence interval (CI) 0.98 to 1.05) but significantly increased mortality in a fixed-effect model (RR 1.03, 95% CI 1.01 to 1.05). Heterogeneity was low with an I(2)- of 12%. In meta-regression analysis, the risk of bias and type of antioxidant supplement were the only significant predictors of intertrial heterogeneity. Meta-regression analysis did not find a significant difference in the estimated intervention effect in the primary prevention and the secondary prevention trials. In the 56 trials with a low risk of bias, the antioxidant supplements significantly increased mortality (18,833 dead/146,320 (12.9%) versus 10,320 dead/97,736 (10.6%); RR 1.04, 95% CI 1.01 to 1.07). This effect was confirmed by trial sequential analysis. Excluding factorial trials with potential confounding showed that 38 trials with low risk of bias demonstrated a significant increase in mortality (2822 dead/26,903 (10.5%) versus 2473 dead/26,052 (9.5%); RR 1.10, 95% CI 1.05 to 1.15). In trials with low risk of bias, beta-carotene (13,202 dead/96,003 (13.8%) versus 8556 dead/77,003 (11.1%); 26 trials, RR 1.05, 95% CI 1.01 to 1.09) and vitamin E (11,689 dead/97,523 (12.0%) versus 7561 dead/73,721 (10.3%); 46 trials, RR 1.03, 95% CI 1.00 to 1.05) significantly increased mortality, whereas vitamin A (3444 dead/24,596 (14.0%) versus 2249 dead/16,548 (13.6%); 12 trials, RR 1.07, 95% CI 0.97 to 1.18), vitamin C (3637 dead/36,659 (9.9%) versus 2717 dead/29,283 (9.3%); 29 trials, RR 1.02, 95% CI 0.98 to 1.07), and selenium (2670 dead/39,779 (6.7%) versus 1468 dead/22,961 (6.4%); 17 trials, RR 0.97, 95% CI 0.91 to 1.03) did not significantly affect mortality. In univariate meta-regression analysis, the dose of vitamin A was significantly associated with increased mortality (RR 1.0006, 95% CI 1.0002 to 1.001, P = 0.002). AUTHORS' CONCLUSIONS We found no evidence to support antioxidant supplements for primary or secondary prevention. Beta-carotene and vitamin E seem to increase mortality, and so may higher doses of vitamin A. Antioxidant supplements need to be considered as medicinal products and should undergo sufficient evaluation before marketing.
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Affiliation(s)
- Goran Bjelakovic
- Department of InternalMedicine,Medical Faculty, University ofNis,Nis, Serbia.
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Mahajan AS, Babbar R, Kansal N, Agarwal SK, Ray PC. Antihypertensive and antioxidant action of amlodipine and vitamin C in patients of essential hypertension. J Clin Biochem Nutr 2011; 40:141-7. [PMID: 18188416 PMCID: PMC2127225 DOI: 10.3164/jcbn.40.141] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2006] [Accepted: 10/20/2006] [Indexed: 12/15/2022] Open
Abstract
The etiology of essential hypertension includes increased oxidative stress. The role of antihypertensive drug amlodipine as an antioxidant and the benefit of addition of vitamin C, an antioxidant to antihypertensive therapy were studied. Forty male patients of essential hypertension were randomly divided into two groups and treated with 5 mg amlodipine. In addition one group also received 1000 mg vitamin C (as two 500 mg tablets) once daily for three months. Although blood pressure decreased in both groups, the systolic blood pressure in patients given vitamin C was less (126.4 ± 7.47) compared to the other group (130.9 ± 7.27). A decrease in malondialdehyde, an increase in erythrocyte sodium-potassium adenosine triphosphatase (Na+ K+ ATPase) and an increase in the superoxide dismutase levels were observed in both groups. The increase in SOD was statistically more in the patients given vitamin C in addition to amlodipine (0.1717 ± 0.0150 compared to 0.152 ± 0.0219 units/100 ml assay). In spite of the known antihypertensive, antioxidant activity, similarity in correcting endothelial dysfunction independently, giving the two drugs together and early introduction of vitamin C perhaps decreases oxidative stress and augments the antioxidant status. This may prevent further vascular damage due to oxidative stress, leading to a better prognosis in essential hypertension patients.
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Affiliation(s)
- Aarti S Mahajan
- Department of Physiology, Maulana Azad Medical College and Lok Nayak, Hospital, New Delhi 110002, India
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31
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Seefeldt TM, Bennet LL. The Role of Antioxidant Vitamins in Cardiovascular Disease. J Pharm Technol 2011. [DOI: 10.1177/875512251102700105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To review the current data on the role of antioxidant vitamins in cardiovascular disease. Data Sources: Articles were obtained from a MEDLINE search covering all years. Terms used in the search included combinations of antioxidant, vitamin, vitamin E, vitamin C, beta-carotene, and cardiovascular disease. Reference lists from articles were examined for additional references. Study Selection and Data Extraction: Randomized clinical trials were selected and evaluated for study design and data obtained. Observational studies, meta-analyses, and basic science articles were also reviewed for background. Data Synthesis: The use of dietary supplements, including vitamins, minerals, and herbal products, is common among patients in the US. Vitamin E, vitamin C, and beta-carotene are all supplements with reported antioxidant activity. Because oxidative stress has been implicated in the development of cardiovascular disease, there has been significant research at the basic science level as well as observational studies and randomized placebo-controlled trials examining the potential impact of vitamin E, vitamin C, and beta-carotene in the prevention and treatment of cardiovascular disease. While basic science data and data from observational studies have identified benefit from antioxidant vitamin supplementation, randomized clinical trials have failed to support a role for antioxidant vitamin supplementation in the prevention or treatment of cardiovascular disease. Conclusions: Data from randomized clinical trials do not support the use of antioxidant vitamins in cardiovascular disease. Therefore, antioxidant vitamins should not be recommended to patients for prevention or treatment of cardiovascular disease.
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Affiliation(s)
- Teresa M Seefeldt
- TERESA M SEEFELDT PhD PharmD, Assistant Professor of Pharmaceutical Sciences, College of Pharmacy, South Dakota State University, Brookings, SD
| | - Lunawati L Bennet
- LUNAWATI L BENNET PhD PharmD, Assistant Professor of Pharmaceutical Sciences, Lloyd Gregory School of Pharmacy, Palm Beach Atlantic University, West Palm Beach, FL
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Tousoulis D, Papageorgiou N, Androulakis E, Paroutoglou K, Stefanadis C. Novel therapeutic strategies targeting vascular endothelium in essential hypertension. Expert Opin Investig Drugs 2010; 19:1395-412. [DOI: 10.1517/13543784.2010.522989] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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33
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Appel LJ, Giles TD, Black HR, Izzo JL, Materson BJ, Oparil S, Weber MA. ASH position paper: dietary approaches to lower blood pressure. ACTA ACUST UNITED AC 2010; 4:79-89. [PMID: 20400052 DOI: 10.1016/j.jash.2010.03.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2008] [Accepted: 11/06/2008] [Indexed: 01/11/2023]
Abstract
A substantial body of evidence has implicated several aspects of diet in the pathogenesis of elevated blood pressure (BP). Well-established risk factors for elevated BP include excess salt intake, low potassium intake, excess weight, high alcohol consumption, and suboptimal dietary pattern. African Americans are especially sensitive to the BP-raising effects of excess salt intake, insufficient potassium intake, and suboptimal diet. In this setting, dietary changes have the potential to substantially reduce racial disparities in BP and its consequences. In view of the age-related rise in BP in both children and adults, the direct, progressive relationship of BP with cardiovascular-renal diseases throughout the usual range of BP, and the worldwide epidemic of BP-related disease, efforts to reduce BP in nonhypertensive as well as hypertensive individuals are warranted. In nonhypertensives, dietary changes can lower BP and delay, if not prevent, hypertension. In uncomplicated stage I hypertension, dietary changes serve as initial treatment before drug therapy. In hypertensive individuals already on drug therapy, lifestyle modifications can further lower BP. The current challenge is designing and implementing effective clinical and public health interventions that lead to sustained dietary changes among individuals and more broadly in the general population.
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Affiliation(s)
- Lawrence J Appel
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
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35
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Gokah TK, Gumpo R. Enabling and empowering--the need for an integrated approach to address hypertension among African adults. HEALTH EDUCATION RESEARCH 2010; 25:510-518. [PMID: 20385625 DOI: 10.1093/her/cyq028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This paper charts analytic and conceptual debates on the burden of hypertension among Africans and the interlocking role of diet and genetic factors. The discussions in this paper are about (indigenous) rather than (white) Africans. In trying to show understanding in the issues raised within this paper, the debate highlights the increasing burden of hypertension in Africans. The paper also mentions the role of adverse factors over the life course on hypertension, which is described in public health literature as a widespread burden. It also mentions that there appears to be an increasing prevalence of high blood pressure among Africans explained by widespread nutrition transitions to lipid-rich diets and a decrease in physical activity; as a result, hypertension has become a ubiquitous cause of morbidity and contributor to mortality among Africans. While these issues are acknowledged, the authors argue that it is not enough to think that persuading and encouraging poorer households to purchase 'cheap' and less fatty foods will address nutritional problems. It is one thing making food available and it is another putting the food basket on the table. Both conditions require negotiations of complex political, social, economic, cultural and environmental hurdles. What is needed is reorienting existing health care systems to meet these challenges while empowering and saturating African populations and households with systematic but intense health information, education and communication.
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Affiliation(s)
- Theophilus K Gokah
- Visiting Lecturer, Royal London College, 82-88 Mile End Road, London, E1 4UN, UK.
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Sucher R, Gehwolf P, Oberhuber R, Hermann M, Margreiter C, Werner ER, Obrist P, Schneeberger S, Ollinger R, Margreiter R, Brandacher G. Tetrahydrobiopterin protects the kidney from ischemia-reperfusion injury. Kidney Int 2010; 77:681-9. [PMID: 20164829 DOI: 10.1038/ki.2010.7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Tetrahydrobiopterin (BH4) is an essential cofactor for the nitric oxide (NO) synthases and represents a critical determinant of NO production. BH4 depletion during ischemia leads to the uncoupling of the synthases, thus contributing to reperfusion injury due to increased superoxide formation. To examine whether BH4 supplementation attenuates ischemia-reperfusion injury, we clamped the left renal arteries of male Lewis rats immediately following right-side nephrectomy. BH4 tissue levels significantly decreased after 45 min of warm ischemia compared with levels in non-ischemic controls. Histopathology demonstrated significant tubular damage and increased peroxynitrite formation. Intravital fluorescent microscopy found perfusion deficits in the microvasculature and leakage of the capillary mesh. Supplemental BH4 treatment before ischemia significantly reduced ischemia-induced renal dysfunction, and decreased tubular histologic injury scores and peroxynitrite generation. BH4 also significantly improved microcirculatory parameters such as functional capillary density and diameter. These protective effects of BH4 on microvasculature were significantly correlated with its ability to abolish peroxynitrite formation. We suggest that BH4 significantly protects against acute renal failure following ischemia reperfusion. Whether BH4 has a therapeutic potential will require more direct testing in humans.
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Affiliation(s)
- Robert Sucher
- Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Innsbruck Medical University, Innsbruck, Austria
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Abstract
Hypertension in association with oxidative stress belongs to the most discussed topics within the literature on cardiovascular diseases. It is generally believed that elevated production of reactive oxygen species (ROS) plays an important role in hypertension, but clinical studies on chronic antioxidant therapy of hypertension fail to confirm this hypothesis. This discrepancy may be partly determined by the different effects of short and long-lasting treatment with antioxidants or scavengers. Elevated ROS production in hypertension need not be only harmful. It may also stimulate the activity of the antioxidant defence system and improve the nitric oxide (NO)/cyclic 3', 5'-guanosine monophosphate pathway, resulting in the establishment of a new equilibrium between enhanced oxidative load and the stimulated NO pathway, thus maintaining sufficient NO bioavailability. It has been suggested that antioxidant treatment might be beneficial for a short time, until increased NO generation predominates over ROS production. Further weakening of ROS formation by antioxidants may attenuate nuclear factor kappa B activation resulting in decreased endothelial NO synthase expression and activity. Prolonged antioxidant therapy may thus attenuate the beneficial regulatory effect of ROS, leading to decreased NO generation and the re-establishment of the undesirable disproportion between deleterious and protective forces. As a consequence prolonged antioxidant treatment in human hypertension may fail to provide the expected clinical profit.
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Appel LJ, Giles TD, Black HR, Izzo JL, Materson BJ, Oparil S, Weber MA. ASH Position Paper: Dietary approaches to lower blood pressure. J Clin Hypertens (Greenwich) 2009; 11:358-68. [PMID: 19583632 DOI: 10.1111/j.1751-7176.2009.00136.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A substantial body of evidence has implicated several aspects of diet in the pathogenesis of elevated blood pressure (BP). Well-established risk factors for elevated BP include excess salt intake, low potassium intake, excess weight, high alcohol consumption, and suboptimal dietary pattern. African Americans are especially sensitive to the BP-raising effects of excess salt intake, insufficient potassium intake, and suboptimal diet. In this setting, dietary changes have the potential to substantially reduce racial disparities in BP and its consequences. In view of the age-related rise in BP in both children and adults, the direct, progressive relationship of BP with cardiovascular-renal diseases throughout the usual range of BP, and the worldwide epidemic of BP-related disease, efforts to reduce BP in nonhypertensive as well as hypertensive individuals are warranted. In nonhypertensives, dietary changes can lower BP and delay, if not prevent, hypertension. In uncomplicated stage I hypertension, dietary changes serve as initial treatment before drug therapy. In hypertensive individuals already on drug therapy, lifestyle modifications can further lower BP. The current challenge is designing and implementing effective clinical and public health interventions that lead to sustained dietary changes among individuals and more broadly in the general population.
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Affiliation(s)
- Lawrence J Appel
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University, Baltimore, MD 21205-2223, USA.
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Vecchione C, Carnevale D, Di Pardo A, Gentile MT, Damato A, Cocozza G, Antenucci G, Mascio G, Bettarini U, Landolfi A, Iorio L, Maffei A, Lembo G. Pressure-induced vascular oxidative stress is mediated through activation of integrin-linked kinase 1/betaPIX/Rac-1 pathway. Hypertension 2009; 54:1028-34. [PMID: 19770407 DOI: 10.1161/hypertensionaha.109.136572] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
High blood pressure induces a mechanical stress on vascular walls and evokes oxidative stress and vascular dysfunction. The aim of this study was to characterize the intracellular signaling causing vascular oxidative stress in response to pressure. In carotid arteries subjected to high pressure levels, we observed not only an impaired vasorelaxation, increased superoxide production, and NADPH oxidase activity, but also a concomitant activation of Rac-1, a small G protein. Selective inhibition of Rac-1, with an adenovirus carrying a dominant-negative Rac-1 mutant, significantly reduced NADPH oxidase activity and oxidative stress and, more importantly, rescued vascular function in carotid arteries at high pressure. The analysis of molecular events associated with mechanotransduction demonstrated at high pressure levels an overexpression of integrin-linked kinase 1 and its recruitment to plasma membrane interacting with paxillin. The inhibition of integrin-linked kinase 1 by small interfering RNA impaired Rac-1 activation and rescued oxidative stress-induced vascular dysfunction in response to high pressure. Finally, we showed that betaPIX, a guanine-nucleotide exchange factor, is the intermediate molecule recruited by integrin-linked kinase 1, converging the intracellular signaling toward Rac-1-mediated oxidative vascular dysfunction during pressure overload. Our data demonstrate that biomechanical stress evoked by high blood pressure triggers an integrin-linked kinase 1/betaPIX/Rac-1 signaling, thus generating oxidative vascular dysfunction.
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Affiliation(s)
- Carmine Vecchione
- Department of Angio-Cardio-Neurology, Neuromed Institute Istituto Di Ricovero e Cura a Carattere Scientifico, Pozzilli, Italy
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Loffredo L, Violi F. The Role of Nicotinamide Adenine Dinucleotide Phosphate Oxidase in the Pathogenesis of Hypertension. High Blood Press Cardiovasc Prev 2009. [DOI: 10.2165/11316970-000000000-00000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Jiang F, Drummond GR, Dusting GJ. Suppression of Oxidative Stress in the Endothelium and Vascular Wall. ACTA ACUST UNITED AC 2009; 11:79-88. [PMID: 15370067 DOI: 10.1080/10623320490482600] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
There is growing evidence that oxidative stress, meaning an excessive production of reactive oxygen and nitrogen species, underlies many forms of cardiovascular disease. The major source of oxidative stress in the artery wall is an NADPH oxidase. This enzyme complex in vascular cells, including endothelium, differs from that in phagocytic leucocytes in both biochemical structure and functions. The crucial flavin-containing catalytic subunits Nox1 and Nox4 are not present in leucocytes, but are highly expressed in vascular cells and upregulated in vascular remodeling, such as that found in hypertension and atherosclerosis. This offers the opportunity to develop "vascular specific" NADPH oxidase inhibitors that do not compromise the essential physiological signaling and phagocytic function carried out by reactive oxygen and nitrogen molecules. Although many conventional antioxidants fail to significantly affect outcomes in cardiovascular disease, targeted inhibitors of NADPH oxidase that block the source of oxidative stress in the vasculature are more likely to prevent the deterioration of vascular function that leads to stroke and heart attack.
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Affiliation(s)
- Fan Jiang
- Howard Florey Institute, University of Melbourne, Victoria, Australia
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42
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Schyvens CG, Andrews MC, Tam R, Mori TA, Croft KD, McKenzie KU, Whitworth JA, Zhang Y. Antioxidant Vitamins and Adrenocorticotrophic Hormone-Induced Hypertension in Rats. Clin Exp Hypertens 2009; 29:465-78. [DOI: 10.1080/10641960701615774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Simonsen U, Christensen FH, Buus NH. The effect of tempol on endothelium-dependent vasodilatation and blood pressure. Pharmacol Ther 2009; 122:109-24. [DOI: 10.1016/j.pharmthera.2009.02.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Accepted: 02/05/2009] [Indexed: 02/07/2023]
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Abstract
This review has summarized some of the data supporting a role of ROS and oxidant stress in the genesis of hypertension. There is evidence that hypertensive stimuli, such as high salt and angiotensin II, promote the production of ROS in the brain, the kidney, and the vasculature and that each of these sites contributes either to hypertension or to the untoward sequelae of this disease. Although the NADPH oxidase in these various organs is a predominant source, other enzymes likely contribute to ROS production and signaling in these tissues. A major clinical challenge is that the routinely used antioxidants are ineffective in preventing or treating cardiovascular disease and hypertension. This is likely because these drugs are either ineffective or act in a non-targeted fashion, such that they remove not only injurious ROS Fig. 5. Proposed role of T cells in the genesis of hypertension and the role of the NADPH oxidase in multiple cells/organs in modulating this effect. In this scenario, angiotensin II stimulates an NADPH oxidase in the CVOs of the brain, increasing sympathetic outflow. Sympathetic nerve terminals in lymph nodes activate T cells, and angiotensin II also directly activates T cells. These stimuli also activate expression of homing signals in the vessel and likely the kidney, which attract T cells to these organs. T cells release cytokines that stimulate the vessel and kidney NADPH oxidases, promoting vasoconstriction and sodium retention. SFO, subfornical organ. 630 Harrison & Gongora but also those involved in normal cell signaling. A potentially important and relatively new direction is the concept that inflammatory cells such as T cells contribute to hypertension. Future studies are needed to understand the interaction of T cells with the CNS, the kidney, and the vasculature and how this might be interrupted to provide therapeutic benefit.
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Affiliation(s)
- David G Harrison
- Department of Medicine, Division of Cardiology, Emory University School of Medicine and the Atlanta Veterans Administration Hospital, Atlanta, GA 30322, USA.
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Hatzitolios A, Iliadis F, Katsiki N, Baltatzi M. Is the anti-hypertensive effect of dietary supplements via aldehydes reduction evidence based? A systematic review. Clin Exp Hypertens 2009; 30:628-39. [PMID: 18855266 DOI: 10.1080/10641960802443274] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Growing evidence indicates that insulin resistance and oxidative stress are involved in the pathogenesis of essential hypertension. In insulin-resistant states, like obesity and type 2 diabetes, altered glucose metabolism may lead to increased formation of methylglyoxal and other ketoaldehydes. Animal studies have shown that increased levels of endogenous aldehydes may lead to hypertension and oxidative stress. In animal models, the administration of vitamin C, vitamin B6 or alpha-lipoic acid reduced tissue levels of aldehydes, prevented oxidative stress, and lowered blood pressure. The purpose of this review article is to critically evaluate the available evidence for the role of dietary supplements in hypertension treatment.
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Affiliation(s)
- Apostolos Hatzitolios
- 1st Propedeutic Department of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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46
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Apocynin attenuates tubular apoptosis and tubulointerstitial fibrosis in transgenic mice independent of hypertension. Kidney Int 2009; 75:156-66. [DOI: 10.1038/ki.2008.509] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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47
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Block G, Jensen CD, Norkus EP, Hudes M, Crawford PB. Vitamin C in plasma is inversely related to blood pressure and change in blood pressure during the previous year in young Black and White women. Nutr J 2008; 7:35. [PMID: 19091068 PMCID: PMC2621233 DOI: 10.1186/1475-2891-7-35] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2007] [Accepted: 12/17/2008] [Indexed: 01/03/2023] Open
Abstract
Background The prevalence of hypertension and its contribution to cardiovascular disease risk makes it imperative to identify factors that may help prevent this disorder. Extensive biological and biochemical data suggest that plasma ascorbic acid may be such a factor. In this study we examined the association between plasma ascorbic acid concentration and blood pressure (BP) in young-adult women. Methods Participants were 242 Black and White women aged 18–21 yr from the Richmond, CA, cohort of the National Heart, Lung and Blood Institute Growth and Health Study. We examined the associations of plasma ascorbic acid with BP at follow-up year 10, and with change in BP during the previous year. Results In cross-sectional analysis, plasma ascorbic acid at year 10 was inversely associated with systolic BP and diastolic BP after adjusting for race, body mass index, education, and dietary intake of fat and sodium. Persons in the highest one-fourth of the plasma ascorbic acid distribution had 4.66 mmHg lower systolic BP (95% CI 1.10 to 8.22 mmHg, p = 0.005) and 6.04 mmHg lower diastolic BP (95% CI 2.70 to 9.38 mmHg, p = 0.0002) than those in the lowest one-fourth of the distribution. In analysis of the change in BP, plasma ascorbic acid was also inversely associated with change in systolic BP and diastolic BP during the previous year. While diastolic blood pressure among persons in the lowest quartile of plasma ascorbic acid increased by 5.97 mmHg (95% CI 3.82 to 8.13 mmHg) from year 9 to year 10, those in the highest quartile of plasma vitamin C increased by only 0.23 mmHg (95% CI -1.90 to +2.36 mmHg) (test for linear trend: p < 0.0001). A similar effect was seen for change in systolic BP, p = 0.005. Conclusion Plasma ascorbic acid was found to be inversely associated with BP and change in BP during the prior year. The findings suggest the possibility that vitamin C may influence BP in healthy young adults. Since lower BP in young adulthood may lead to lower BP and decreased incidence of age-associated vascular events in older adults, further investigation of treatment effects of vitamin C on BP regulation in young adults is warranted.
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Affiliation(s)
- Gladys Block
- School of Public Health, 50 University Hall, University of California, Berkeley, CA 94720, USA.
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48
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Abstract
CVD is a major cause of mortality and morbidity in the Western world. In recent years its importance has expanded internationally and it is believed that by 2020 it will be the biggest cause of mortality in the world, emphasising the importance to prevent or minimise this increase. A beneficial role for vitamins in CVD has long been explored but the data are still inconsistent. While being supported by observational studies, randomised controlled trials have not yet supported a role for vitamins in primary or secondary prevention of CVD and have in some cases even indicated increased mortality in those with pre-existing late-stage atherosclerosis. The superiority of combination therapy over single supplementation has been suggested but this has not been confirmed in trials. Studies have indicated that beta-carotene mediates pro-oxidant effects and it has been suggested that its negative effects may diminish the beneficial effects mediated by the other vitamins in the supplementation cocktail. The trials that used a combination of vitamins that include beta-carotene have been disappointing. However, vitamin E and vitamin C have in combination shown long-term anti-atherogenic effects but their combined effect on clinical endpoints has been inconsistent. Studies also suggest that vitamins would be beneficial to individuals who are antioxidant-deficient or exposed to increased levels of oxidative stress, for example, smokers, diabetics and elderly patients, emphasising the importance of subgroup targeting. Through defining the right population group and the optimal vitamin combination we could potentially find a future role for vitamins in CVD.
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Lopez-Ruiz A, Sartori-Valinotti J, Yanes LL, Iliescu R, Reckelhoff JF. Sex differences in control of blood pressure: role of oxidative stress in hypertension in females. Am J Physiol Heart Circ Physiol 2008; 295:H466-74. [PMID: 18567715 PMCID: PMC2519220 DOI: 10.1152/ajpheart.01232.2007] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In general, blood pressure is higher in normotensive men than in age-matched women, and the prevalence of hypertension in men is also higher until after menopause, when the prevalence of hypertension increases for women. It is likely then that the mechanisms by which blood pressure increases in men and women with aging may be different. Although clinical trials to reduce blood pressure with antioxidants have typically not been successful in human cohorts, studies in male rats suggest that oxidative stress plays an important role in mediating hypertension. The exact mechanisms by which oxidative stress increases blood pressure have not been completely elucidated. There may be several reasons for the discrepancies between clinical and animal studies. In this review, the data obtained in selected clinical and animal studies are discussed, and the hypothesis is put forward that oxidative stress may not be as important in mediating hypertension in females as has been shown previously in male rats. Furthermore, it is likely that differences in genetics, age, length of time with hypertension, endothelial dysfunction, and sex are all factored in to modulate the responses to antioxidants in humans. As such, future clinical trials should be designed and powered to evaluate the effects of oxidative stress on blood pressure separately in men and women.
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Affiliation(s)
- Arnaldo Lopez-Ruiz
- Dept. of Physiology and Biophysics, Univ. of Mississippi Medical Center, 2500 North State St., Jackson, MS 39216-4505, USA
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Bjelakovic G, Nikolova D, Simonetti RG, Gluud C. Antioxidant supplements for preventing gastrointestinal cancers. Cochrane Database Syst Rev 2008:CD004183. [PMID: 18677777 DOI: 10.1002/14651858.cd004183.pub3] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Oxidative stress may cause gastrointestinal cancers. The evidence on whether antioxidant supplements are effective in preventing gastrointestinal cancers is contradictory. OBJECTIVES To assess the beneficial and harmful effects of antioxidant supplements in preventing gastrointestinal cancers. SEARCH STRATEGY We identified trials through the trials registers of the four Cochrane Review Groups on gastrointestinal diseases, The Cochrane Central Register of Controlled Trials in The Cochrane Library (Issue 2, 2007), MEDLINE, EMBASE, LILACS, SCI-EXPANDED, and The Chinese Biomedical Database from inception to October 2007. We scanned reference lists and contacted pharmaceutical companies. SELECTION CRITERIA Randomised trials comparing antioxidant supplements to placebo/no intervention examining occurrence of gastrointestinal cancers. DATA COLLECTION AND ANALYSIS Two authors (GB and DN) independently selected trials for inclusion and extracted data. Outcome measures were gastrointestinal cancers, overall mortality, and adverse effects. Outcomes were reported as relative risks (RR) with 95% confidence interval (CI) based on random-effects and fixed-effect model meta-analysis. Meta-regression assessed the effect of covariates across the trials. MAIN RESULTS We identified 20 randomised trials (211,818 participants), assessing beta-carotene (12 trials), vitamin A (4 trials), vitamin C (8 trials), vitamin E (10 trials), and selenium (9 trials). Trials quality was generally high. Heterogeneity was low to moderate. Antioxidant supplements were without significant effects on gastrointestinal cancers (RR 0.94, 95% CI 0.83 to 1.06). However, there was significant heterogeneity (I(2) = 54.0%, P = 0.003). The heterogeneity may have been explained by bias risk (low-bias risk trials RR 1.04, 95% CI 0.96 to 1.13 compared to high-bias risk trials RR 0.59, 95% CI 0.43 to 0.80; test of interaction P < 0.0005), and type of antioxidant supplement (beta-carotene potentially increasing and selenium potentially decreasing cancer risk). The antioxidant supplements had no significant effects on mortality in a random-effects model meta-analysis (RR 1.02, 95% CI 0.97 to 1.07, I(2) = 53.5%), but significantly increased mortality in a fixed-effect model meta-analysis (RR 1.04, 95% CI 1.02 to 1.07). Beta-carotene in combination with vitamin A (RR 1.16, 95% CI 1.09 to 1.23) and vitamin E (RR 1.06, 95% CI 1.02 to 1.11) significantly increased mortality. Increased yellowing of the skin and belching were non-serious adverse effects of beta-carotene. In five trials (four with high risk of bias), selenium seemed to show significant beneficial effect on gastrointestinal cancer occurrence (RR 0.59, 95% CI 0.46 to 0.75, I(2) = 0%). AUTHORS' CONCLUSIONS We could not find convincing evidence that antioxidant supplements prevent gastrointestinal cancers. On the contrary, antioxidant supplements seem to increase overall mortality. The potential cancer preventive effect of selenium should be tested in adequately conducted randomised trials.
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Affiliation(s)
- Goran Bjelakovic
- Copenhagen Trial Unit, Centre for Clinical Intervention Research,, Department 3344, Rigshospitalet, Copenhagen University Hospital,, Blegdamsvej 9, Copenhagen, Denmark, DK-2100.
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