Dietary Nitrate Supplementation Attenuates Blood Pressure in Young Prehypertensive Men during Exercise
1director of the Applied Physiology Lab at KyungHee University in Yongin, Korea
DOI: 10.31083/jomh.v12i1.22 Vol.12,Issue 1,January 2016 pp.25-33
Published: 04 January 2016
Background: Acute dietary nitrate (NO3-) supplementation with beetroot juice (BRJ) can lower blood pressure (BP) at rest and during exercise in healthy individuals; however, the effects on endothelial function and BP response to dynamic exercise are not known in prehypertensive individuals. We compared the effects of 15 days BRJ supplementation on hemodynamic responses during progressive dynamic exercise.
Methods: In a double-blind, randomized, crossover design, 11 healthy, prehypertensive men were supplemented with either BRJ (5.6 mmol, 70 ml BRJ) or a placebo (PL)(70 ml control drink) every day for 15 days. Participants completed two bouts of cycling exercise at each of the two
workout intensities, corresponding to 30% and 60% of their predetermined VO2peak values. Flow-mediated dilation (FMD) of the brachial artery and plasma concentration of NOx (NO3- and NO2-) were measured, and the mean arterial pressure (MAP), cardiac output (CO), and total vascular conductance (TVC) were assessed at rest and during exercise before and after each treatment. Results: BRJ supplementation significantly increased resting plasma NOx concentrations (123.0±11.3 vs. 181.9±19.5 μM) and the brachial artery FMD (9.8±1.0 vs. 13.5±1.4%) compared to no change after ingestion of the PL. Compared with the PL, BRJ supplementation reduced the MAP (101±1 vs. 99±1 mmHg) at rest and this reduction occurred across workloads, while the TVC was increased only during exercise (p<0.05). There was no difference in CO.
Conclusions: 15 days of dietary nitrate supplementation could improve endothelial function and contribute to attenuation of an exaggerated exercise BP resulting mainly from a failure to reduce peripheral resistance during exercise.
Beetroot juice; Dynamic exercise; Cardiac output; Endothelial function
Hyun-Min Choi,Bo-Hee Kim,Hosung Nho,Kyung-Ae Kim,Joonsung Park,Myoung-Jei Chang,Jong-Kyung Kim. Dietary Nitrate Supplementation Attenuates Blood Pressure in Young Prehypertensive Men during Exercise. Journal of Men's Health. 2016. 12(1);25-33.
1. Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension 2003; 42:1206-1252.
2. Mittleman MA, Maclure M, Tofler GH, et al. Triggering of acute myocardial infarction by heavy physical exertion--protection against triggering by regular exertion. New England Journal of Medicine 1993;329:1677-1683.
3. Fazio S, Palmieri EA, Izzo R, et al. An exaggerated systolic blood pressure response to exercise is associated with cardiovascular remodeling in subjects with prehypertension. Italian Heart Journal: Official Journal of the Italian Federation of Cardiology 2005;6:886-892.
4. Kokkinos PF, Andreas PE, Coutoulakis E, et al. Determinants of exercise blood pressure response in normotensive and hypertensive women: Role of cardiorespiratory fitness. Journal of Cardiopulmonary Rehabilitation and Prevention 2002;22:178-183.
5. Choi HM, Stebbins CL, Lee OT, et al. Augmentation of the exercise pressor reflex in prehypertension: Roles of the muscle metaboreflex and mechanoreflex. Applied Physiology, Nutrition, and Metabolism = Physiologie Appliquee, Nutrition Et Metabolisme 2013;38:209-215.
6. Weil BR, Stauffer BL, Greiner JJ, et al. Prehypertension is associated with impaired nitric oxide-mediated endothelium-dependent vasodilation in sedentary adults. American Journal of Hypertension 2011;24:976-981.
7. Stewart KJ, Sung J, Silber HA, et al. Exaggerated exercise blood pressure is related to impaired endothelial vasodilator function. American Journal of Hypertension 2004;17:314-320.
8. Joyner MJ and Tschakovsky ME Nitric oxide and physiologic vasodilation in human limbs: Where do we go from here? Canadian Journal of Applied Physiology 2003;28:475-490.
9. Stamler JS and Meissner G. Physiology of nitric oxide in skeletal muscle. Physiological Reviews 2001;81:209-237.
10. Hord NG, Tang Y and Bryan NS. Food sources of nitrates and nitrites: The physiologic context for potential health benefits. The American Journal of Clinical Nutrition 2009;90:1-10.
11. Duncan C, Dougall H, Johnston P, et al. Chemical generation of nitric oxide in the mouth from the enterosalivary circulation of dietary nitrate. Nature Medicine 1995;1:546-551.
12. Bryan NS. Nitrite in nitric oxide biology: Cause or consequence?: A systems-based review. Free Radical Biology and Medicine 2006;41:691-701.
13. Cosby K, Partovi KS, Crawford JH, et al. Nitrite reduction to nitric oxide by deoxyhemoglobin vasodilates the human circulation. Nature Medicine 2003;9:1498-1505.
14. Bond V, Curry BH, Adams RG, et al. Effects of dietary nitrates on systemic and cerebrovascular hemodynamics. Cardiology Research and Practice, 2013, 435629. doi: 10.1155/2013/435629.
15. Ferguson SK, Hirai DM, Copp SW, et al. Impact of dietary nitrate supplementation via beetroot juice on exercising muscle vascular control in rats. The Journal of Physiology 2013;591:547-557.
16. Boushel R, Langberg H, Gemmer C, et al. Combined inhibition of nitric oxide and prostaglandins reduces human skeletal muscle blood flow during exercise. The Journal of Physiology 2002;543:691-698.
17. Dinenno FA and Joyner MJ. Combined NO and PG inhibition augments alpha-adrenergic vasoconstriction in contracting human skeletal muscle. American Journal of Physiology.Heart and Circulatory Physiology 2004;287:H2576-2584.
18. Kaplan V, Bucklar GB and Bloch KE. Noninvasive monitoring of cardiac output during exercise by inductance cardiography. Medicine and Science in Sports and Exercise 2003;35:747-752.
19. Richard R, Lonsdorfer-Wolf E, Charloux A, et al. Non-invasive cardiac output evaluation during a maximal progressive exercise test, using a new impedance cardiograph device. European Journal of Applied Physiology 2001;85:202-207.
20. Charloux A, Lonsdorfer-Wolf E, Richard R, et al. A new impedance cardiograph device for the non-invasive evaluation of cardiac output at rest and during exercise: Comparison with the “direct” Fick method. European Journal of Applied Physiology 2000;82:313-320.
21. Lansley KE, Winyard PG, Bailey SJ, et al. Acute dietary nitrate supplementation improves cycling time trial performance. Medicine and Science in Sports and Exercise 2011;43:1125-1131.
22. Vanhatalo A, Bailey SJ, Blackwell JR, et al. Acute and chronic effects of dietary nitrate supplementation on blood pressure and the physiological responses to moderate-intensity and incremental exercise. American Journal of Physiology. Regulatory, Integrative and Comparative Physiolog 2010; 299:R1121-1131.
23. Beck DT, Martin JS, Casey DP, et al. Exercise training improves endothelial function in resistance arteries of young prehypertensives. Journal of Human Hypertension 2014;28:303-309.
24. Vanhoutte P, Shimokawa H, Tang E, et al. Endothelial dysfunction and vascular disease. Acta Physiologica 2009;196:193-222.
25. Higashi Y, Oshima T, Sasaki N, et al. Relationship between insulin resistance and endothelium-dependent vascular relaxation in patients with essential hypertension. Hypertension 1997;29:280-285.
26. Park JB, Charbonneau F and Schiffrin EL. Correlation of endothelial function in large and small arteries in human essential hypertension. Journal of Hypertension 2001;19:415-420.
27. Larsen FJ, Ekblom B, Sahlin K, et al. Effects of dietary nitrate on blood pressure in healthy volunteers. New England Journal of Medicine 2006;355:2792-2793.
28. Webb AJ, Patel N, Loukogeorgakis S, et al. Acute blood pressure lowering, vasoprotective, and antiplatelet properties of dietary nitrate via bioconversion to nitrite. Hypertension 2008;51:784-790.
29. Boushel R. Muscle metaboreflex control of the circulation during exercise. Acta Physiologica (Oxford, England) 2010;199:367-383.
30. Pal G, Adithan C, Amudharaj D, et al. Assessment of sympathovagal imbalance by spectral analysis of heart rate variability in prehypertensive and hypertensive patients in Indian population. Clinical and Experimental Hypertension 2011;33:478-483.
31. Wang S, Li S, Xu X, et al. Effect of slow abdominal breathing combined with biofeedback on blood pressure and heart rate variability in prehypertension. The Journal of Alternative and Complementary Medicine 2010;16:1039-1045.
32. Sander M, Chavoshan B and Victor RG. A large blood pressure-raising effect of nitric oxide synthase inhibition in humans. Hypertension 1999;33:937-942.
33. Young CN, Fisher JP, Gallagher KM, et al. Inhibition of nitric oxide synthase evokes central sympatho‐excitation in healthy humans. The Journal of Physiology 2009;587:4977-4986.
34. Vials AJ, Crowe R and Burnstock G. A neuromodulatory role for neuronal nitric oxide in the rabbit renal artery. British Journal of Pharmacology 1997;121:213-220.
Science Citation Index Expanded Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.
Social Sciences Citation Index Social Sciences Citation Index contains over 3,400 journals across 58 social sciences disciplines, as well as selected items from 3,500 of the world’s leading scientific and technical journals. More than 9.37 million records and 122 million cited references date back from 1900 to present.
Current Contents - Social & Behavioral Sciences Current Contents - Social & Behavioral Sciences provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in the social and behavioral sciences.
Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.
SCOPUS Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
DOAJ DOAJ is a community-curated online directory that indexes and provides access to high quality, open access, peer-reviewed journals.
CrossRef Crossref makes research outputs easy to find, cite, link, assess, and reuse. Crossref committed to open scholarly infrastructure and collaboration, this is now announcing a very deliberate path.
Portico Portico is a community-supported preservation archive that safeguards access to e-journals, e-books, and digital collections. Our unique, trusted process ensures that the content we preserve will remain accessible and usable for researchers, scholars, and students in the future.