Dietary inorganic nitrate/nitrite supplementation reduces central and peripheral blood pressure in patients with type 2 diabetes mellitus

Joshua M Bock; William E Hughes; Kenichi Ueda; Andrew J Feider; Satoshi Hanada; Darren P Casey

doi:10.1093/ajh/hpac068

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Dietary inorganic nitrate/nitrite supplementation reduces central and peripheral blood pressure in patients with type 2 diabetes mellitus

Journal article

Open access

Peer reviewed

Dietary inorganic nitrate/nitrite supplementation reduces central and peripheral blood pressure in patients with type 2 diabetes mellitus

Joshua M Bock, William E Hughes, Kenichi Ueda, Andrew J Feider, Satoshi Hanada and Darren P Casey

American journal of hypertension, Vol.35(9), pp.803-809

05/26/2022

DOI: 10.1093/ajh/hpac068

PMCID: PMC9434218

PMID: 35639721

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9434218View

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Abstract

Patients with type 2 diabetes mellitus (T2DM) have increased cardiovascular risk partially due to elevated blood pressure (BP). As low levels of nitric oxide (NO) may contribute to increased BP, we studied the effects of increasing NO bioavailability via 8wks of supplementation with beetroot juice containing inorganic nitrate/nitrite (4.03mmol nitrate, 0.29mmol nitrite, n=19) on central and peripheral BP relative to nitrate/nitrite-depleted beetroot juice (n=18). Peripheral BP was measured via an indwelling brachial arterial catheter maintained at heart-level with central BP, as well as augmentation index (AIx), measured using applanation tonometry while subjects were supine. Plasma nitrate and nitrite increased following inorganic nitrate/nitrite (both p<0.05), but not placebo (p=0.63 and 0.57) supplementation. Nitrate/nitrite supplementation reduced peripheral systolic BP (148±16 to 142±18mmHg, p<0.05) but not placebo (150±19 to 149±17mmHg, p=0.93); however, diastolic BP and pulse pressure were unaffected (supplement-by-time p=0.08 and 0.22). Central systolic BP (131±16 to 127±17mmHg) and augmented pressure (13.3±6.6 to 11.6±6.9mmHg, both p<0.05) were reduced after nitrate/nitrite, but not placebo (134±17 to 135±16mmHg, p=0.62; 14.1±6.6 to 15.2±7.4mmHg, p=0.20); neither central diastolic BP nor pulse pressure changed during the interventions (supplement-by-time p=0.16 and 0.39). Inorganic nitrate/nitrite reduced both AIx (24.3±9.9 to 21.0±9.6%) and AIx normalized to a heart rate of 75bpm (21.9±10.8 to 18.5±10.6%, both p<0.05) whereas no changes were observed following placebo (24.6±9.3 to 25.6±9.9%, p=0.46; 23.0±7.0 to 24.1±9.2%, p=0.51). Our data indicate inorganic nitrate/nitrite supplementation improves peripheral and central BP as well as AIx in patients with T2DM.

arterial stiffness

blood pressure

nitric oxide

augmentation index

Details

Title: Subtitle: Dietary inorganic nitrate/nitrite supplementation reduces central and peripheral blood pressure in patients with type 2 diabetes mellitus
Creators: Joshua M Bock - University of Iowa
William E Hughes - University of Iowa
Kenichi Ueda - University of Iowa
Andrew J Feider - University of Iowa
Satoshi Hanada - University of Iowa
Darren P Casey - University of Iowa
Resource Type: Journal article
Publication Details: American journal of hypertension, Vol.35(9), pp.803-809
DOI: 10.1093/ajh/hpac068
PMID: 35639721
PMCID: PMC9434218
NLM abbreviation: Am J Hypertens
ISSN: 0895-7061
eISSN: 1879-1905
Grant note: DOI: 10.13039/100000041, name: American Diabetes Association, award: 1-16-1CTS-015; DOI: 10.13039/100000002, name: National Institutes of Health, award: P30 CA086862
Language: English
Date published: 05/26/2022
Academic Unit: Anesthesia; Physical Therapy and Rehabilitation Science; Fraternal Order of Eagles Diabetes Research Center
Record Identifier: 9984295059602771

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