Nutraceuticals and Hypertensive Disorders in Pregnancy: The Available Clinical Evidence

The aim of the present critical review is to summarize the available clinical evidence supporting the use of some dietary supplements that have been shown to lower blood pressure in hypertensive pregnant women. A systematic search strategy was carried out to identify trials in MEDLINE (National Library of Medicine, Bethesda, Maryland, MD, USA; January 1980 to September 2019) and the Cochrane Register of Controlled Trials (The Cochrane Collaboration, Oxford, UK). The terms \u2018nutraceuticals\u2019, \u2018dietary supplements\u2019, \u2018pregnancy\u2019, \u2018pre-eclampsia\u2019, \u2018clinical trial\u2019, and \u2018human\u2019 were incorporated into an electronic search strategy. The references of the identified studies and review articles were reviewed to look for additional studies of interest. We preferably selected papers that reported recent comprehensive reviews or meta-analysis, or original clinical trials of substances with blood pressure-lowering or vascular protective effect in pregnancy. There is a relative body of evidence that supports the use of calcium, vitamin D, folic acid, and resveratrol in preventing the development of hypertensive disorders in pregnancy, and evidence supporting drug treatment too. Further clinical research is advisable to identify the dosage and timing of the supplementation, the group of women that might benefit the most from this approach, and the nutraceuticals with the best cost-effectiveness and risk-benefit ratio for widespread use in clinical practice

Vitamin D supplementation and incident preeclampsia: a systematic review and meta-analysis of randomized clinical trials

Background: Maternal vitamin D deficiency has been associated with an increased risk for preeclampsia. Despite this, the current evidence regarding the efficacy of vitamin D supplementation in preventing preeclampsia is controversial. To assess the impact of vitamin D supplementation on the risk of preeclampsia, we performed a systematic review of the literature and a meta-analysis of the available randomized clinical trials (RCTs). Methods: The primary outcome was preeclampsia. Subgroup analyses were carried out considering the timing of the supplementation, type of intervention and the study design. Meta-regression analysis, including the amount of vitamin D and maternal age, were planned to explore heterogeneity (PROSPERO database registration number: CRD42019119207). Results: Data were pooled from 27 RCTs comprising 59 arms, which included overall 4777 participants, of whom 2487 were in the vitamin D-treated arm and 2290 in the control arm. Vitamin D administration in pregnancy was associated with a reduced risk of preeclampsia (odd ratio [OR] 0.37, 95% confidence interval [CI]: 0.26, 0.52; I2 = 0%). If the vitamin D supplementation was started up to 20 weeks' gestation, the odds was a little lower (OR 0.35, 95% CI: 0.24, 0.50, p < 0.001). The effect was largely independent of the supplementation cessation (until delivery or not), type of intervention (vitamin D alone or in association with calcium), and study design. Increasing dose of vitamin D was associated with reduced incidence of preeclampsia (slope of log OR: -1.1, 95% CI: -1.73, -0.46; p < 0.001). Conclusions: Results suggest that vitamin D supplementation may be useful in preventing preeclampsia. These data are especially useful for health-care providers who engage in the management of pregnant women at risk for preeclampsia. Our findings are a call for action to definitively address vitamin D supplementation as a possible intervention strategy in preventing preeclampsia in pregnancy

Effect of spontaneous changes in dietary components and lipoprotein(a) levels: Data from the Brisighella Heart Study

none22noabstract non availablenoneFogacci, Federica; Cicero, Arrigo F. G.; D'Addato, Sergio; Giovannini, Marina; Borghi, Claudio; Cicero, Arrigo F. G.; D'Addato, Sergio; Giovannini, Marina; Rosticci, Martina; Fogacci, Federica; Morbini, Martino; Grandi, Elisa; Bertagnin, Enrico; Ilaria Ricci, Iamino; Palmisano, Silvia; Rizzoli, Elisabetta; Parini, Angelo; Urso, Riccardo; Cagnati, Marcella; Derosa, Giuseppe; Bacchelli, Stefano; Borghi, ClaudioFogacci, Federica; Cicero, Arrigo F. G.; D'Addato, Sergio; Giovannini, Marina; Borghi, Claudio; Cicero, Arrigo F. G.; D'Addato, Sergio; Giovannini, Marina; Rosticci, Martina; Fogacci, Federica; Morbini, Martino; Grandi, Elisa; Bertagnin, Enrico; Ilaria Ricci, Iamino; Palmisano, Silvia; Rizzoli, Elisabetta; Parini, Angelo; Urso, Riccardo; Cagnati, Marcella; Derosa, Giuseppe; Bacchelli, Stefano; Borghi, Claudi