The Relationship Between Microvascular Endothelial Function and Carotid-Radial Pulse Wave Velocity in Patients with Mild Hypertension

Carotid-radial pulse wave velocity (CRPWV) can be measured rapidly using applanation tonometry and significantly higher values have been reported among patients with risk factors for vascular disease. Forearm blood flow responses to intrabrachial infusion of acetylcholine independently predict cardiovascular morbidity among hypertensive patients. We aimed to examine the relationship between CRPWV, a potentially informative, noninvasive measure and this more established parameter of arterial health.One hundred and fifteen mildly hypertensive individuals (67% men, mean (± SD) age 54 ± 8 years, mean (± SD) blood pressure (BP) 143 ± 16/83 ± 12 mmHg) were recruited from a weekly medical outpatient clinic. Each volunteer had CRPWV measured using sequential tonometry before forearm blood flow responses to intra-arterial, endothelium-dependent (acetylcholine) and independent (sodium nitroprusside) vasodilators were assessed.There was a significant negative correlation between CRPWV and maximum forearm blood flow response to acetylcholine (r = −0.225, p = 0.016). This association remained significant in a multiple regression analysis (β = −0.213, p = 0.034). Mean arterial pressure and weight were additional independent predictors of CRPWV in this model. There was no such relationship between CRPWV and response to sodium nitroprusside (r = 0.088, p = 0.349).In patients with mild hypertension, a poor forearm blood flow response to acetylcholine independently predicted faster CRPWV, thus linking an established measure of microvascular endothelial function with a noninvasive index of conduit vessel stiffness.<br/

The effect of increased fruit and vegetable consumption on selected macronutrient and micronutrient intakes in four randomised-controlled trials

AbstractFruit and vegetable (FV) intake is associated with reduced risk of a number of non-communicable diseases. Research tends to focus on antioxidants, flavonoids and polyphenols contained in FV as the main beneficial components to health; however, increasing FV may also alter overall diet profile. Extra FV may be substituted for foods thought to be less healthy, therefore altering the overall macronutrient and/or micronutrient content in the diet. This analysis merged dietary data from four intervention studies in participants with varying health conditions and examined the effect of increased FV consumption on diet profile. Dietary intake was assessed by either diet diaries or diet histories used in four FV randomised intervention studies. All food and drink intake recorded was analysed using WISP version 3.0, and FV portions were manually counted using household measures. Regression analysis revealed significant increases in intakes of energy (172 kJ (+41 kcal)), carbohydrate (+3·9 g/4184 kJ (1000 kcal)), total sugars (+6·0 g/4184 kJ (1000 kcal)) and fibre (+0·8 g/4184 kJ (1000 kcal)) and significant decreases in intakes of total fat (−1·4 g/4184 kJ (1000 kcal)), SFA (−0·6 g/4184 kJ (1000 kcal)), MUFA (−0·6 g/4184 kJ (1000 kcal)), PUFA (−0·1 g/4184 kJ (1000 kcal)) and starch (−2·1 g/4184 kJ (1000 kcal)) per one portion increase in FV. Significant percentage increases were also observed in vitamin C (+24 %) and -carotene (+20 %) intake, per one portion increase in FV. In conclusion, pooled analysis of four FV intervention studies, that used similar approaches to achieving dietary change, in participants with varying health conditions, demonstrated an increase in energy, total carbohydrate, sugars and fibre intake, and a decrease in fat intake alongside an expected increase in micronutrient intake.</jats:p

Serum amyloid A-related inflammation is lowered by increased fruit and vegetable intake, while high-sensitive C-reactive protein, IL-6 and E-selectin remain unresponsive

The present study assessed whether increased fruit and vegetable (F&amp;V) intake reduced the concentrations of the inflammatory marker serum amyloid A (SAA) in serum, HDL2and HDL3and whether the latter reduction influenced any of the functional properties of these HDL subfractions. The present study utilised samples from two previous studies: (1) the FAVRIT (Fruit and Vegetable Randomised Intervention Trial) study – hypertensive subjects (systolic blood pressure (BP) range 140–190 mmHg; diastolic BP range 90–110 mmHg) were randomised to receive a 1-, 3- or 6-portion F&amp;V/d intervention for 8 weeks, and (2) the ADIT (Ageing and Dietary Intervention Trial) study – older subjects (65–85 years) were randomised to receive a 2- or 5-portion F&amp;V/d intervention for 16 weeks. HDL2and HDL3were isolated by rapid ultracentrifugation. Measurements included the following: serum high-sensitive C-reactive protein (hsCRP) by an immunoturbidimetric assay; serum IL-6 and E-selectin and serum-, HDL2- and HDL3-SAA by ELISA procedures; serum-, HDL2- and HDL3-cholesterol ester transfer protein (CETP) activity by a fluorometric assay. Although the concentrations of hsCRP, IL-6 and E-selectin were unaffected by increasing F&amp;V intake in both studies (P&gt;0·05 for all comparisons), those of SAA in HDL3decreased in the FAVRIT cohort (P= 0·049) and those in HDL2and HDL3decreased in the ADIT cohort (P= 0·035 and 0·032), which was accompanied by a decrease in the activity of CETP in HDL3in the FAVRIT cohort (P= 0·010) and in HDL2in the ADIT cohort (P= 0·030). These results indicate that SAA responds to increased F&amp;V intake, while other inflammatory markers remain unresponsive, and this leads to changes in HDL2and HDL3, which may influence their antiatherogenic potential. Overall, the present study provides tangible evidence of the effectiveness of increased F&amp;V intake, which may be of use to health policy makers and the general public.</jats:p

The effect of increased fruit and vegetable consumption on blood pressure and lipids: a pooled analysis of six randomised controlled fruit and vegetable intervention trials

BackgroundIncreasing fruit and vegetable (FV) consumption is associated with reduced cardiovascular disease risk in observational studies but with little evidence from randomised controlled trials (RCTs). The impact of concurrent pharmacological therapy is unknown.ObjectiveTo pool data from six RCTs to examine the effect of increasing FV intake on blood pressure (BP) and lipid profile, also exploring whether effects differed by medication use.DesignAcross trials, dietary intake was assessed by diet diaries or histories, lipids by routine biochemical methods and BP by automated monitors. Linear regression provided an estimate of the change in lipid profile or BP associated with a one portion increase in self-reported daily FV intake, with interaction terms fitted for medication use.ResultsThe pooled sample included a total of 554 participants (308 males and 246 females). Meta-analysis of regression coefficients revealed no significant change in either systolic or diastolic BP per portion FV increase, although there was significant heterogeneity across trials for systolic BP (I2 = 73%). Neither adjusting for change in body mass index, nor analysis according to use of anti-hypertensive medication altered the relationship. There was no significant change in lipid profile per portion FV increase, although there was a significant reduction in total cholesterol among those not on lipid-lowering therapy (P &lt; 0.05 after Bonferroni correction).ConclusionPooled analysis of six individual FV trials showed no impact of increasing intake on BP or lipids, but there was a total cholesterol-lowering effect in those not on lipid-lowering therapy.<br/