L. Nogueira

Consumption of High-Polyphenol Dark Chocolate Improves Endothelial Function in Individuals with Stage 1 Hypertension and Excess Body Weight

Background. Hypertension and excess body weight are important risk factors for endothelial dysfunction. Recent evidence suggests that high-polyphenol dark chocolate improves endothelial function and lowers blood pressure. This study aimed to evaluate the association of chocolate 70% cocoa intake with metabolic profile, oxidative stress, inflammation, blood pressure, and endothelial function in stage 1 hypertensives with excess body weight. Methods. Intervention clinical trial includes 22 stage 1 hypertensives without previous antihypertensive treatment, aged 18 to 60 years and presents a body mass index between 25.0 and 34.9 kg/m2. All participants were instructed to consume 50 g of chocolate 70% cocoa/day (2135 mg polyphenols) for 4 weeks. Endothelial function was evaluated by peripheral artery tonometry using Endo-PAT 2000 (Itamar Medical). Results. Twenty participants (10 men) completed the study. Comparison of pre-post intervention revealed that (1) there were no significant changes in anthropometric parameters, percentage body fat, glucose metabolism, lipid profile, biomarkers of inflammation, adhesion molecules, oxidized LDL, and blood pressure; (2) the assessment of endothelial function through the reactive hyperemia index showed a significant increase: 1.94 ± 0.18 to 2.22 ± 0.08, P = 0.01. Conclusion.In individuals with stage 1 hypertension and excess body weight, high-polyphenol dark chocolate improves endothelial function.

Short-term Effects of Green Tea on Blood Pressure, Endothelial Function, and Metabolic Profile in Obese Prehypertensive Women: A Crossover Randomized Clinical Trial

Background: Green tea consumption has been inversely associated with cardiovascular disease (CVD) in epidemiological studies. Although some interventional trials suggest that green tea has beneficial effects on CVD risk factors, such as hypertension and obesity, others have failed to show such benefits. Aims: To evaluate the short-term effects of green tea on blood pressure, endothelial function, metabolic profile, and inflammatory activity in obese prehypertensive women. Methods: This study was a crossover, randomized, double-blind, placebo-controlled clinical trial. Participants were randomly allocated to receive daily 3 capsules containing either 500 mg of green tea extract (GTE) or a matching placebo for 4 weeks, with a washout period of 2 weeks between treatments. Each GTE capsule contained 260 mg of polyphenols. At the beginning and at the end of each treatment, participants were submitted to evaluation of blood pressure (ambulatory blood pressure monitoring, ABPM), endothelial function (Endo-PAT 2000 and cellular adhesion molecules), nutritional parameters, metabolic profile, and biomarkers of inflammation. Results: Twenty women age 41.1 ± 8.4 years completed the study. After 4 weeks of GTE supplementation in comparison with placebo, there was a significant decrease (p < 0.05) in systolic blood pressure at 24 hours (−3.61 ± 1.23 vs 1.05 ± 1.34 mmHg), daytime (−3.61 ± 1.26 vs 0.80 ± 1.57 mmHg), and nighttime (−3.94 ± 1.70 vs 1.90 ± 1.66 mmHg). Changes in diastolic blood pressure and in all other parameters did not present a significant difference between GTE and placebo. Conclusion: The findings of this study suggest that in obese prehypertensive women, short-term daily intake of GTE may decrease blood pressure.

Dietary counseling on long-term weight loss in overweight hypertensive patients

OBJECTIVE: This study aimed to evaluate long-term weight loss in overweight hypertensive patients receiving dietary counseling. METHODS : Longitudinal study included overweight hypertensive patients who had an initial individual consultation with a nutritionist between January 2002 and December 2005 and were followed for four years in a hypertension clinic. Patients who had at least four consultations during the follow-up period were included in the dietary counseling group. Those who scheduled their first consultation but missed that appointment or had fewer than four consultations during the follow-up period were allocated to the control group. Target Energy intake was calculated at 20–25 kcal/kg actual body weight/day. RESULTS: The study included 102 patients aged 55±1 years old (58 in the dietary counseling group). As compared with the control group, patients in the dietary counseling group showed a significantly greater reduction in body weight (-3.6±0.8 vs. 0.8±0.7 kg), which remained significant after controlling for age, gender, baseline body mass index, and the use of different antihypertensive and antidiabetic drugs. Weight loss between 5.0% and 9.9% was observed in a significantly higher percentage of patients in the dietary counseling group (28% vs. 11%). A weight loss of at least 10% was only observed in dietary counseling group patients, who had a significantly lower odds ratio for increasing the number and/or dosage of antihypertensive agents, even after controlling for age, gender, and baseline body mass index. CONCLUSIONS: Dietary counseling may be associated with long-term weight loss in overweight hypertensive patients.

Serum Uric Acid Levels are Associated with Cardiometabolic Risk Factors in Healthy Young and Middle-Aged Adults

Background Observational studies have highlighted an association between serum uric acid (SUA) levels and cardiovascular risk factors. Despite the growing body of evidences, several studies were conducted in older individuals or in carriers of diseases susceptible to affect SUA levels and cardiometabolic risk markers. Objective To evaluate the relationship of SUA with body adiposity, metabolic profile, oxidative stress, inflammatory biomarkers, blood pressure and endothelial function in healthy young and middle-aged adults. Methods 149 Brazilian adults aged 20-55 years, both sexes, underwent evaluation of body adiposity, SUA, fasting glucose and insulin, lipid profile, malondialdehyde (MDA), high sensitivity C-reactive protein (hs-CRP), adiponectin, blood pressure and endothelial function. Endothelial function was assessed by the reactive hyperemia index (RHI) derived from peripheral arterial tonometry method. Participants were allocated in two groups according to SUA levels: control group (CG; n = 130; men ≤ 7 mg/dL, women ≤ 6 mg/dL) and hyperuricemia group (HG; n = 19; men > 7 mg/dL, women > 6 mg/dL). A P-value < 0.05 was considered statistically significant. Results After adjustment for confounders, participants in HG compared with those in CG displayed higher body mass index (BMI): 34.15(33.36-37.19) vs.31.80 (26.26-34.42) kg/m2,p = 0.008, higher MDA: 4.67(4.03-5.30) vs. 3.53(3.10-4.07) ng/mL, p < 0.0001 and lower RHI: 1.68 ± 0.30 vs. 2.05 ± 0.46, p = 0.03). In correlation analysis adjusted for confounders, SUA was positively associated (p < 0.05) with BMI, waist circumference, LDL-cholesterol, triglycerides and MDA, and negatively associated (p < 0.05) with HDL-cholesterol, adiponectin and RHI. Conclusions This study suggests that in healthy young and middle-aged adults higher SUA levels are associated with higher body adiposity, unfavorable lipid and inflammatory phenotype, higher oxidative stress and impaired endothelial function.