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Nutritional Therapy for High Blood Pressure

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: closed (31 July 2020) | Viewed by 51360

Special Issue Editors


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Guest Editor

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Guest Editor
Department of Food Science & Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 75 Iera Odos, 11855 Athens, Greece
Interests: vascular health; dietary patterns; adult hypertension; childhood hypertension; nutraceuticals; vasoactive food constituents
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Hypertension is a common health problem, and one of the most important risk factors for cardiovascular disease. Hypertension treatment is usually based on drug administration, yet lifestyle changes and especially diet have also been proven to be almost as effective in hypertension therapy. Dietary components may act favorably in many pathophysiological mechanisms responsible for blood pressure elevation, such as vasoconstriction, arterial stiffness, peripheral resistance, and fluid balance—both acutely and after long-term use. This Special Issue aims to bring together the latest knowledge regarding the nutrition therapy of high blood pressure either through original research or review articles including systematic reviews or meta- analyses, which will offer valuable insight into how diet as a whole, dietary patterns, nutrients, nutraceuticals, or other components of diet can serve as valuable means for blood pressure control in patients or apparently healthy populations.

Dr. George Moschonis
Dr. Kalliopi Karatzi
Guest Editors

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Keywords

  • adult hypertension
  • childhood hypertension
  • diet
  • dietary patterns
  • nutraceuticals
  • vasoactive nutrients
  • nutritional therapy

Published Papers (9 papers)

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Editorial

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4 pages, 180 KiB  
Editorial
Novel Dietary Approaches for Controlling High Blood Pressure
by George Moschonis and Kalliopi Karatzi
Nutrients 2020, 12(12), 3902; https://doi.org/10.3390/nu12123902 - 21 Dec 2020
Cited by 2 | Viewed by 4340
Abstract
Hypertension is a common health problem, and one of the most important risk factors for cardiovascular disease [...] Full article
(This article belongs to the Special Issue Nutritional Therapy for High Blood Pressure)

Research

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17 pages, 880 KiB  
Article
The Effect of High Polyphenol Extra Virgin Olive Oil on Blood Pressure and Arterial Stiffness in Healthy Australian Adults: A Randomized, Controlled, Cross-Over Study
by Katerina Sarapis, Colleen J. Thomas, Johanna Hoskin, Elena S. George, Wolfgang Marx, Hannah L. Mayr, Greg Kennedy, Andrew Pipingas, Jane C. Willcox, Luke A. Prendergast, Catherine Itsiopoulos and George Moschonis
Nutrients 2020, 12(8), 2272; https://doi.org/10.3390/nu12082272 - 29 Jul 2020
Cited by 19 | Viewed by 10287
Abstract
Extra virgin olive oil (EVOO) is suggested to be cardioprotective, partly due to its high phenolic content. We investigated the effect of extra virgin high polyphenol olive oil (HPOO) versus low polyphenol olive oil (LPOO) on blood pressure (BP) and arterial stiffness in [...] Read more.
Extra virgin olive oil (EVOO) is suggested to be cardioprotective, partly due to its high phenolic content. We investigated the effect of extra virgin high polyphenol olive oil (HPOO) versus low polyphenol olive oil (LPOO) on blood pressure (BP) and arterial stiffness in healthy Australian adults. In a double-blind, randomized, controlled cross-over trial, 50 participants (age 38.5 ± 13.9 years, 66% female) were randomized to consume 60 mL/day of either HPOO (360 mg/kg polyphenols) or LPOO (86 mg/kg polyphenols) for three weeks. Following a two-week washout period, participants crossed over to consume the alternate oil. Anthropometric data, peripheral BP, central BP and arterial stiffness were measured at baseline and follow up. No significant differences were observed in the changes from baseline to follow up between the two treatments. However, a significant decrease in peripheral and central systolic BP (SBP) by 2.5 mmHg (95% CI: −4.7 to −0.3) and 2.7 mmHg (95% CI: −4.7 to −0.6), respectively, was observed after HPOO consumption. Neither olive oil changed diastolic BP (DBP) or measures of arterial stiffness. The reductions in SBP after HPOO consumption provide evidence for a potentially widely accessible dietary intervention to prevent cardiovascular disease in a multiethnic population. Longer intervention studies and/or higher doses of EVOO polyphenols are warranted to elucidate the potential effect on DBP and arterial stiffness. Full article
(This article belongs to the Special Issue Nutritional Therapy for High Blood Pressure)
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17 pages, 329 KiB  
Article
Bioactive Compounds and Their Effect on Blood Pressure—A Review
by Bartosz Malinowski, Raul Ignacio Fajardo Leighton, Christopher George Hill, Paweł Szandorowski and Michał Wiciński
Nutrients 2020, 12(6), 1659; https://doi.org/10.3390/nu12061659 - 03 Jun 2020
Cited by 5 | Viewed by 4701
Abstract
Elevated blood pressure affects a great part of the elderly population and is the leading risk factor for cardiovascular disease. New approaches have been taken in the fight against this growing problem, in the form of diets (Mediterranean, Dietary Approaches to Stop Hypertension [...] Read more.
Elevated blood pressure affects a great part of the elderly population and is the leading risk factor for cardiovascular disease. New approaches have been taken in the fight against this growing problem, in the form of diets (Mediterranean, Dietary Approaches to Stop Hypertension (DASH) and intermittent fasting). Recent research has shown the promising results regarding diets and their effect on the prevention and improvement of elevated blood pressure. This review attempts to take this a step further, reviewing 26 studies in the search for dietary elements that may be causing this improvement. Although good evidence was found in favor of lycopene, Docosahexaenoic acid (DHA), fiber and anthocyanin, further evidence is needed before any conclusions can be made. In contrast, the evidence shows that licorice increases blood pressure. Full article
(This article belongs to the Special Issue Nutritional Therapy for High Blood Pressure)
17 pages, 1965 KiB  
Article
The Effects of Beetroot Juice on Blood Pressure, Microvascular Function and Large-Vessel Endothelial Function: A Randomized, Double-Blind, Placebo-Controlled Pilot Study in Healthy Older Adults
by Tomos Jones, Emily Louise Dunn, Jamie Hugo Macdonald, Hans-Peter Kubis, Nicholas McMahon and Aamer Sandoo
Nutrients 2019, 11(8), 1792; https://doi.org/10.3390/nu11081792 - 02 Aug 2019
Cited by 28 | Viewed by 8075
Abstract
Dietary nitrate (NO3) has been reported to improve endothelial function (EF) and blood pressure (BP). However, most studies only assess large-vessel EF with little research on the microvasculature. Thus, the aim of the present pilot study is to examine NO [...] Read more.
Dietary nitrate (NO3) has been reported to improve endothelial function (EF) and blood pressure (BP). However, most studies only assess large-vessel EF with little research on the microvasculature. Thus, the aim of the present pilot study is to examine NO3 supplementation on microvascular and large-vessel EF and BP. Twenty older adults (63 ± 6 years) were randomized to a beetroot juice (BRJ) or placebo (PLA) group for 28 (±7) days and attended three laboratory visitations. Across visitations, blood pressure, microvascular function and large-vessel EF were assessed by laser Doppler imaging (LDI) with iontophoresis of vasoactive substances and flow-mediated dilatation (FMD), respectively. Plasma NO3concentrations, BP and the presence of NO3 reducing bacteria were also assessed. Plasma NO3 increased following two weeks of BRJ supplementation (p = 0.04) along with a concomitant decrease in systolic and diastolic BP of approximately −6 mmHg and −4 mmHg, respectively (p = 0.04; p = 0.01, respectively). BP remained unchanged in the PLA group. There were no significant differences in endothelium-dependent or endothelium-independent microvascular responses between groups. FMD increased by 1.5% following two weeks of BRJ (p = 0.04), with only a minimal (0.1%) change for the PLA group. In conclusion, this pilot study demonstrated that medium-term BRJ ingestion potentially improves SBP, DBP and large-vessel EF in healthy older adults. The improvements observed in the present study are likely to be greater in populations presenting with endothelial dysfunction. Thus, further prospective studies are warranted in individuals at greater risk for cardiovascular disease. Full article
(This article belongs to the Special Issue Nutritional Therapy for High Blood Pressure)
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15 pages, 641 KiB  
Article
‘Low-Salt’ Bread as an Important Component of a Pragmatic Reduced-Salt Diet for Lowering Blood Pressure in Adults with Elevated Blood Pressure
by Kevin D. Cashman, Sorcha Kenny, Joseph P. Kerry, Fanny Leenhardt and Elke K. Arendt
Nutrients 2019, 11(8), 1725; https://doi.org/10.3390/nu11081725 - 26 Jul 2019
Cited by 21 | Viewed by 4975
Abstract
Reformulation of bread in terms of salt content remains an important measure to help achieve a reduction in salt intake in the population and for the prevention of hypertension and elevated blood pressure (BP). Our fundamental studies on the reduction of salt on [...] Read more.
Reformulation of bread in terms of salt content remains an important measure to help achieve a reduction in salt intake in the population and for the prevention of hypertension and elevated blood pressure (BP). Our fundamental studies on the reduction of salt on dough and bread characteristics showed that wheat breads produced with 0.3 g salt/100 g (“low-salt”) were found to be comparable quality to that produced with the typical level of salt (1.2%). This food-based intervention trial examined, using a 5 week cross-over design, the potential for inclusion of “low-salt” bread as part of a pragmatic reduced-salt diet on BP, markers of bone metabolism, and plasma lipids in 97 adults with slightly to moderately elevated BP. Assuming all sodium from dietary intake was excreted through the urine, the intake of salt decreased by 1.7 g/day, on average, during the reduced-salt dietary period. Systolic BP was significantly lower (by 3.3 mmHg on average; p < 0.0001) during the reduced-salt dietary period compared to the usual-salt dietary period, but there was no significant difference (p = 0.81) in diastolic BP. There were no significant differences (p > 0.12, in all cases) in any of the urinary- or serum-based biochemical indices of calcium or bone metabolism or in plasma lipids between the two periods. In conclusion, a modest reduction in dietary salt intake, in which the use of “low-salt” (i.e., 0.3 g/100g) bread played a key role along with dietary advice, and led to a significant, and clinically meaningful, decrease in systolic, but not diastolic, BP in adults with mildly to moderately elevated BP. Full article
(This article belongs to the Special Issue Nutritional Therapy for High Blood Pressure)
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11 pages, 400 KiB  
Article
Combination of Healthy Lifestyle Factors on the Risk of Hypertension in a Large Cohort of French Adults
by Helene Lelong, Jacques Blacher, Julia Baudry, Solia Adriouch, Pilar Galan, Leopold Fezeu, Serge Hercberg and Emmanuelle Kesse-Guyot
Nutrients 2019, 11(7), 1687; https://doi.org/10.3390/nu11071687 - 23 Jul 2019
Cited by 24 | Viewed by 5166
Abstract
Background: Healthy lifestyle factors are widely recommended for hypertension prevention and control. Nevertheless, little is known about their combined impact on hypertension, in the general population. Our aim was to compute a Healthy Lifestyle Index (HLI) comprising the main non-pharmacological measures usually recommended [...] Read more.
Background: Healthy lifestyle factors are widely recommended for hypertension prevention and control. Nevertheless, little is known about their combined impact on hypertension, in the general population. Our aim was to compute a Healthy Lifestyle Index (HLI) comprising the main non-pharmacological measures usually recommended to improve hypertension prevention: normal weight, regular physical activity, limited alcohol consumption, adoption of a healthy diet; to evaluate their combined impact on hypertension incidence. Methods: We prospectively followed the incidence of hypertension among 80,426 French adults participating in the NutriNet-Santé cohort study. Self-reported dietary, socio-demographic, lifestyle and health data were assessed at baseline and yearly using a dedicated website; the association between HLI and hypertension risk was assessed by multivariable Cox proportional hazards models adjusted for age, sex, family history of hypertension, socio-demographic and lifestyle factors. Hypothetical Population Attributable Risks associated to each factor were estimated. Results: During a median follow-up of 3.5 years (IQR: 1.5–5.3), 2413 incident cases of hypertension were identified. Compared with no or one healthy lifestyle factor, the hazard ratios (HR) for hypertension were 0.76 (95% CI, 0.67–0.85) for two factors, 0.47 (95% CI, 0.42–0.53) for three factors and 0.35 (95% CI, 0.30–0.41) for all healthy lifestyle factors (p-trend <0.0001). Compared with adhering to 0, 1, 2 or 3 healthy lifestyles, adhering to all of them was found associated with a reduction of the hypertension risk of half (HR = 0.55 (95% CI, 0.46–0.65)). Conclusion: Active promotion of healthy lifestyle factors at population level is a key leverage to fight the hypertension epidemic. Full article
(This article belongs to the Special Issue Nutritional Therapy for High Blood Pressure)
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15 pages, 804 KiB  
Article
Relationship between Nutrition and Alcohol Consumption with Blood Pressure: The ESTEBAN Survey
by Alexandre Vallée, Amélie Gabet, Valérie Deschamps, Jacques Blacher and Valérie Olié
Nutrients 2019, 11(6), 1433; https://doi.org/10.3390/nu11061433 - 25 Jun 2019
Cited by 18 | Viewed by 5470
Abstract
Background: Dietary interventions are recommended for the prevention of hypertension. The aim of this study was to evaluate and quantify the relationship between alcohol consumption and the DASH (Dietary Approaches to Stop Hypertension) score with blood pressure (BP) stratified by gender. Methods: Cross-sectional [...] Read more.
Background: Dietary interventions are recommended for the prevention of hypertension. The aim of this study was to evaluate and quantify the relationship between alcohol consumption and the DASH (Dietary Approaches to Stop Hypertension) score with blood pressure (BP) stratified by gender. Methods: Cross-sectional analyses were performed using data from 2105 adults from the ESTEBAN survey, a representative sample of the French population. Pearson correlation analyses were used to assess the correlation between the DASH score and alcohol with BP. Regressions were adjusted by age, treatment, socio-economic level, tobacco, exercise, Body mass index (BMI), and cardiovascular risk factors and diseases. Results: The DASH score was negatively correlated with systolic (SBP) and diastolic BP (DBP) (p < 0.0001). Alcohol was positively associated with increased BP only in men. The worst quintile of the DASH score was associated with an 1.8 mmHg increase in SBP and an 0.6 mmHg increase in SBP compared to the greatest quintile in men and with a 1.5 mmHg increase in SBP and an 0.4 mmHg increase in SBP in women. Male participants in the worst quintile of alcohol consumption showed an increase of 3.0 mmHg in SBP and 0.8 mmHg in DBP compared to those in the greatest quintile. Conclusion: A high DASH score and a reduction in alcohol consumption could be effective nutritional strategies for the prevention of hypertension. Full article
(This article belongs to the Special Issue Nutritional Therapy for High Blood Pressure)
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Review

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17 pages, 2095 KiB  
Review
Vitamin D Supplementation and Blood Pressure in Children and Adolescents: A Systematic Review and Meta-Analysis
by Myriam Abboud
Nutrients 2020, 12(4), 1163; https://doi.org/10.3390/nu12041163 - 22 Apr 2020
Cited by 25 | Viewed by 4100
Abstract
Suboptimal vitamin D status is associated with elevated blood pressure (BP) in children and adolescents. Whether vitamin D supplementation reduces BP remains unclear. To systematically review whether vitamin D supplementation reduces BP in children and adolescents, we conducted a literature review according to [...] Read more.
Suboptimal vitamin D status is associated with elevated blood pressure (BP) in children and adolescents. Whether vitamin D supplementation reduces BP remains unclear. To systematically review whether vitamin D supplementation reduces BP in children and adolescents, we conducted a literature review according to the PRISMA statement. We included vitamin-D supplementation human interventions studies that reported on BP as an outcome. We searched PUBMED, MEDLINE, CINAHL, EMBASE, the Cochrane Library, and the clinical trials website. We also hand searched the references of the included articles and previous reviews of vitamin D therapy. No language or time restrictions were applied. We extracted data on population characteristics, baseline and endline vitamin D and BP values, and assessed the risk of bias of the included studies. We performed a narrative review of the findings, conducted a meta-analysis when possible, and performed sensitivity analyses to test the robustness of our results. We assessed the overall quality of the evidence produced in the meta-analysis. We included eight studies in our review and five studies in the meta-analysis, none of which included hypertensive only participants. The risk of bias was variable. In non-randomized studies, no effect of vitamin D supplementation was seen on systolic BP (SBP) (mean difference: 0.39 (95% confidence interval (CI): −0.9; 1.68) mmHg; p = 0.55; I2 = 0%). Only a significant decrease in diastolic BP (DBP) (mean difference: −1.87 (95% CI: −3.02; −0.72) mmHg; p = 0.001; I2 = 0%) was noted. Both analyses had a low quality of evidence. In randomized controlled trials (RCTs), no effect was noted on SBP (mean difference: −2.04 (95% CI: −5.12; 1.04) mmHg; p = 0.19; I2 = 71%) nor DBP (mean difference: 0.01 (95% CI: −1.09; 1.12) mmHg; p = 0.98; I2 = 0%). The final quality of evidence ranged between low and moderate. Sensitivity analyses did not affect the results. Vitamin D supplementation was found to be ineffective in lowering SBP and DBP in children and adolescents. Full article
(This article belongs to the Special Issue Nutritional Therapy for High Blood Pressure)
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28 pages, 750 KiB  
Review
Current Data on Dietary Sodium, Arterial Structure and Function in Humans: A Systematic Review
by Christiana Tsirimiagkou, Eirini D. Basdeki, Antonios Argyris, Yannis Manios, Maria Yannakoulia, Athanase D. Protogerou and Kalliopi Karatzi
Nutrients 2020, 12(1), 5; https://doi.org/10.3390/nu12010005 - 18 Dec 2019
Cited by 8 | Viewed by 3021
Abstract
Background: Subclinical arterial damage (SAD) (arteriosclerosis, arterial remodeling and atheromatosis) pre-exists decades before cardiovascular disease (CVD) onset. Worldwide, sodium (Na) intake is almost double international recommendations and has been linked with CVD and death, although in a J-shape manner. Studies regarding dietary Na [...] Read more.
Background: Subclinical arterial damage (SAD) (arteriosclerosis, arterial remodeling and atheromatosis) pre-exists decades before cardiovascular disease (CVD) onset. Worldwide, sodium (Na) intake is almost double international recommendations and has been linked with CVD and death, although in a J-shape manner. Studies regarding dietary Na and major types of SAD may provide pathophysiological insight into the association between Na and CVD. Objectives: Systematic review of data derived from observational and interventional studies in humans, investigating the association between dietary Na with (i) atheromatosis (arterial plaques); (ii) arteriosclerosis (various biomarkers of arterial stiffness); (iii) arterial remodeling (intima–media thickening and arterial lumen diameters). Data sources: Applying the PRISMA criteria, the PubMed and Scopus databases were used. Results: 36 studies were included: 27 examining arteriosclerosis, four arteriosclerosis and arterial remodeling, three arterial remodeling, and two arterial remodeling and atheromatosis. Conclusions: (i) Although several studies exist, the evidence does not clearly support a clinically meaningful and direct (independent from blood pressure) effect of Na on arterial wall stiffening; (ii) data regarding the association of dietary Na with arterial remodeling are limited, mostly suggesting a positive trend between dietary Na and arterial hypertrophy but still inconclusive; (iii) as regards to atheromatosis, data are scarce and the available studies present high heterogeneity. Further state-of-the-art interventional studies must address the remaining controversies. Full article
(This article belongs to the Special Issue Nutritional Therapy for High Blood Pressure)
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