Search

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, highpolyphenol dark chocolate improves endothelial function. [ABSTRACT FROM AUTHOR]

Background: Obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular disease (CVD). Several of the proposed mechanisms for the development of CVD in OSA are similar to those proposed for the increased risk of CVD in obesity, being difficult to determine the influence of OSA on these pathogenic mechanisms in obese individuals.Objectives: The purpose of this study was to evaluate the relationship of OSA with endothelial function, oxidative stress, inflammatory biomarkers, metabolic profile, sympathetic nervous system activity and blood pressure (BP) in obese individuals.Methods: In this cross-sectional study, were included 53 obese adults (28 women). Sleep study was performed with Watch-PAT200® and the diagnosis of OSA was made when apnea-hipopnea index (AHI) ≥5 events/h (n=33). All participants underwent evaluation of: body adiposity, BP, plasma catecholamines, high sensitivity C-reactive protein (hs-CRP), adiponectin, malondialdehyde, glucose, insulin, lipid profile and endothelial function (Endo-PAT 2000®).Results: Mean age (39.6 ± 1.5 vs. 32.5 ± 2.1y) and percentage of male participants (61% vs. 25%) were significantly higher in participants with OSA than in those without OSA (p=0.01). In univariate analysis participants with OSA compared with those without OSA exhibited higher values of neck circumference (40.98 ± 0.63 vs. 38.65 ± 0.75 cm, p=0.02), glucose (92.54 ± 1.97 vs. 80.2 ± 1.92 mg/dL, p=0.0001), noradrenaline (0.16±0.02 vs. 0.12±0.03 ng/mL, p=0.02) and systolic BP (126.05 ± 1.61 vs. 118.16 ± 1.86 mmHg, p=0.003). After adjustment for confounders, only glucose and hs-CRP were significantly higher in OSA patients. In correlation analysis, after controlling for confounders, AHI was associated with neck circumference (r=0.31,p=0.03) and hs-CRP (r=0.30,p=0.04), while minimum O2 saturation was associated with neck circumference (r=-0.31,p=0.03), insulin (r=-0.29,p=0.04) and HOMA-IR (r=-0.30,p=0.04).Conclusion: The present study suggests that in obese individuals OSA is associated with inflammation and worse glycemia; higher AHI correlates with increased central adiposity and inflammation; and lower oxygen saturation is related with insulin resistance. [ABSTRACT FROM AUTHOR]

Introduction: Weight loss is one of the treatment options for obstructive sleep apnea (OSA) in patients with excess body adiposity. However, the effects of moderate energy restriction on OSA are not known.Objective: To evaluate the effects of moderate energy restriction on severity of OSA, blood pressure (BP), sympathetic activity, oxidative stress, inflammation, body adiposity, metabolic profile and endothelial function in obese patients with OSA.Methods: A 16-week randomized clinical trial, involving 21 obese subjects aged 20-55y with apnea/hipopnea index (AHI) ≥ 5 events/h. Subjects were randomized in 2 groups: 11 in energy restriction group (ERG) and 10 in control group (CG). ERG was instructed to follow an energy-restricted diet (-800 kcal/day) and CG was advised not to change food intake. At the beginning and at the end of the study, participants underwent evaluation of: OSA with Watch- PAT200® including the determination of OSA severity parameters, body adiposity, BP, plasma catecholamines, c-reactive protein (CRP), adiponectin, malondialdehyde, metabolism of glucose, lipid profile and endothelial function (Endo PAT 2000®).Results: ERG, compared to CG, presented significantly greater reduction in body weight (-5.6±1.8 vs. 0.4±1.2kg, p<0.001) and in all parameters of body adiposity; AHI (-7.2±2.8 vs. 0.1±1.9 events/h, p=0.04); number of O2 desaturation >4% (-33.7±15.6 vs. 1.8±7.9, p=0.04); plasma adrenaline (-12.7±3.0 vs. -1.3±3.9pg/mL, p=0.04); and significantly greater increase in minimum O2 saturation (4.6±1.6 vs. -0.6±1.4%, p=0.03). ERG showed greater decrease, however without statistical significance, in systolic BP (-4.2±1.9 vs. 2.3±1.4mmHg, p=0.05), insulin (-5.1±1.9 vs. -0.7±1.3μU/mL, p=0.07) and HOMA-IR (-1.2±0.5 vs. -0.08±0.3, p=0.09). During the study period, changes in body adiposity presented significant correlation with changes in parameters of OSA severity, BP, insulin, HOMA-IR, norepinephrine and adiponectin. Changes in parameters of OSA severity presented significant association with changes in CRP.Conclusions: This study suggests that in obese patients with OSA moderate energy restriction is able to reduce body adiposity, parameters of OSA severity and sympathetic nervous system activity. [ABSTRACT FROM AUTHOR]

Background: Obstructive sleep apnea (OSA) is considered an independent risk factor for cardiovascular disease and reported as the most common secondary cause of high blood pressure (BP) maintenance.Objective: To determine the prevalence of OSA and verify its association with endothelial function behavior and anthropometric parameters in patients with resistant hypertension (RHGroup) and BP controlled by medication (CHGroup).Methods: Cross-sectional study involving 40 hypertensive patients (20 in RHG and 20 in CHG), aged between 18 and 75 years. Endothelial function and OSA were assessed by peripheral arterial tonometry. BP was measured by oscillometric method on automatic device. Endothelial function was assessed by peripheral arterial tonometry (PAT) by EndoPAT2000 and the OSA diagnosis also through PAT, using the portable device WatchPAT200. Anthropometric evaluation was performed through measurements of waist (WaC), hip and neck circumference (NC), BMI, waist to height ratio (WHtR), and body composition assessed by BIA.Results: The prevalence of OSA in RHG was 85% (17 of 20)[apnea-hypopnea index = 12.39±1.89], and 80% (16 of 20) in CHG (AHI=20.74±4.69) and it was more frequent in men (93.7% [15 of 16] vs 75% [16 of 24]; p=0.0455, OR=3.86; 95% IC 0.99 to 5.09). Both groups presented similar anthropometric parameters values. Endothelial function evaluated by reactive hyperemia index was similar in both groups (RHG: 1.88±0.44 vs CHG: 2.03±0.43; p=0.47). Although we found differences in oxygen desaturation> 4% (RHG: 28.75 ± 5.08 vs CHG: 64.15 ± 16.97, p = 0.05), total sleep time (RHG: 307.2 ± 71.3 vs CHG: 323.3 ± 83.8 min) and minimum saturation (RHG: 87.8±3.8 vs CHG: 83.3±10.6%) was not different. In general, OSA was correlated with weight (r = 0.5135, p = 0.0007), BMI (r = 0.4146, p = 0.0078), WaC (r = 0, 4458, p = 0.005), NC (r = 0.3863, p = 0.01) and WHtR (r = 0.3907, p = 0.01) and independently associated with impairment of endothelial function (p = 0.0297, OR = 0.17, 95% CI 0.04 to 0.72).Conclusions: The findings of the present study show that the prevalence of OSA was similar in both groups and suggest that, in hypertensive subjects, OSA occurs more frequently in men, being associated with endothelial dysfunction and correlated positively with weight, BMI and WaC. [ABSTRACT FROM AUTHOR]

Background: Recent evidence suggests that vitamin D deficiency is associated with an increased risk of cardiovascular morbidity and mortality. However, the relationship between vitamin D deficiency and cardiovascular disease risk factors has not been established.Objectives: To investigate the prevalence of vitamin D deficiency and its association with body adiposity, metabolic profile, inflammatory biomarkers, blood pressure (BP) and endothelial function in healthy premenopausal women.Methods: In this cross-sectional study were included 73 adult women who were submitted to the evaluation of: serum levels of 25 hidroxyvitamin D [25(OH)D]; body adiposity; metabolic profile (glucose, insulin, HOMA-IR, leptin, triglycerides and cholesterol); inflammatory biomarkers (adiponectin and C-reactive protein); BP; and endothelial function by serum concentrations of adhesion molecules and by reactive hyperemia index (RHI), determined by peripheral arterial tonometry, using Endo-PAT 2000®. Participants were stratified into 2 groups according to their vitamin D status: with vitamin D deficiency (Group 1; 25 (OH) D < 20ng/ml; n=12), and without vitamin D deficiency (Group 2; 25 (OH) D ≥ 20ng/ml; n=61).Results: The prevalence of vitamin D deficiency was 16% (12 of 73). Women in Group 1 compared with those in Group 2 were older (36.5±3.2 vs. 30.4±1.1 years; p=0.03) and showed higher values of BMI (28.7±1.4 vs. 25.1±0.7kg/m2; p=0.03); % body fat (35.3±1.7 vs. 31.1±0.7%; p=0.02); glucose (88.3±3.2 vs. 80.2±1.1 mg/dl; p=0.01); HOMA-IR (6.3±0.7 vs. 4.4±0.2; p=0.002); and leptin (29.6±3.5 vs. 20.9±1.7 ng/ml; p=0.04). RHI was lower in participants in Group 1 than in Group 2 (1.7±0.1 vs. 2.1±0.1; p=0.02). After adjustments for age and BMI, women with vitamin D deficiency remained with higher levels of glucose and HOMA-IR, and lower levels of RHI. Systolic and diastolic BP were higher in Group 1 than in Group 2 (110.2 ± 5.1 vs. 102.9 ± 1.4mmHg and 72.8 ± 4,0 vs. 68.6 ± 1.3mmHg, respectively), however without statistical significance. The other variables did not differ between groups.Conclusions: In the present study, vitamin D deficiency was associated with higher body adiposity, greater insulin resistance and worse endothelial function in women. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular diseases are the leading cause of mortality in Western countries. Some studies have suggested that green tea has beneficial effects on different cardiovascular risk factors. However, others have failed to show such an association.Objective: To evaluate the effects of green tea on blood pressure, endothelial function, metabolic profile, inflammatory biomarkers and body adiposity in obese pre-hypertensive women.Methods: Crossover randomized controlled double-blinded trial. Twenty women with obesity and pre-hypertension, aged 28-59 years, with stable body weight were randomized to receive a daily supplement of 3 capsules that contained either 500mg of green tea extract (GTE) or a matching placebo for 4 weeks, with a washout period of 2 weeks between the treatments. Blood pressure was evaluated by ambulatory blood pressure monitoring (ABMP). Endothelial function was evaluated by peripheral arterial tonometry method, using Endo-PAT 2000®. The inflammatory status was assessed by interleukin 6, tumor necrosis factor alpha, vascular cell adhesion molecule, intercellular adhesion molecule, plasminogen activator inhibitor-1, vascular endothelial growth factor, E-selectin, adiponectin and C-reactive protein.Results: After administration of GTE compared with placebo there was a significant reduction in systolic blood pressure during 24h (pre 130.3±1.7 vs. post 127.0±2.0 mmHg; p= 0.02), daytime (pre 134.0±1.7 vs. post 130.7±2.0 mmHg; p= 0.04) and nighttime (pre 122.2±1.8 vs. post 118.4±2.2 mmHg; p= 0.02). After consumption of green tea, there was an increase, although not statistically significant, in reactive hyperemia index (pre 1.98±0.10 vs. post 2.22±0.14), besides reduction in the concentration of intercellular adhesion molecule (pre 91.8±8.0 vs. post 85.8±5.6 ng/ml) and vascular endothelial growth factor (pre 195.8±46.2 vs. post 158.6±38.7 pg/ml), however without statistical significance. The other variables did not change significantly after consumption of green tea.Conclusions: The findings of the present study suggest that green tea has a beneficial effect on blood pressure and possibly on endothelial function. [ABSTRACT FROM AUTHOR]

Background: Recent studies suggest that dietary calcium may have beneficial effects on adiposity, insulin resistance, dyslipidemia and blood pressure (BP). One potential mechanism underlying these benefits involves modifications in intracellular calcium concentration ([Ca2+]i).Objectives: To evaluate the associations of dietary calcium with adiposity, erythrocyte [Ca2+]i, metabolic profile, BP, inflammatory state and endothelial function in healthy premenopausal women.Methods: In this cross-sectional study 76 women aged 18-50 years were submitted to the evaluation of dietary intake, anthropometric parameters, body composition, erythrocyte [Ca2+]i, biochemical variables, endothelial function and BP. A food frequency questionnaire was used to assess the usual dietary intake. Endothelial function was evaluated by serum concentrations of adhesion molecules and by peripheral arterial tonometry (PAT) method, using Endo-PAT 2000®. Participants were allocated in two groups according to calcium intake: low calcium group (LCG; n=32; < 600mg/day) and high calcium group (HCG; n=44; ≥ 600mg/day).Results: Women in LCG compared with those in HCG exhibited, after adjustments for potential confounders (age and intake of energy, alcohol, protein, carbohydrates and lipids) higher values of body mass index (27.0 ± 1.1 vs. 25.6 ± 0.8 kg/m2, p = 0.02), waist circumference (87.8 ± 2.7 vs. 84.4 ± 2.1cm, p = 0.04), waist-to-height ratio (0.54 ± 0.02 vs. 0.52 ± 0.01, p = 0.02), percentage of body fat (27.0 ± 1.1 vs. 25.6 ± 0.8, p = 0.02), insulin (27.2 ± 2.9 vs. 22.6 ± 1.4 μU/ml, p = 0.02), HOMA-IR (5.7 ± 0.6 vs. 4.7 ± 0.4, p = 0.02), leptin (24.9 ± 2.5 vs. 21.5 ± 2.2ng/ml, p = 0.01) and diastolic BP (72.4 ± 2.0 vs. 68.2 ± 1.6mmHg, p = 0.04); and lower levels of HDL-cholesterol (52.9 ± 2.2 vs. 58.6 ± 1.8mg/dl, p = 0.004) and adiponectin (31.9 ± 3.5 vs. 34.6 ± 3.0μg/ml, p = 0.004). Endothelial function assessed by PAT and [Ca2+]i were similar in both groups. Subjects in HCG had lower odds ratio for prevalent overweight, obesity, abdominal obesity, insulin resistance, HDL-cholesterol < 60mg/dl and systolic BP > 120mmHg.Conclusions: The findings of the present study suggest that high calcium intake is inversely associated with some cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the behavior of BP and endothelial function after spironolactone or clonidine, associated with optimized antihypertensive treatment in patients with resistant hypertension (PRH).Methods: Prospective and randomized study, visits every 4 weeks. VISIT (V) 0: Inclusion of patients with BP>160/100mmHg and <220mmHg. They receive chlorthalidone 25mg/day and Enalapril 40mg/day or Losartan 100mg/day. V1: If BP>140/90 amlodipine was added 5mg/day. Laboratory evaluation (LE), plasma renin and aldosterone and 20 min ECG, ABPM. V2: If BP>140/90 amlodipine titrated to 10mg/day. V3 (Randomization): ABPM, LE and assessment of endothelial function. If BP>140/90 and/or 24h ABPM>130/80 patients received spironolactone 12.5mg/day or clonidine 0.200mg/day. V4 and V5 (PRH): titration of clonidine (0.200mg to 0.600mg) or spironolactone (12.5mg to 50mg). V6: The same evaluation of V3. Patients with controlled BP in V3 have maintained their medication in V4, V5 and V6 and undergo the same tests that PRH. BP and ABPM was assessed by an automatic device; endothelial function by tonometry arteriolar peripheral (PAT) with Endo-PAT2000 ® and biomarkers (I-CAM, V-CAM, E-sel, PCR); plasma renin and aldosterone by RIA.Results: So far the study evaluated 46 patients where 28 patients had controlled BP and 13 remained resistant. In the spironolactone group the 24h-BP behavior, assessed by ABPM was SBP (V1) 162,8±7,9 and (V6) 124,3±3,7 (p<0,05), DBP (V1) 99,7±5,1 and (V6) 78,2±6,3 (p<0,05); while in the clonidine group SBP (V1) 158,8±11,7 and (V6) 134±19 (p<0,05), DBP (V1) 92±8,4 and (V6) 87,5±13,5 (p<0,05). In the controlled BP group SBP (V1) 134,4±2,7 and (V6) 124,3±3,1 (p<0,05), DBP (V1) 85,2±1,7 and (V6) 78,5±2,5 (p<0,05). The reactive hyperemia index (RHI) determined by the PAT in the spirolactone group was V3: 1,83 ± 0,13 and V6: 1,84 ± 0,2; clonidine group V3: 1,72 ± 0,22 and V6: 1,9 ± 0,6 and controlled BP group V3: 1,87 ± 0,08 and V6: 2,0 ± 0,12.Conclusion: Despite the statistically significant reduction of BP with spironolactone and clonidine, it seems that the improvement in endothelial function has been most pronounced in the clonidine group, although without statistical relevance. [ABSTRACT FROM AUTHOR]

Background: Obstructive sleep apnea (OSA) is considered an independent risk factor for cardiovascular disease. There is evidence that individuals with OSA may have increased levels of inflammatory mediators, altered metabolic profile and endothelial dysfunction.Objective: To evaluate the relation of OSA with endothelial function, anthropometric parameters, body composition, metabolic profile and blood pressure in obese individuals.Methods: Cross-sectional study involving 22 obese patients with body mass index >30 and < 40 kg/m2, aged between 24 and 54 years. The diagnosis of OSA was performed using the equipment Watch-PAT200®. Endothelial function by peripheral arterial tonometry method, using Endo-PAT 2000®.Results: After the evaluation of apnea hypopnea index (AHI), participants were allocated in two groups according to AHI: OSA group (OSAG; n=11; AHI = 18.4 ± 3.9) and control group (CG; n=11; AHI= 2.6 ± 0.3). The percentage of men in AOSG (82%, n = 9) was greater than in CG (36%, n = 4); p = 0.03. Both groups presented similar (p > 0.05) age (OSAG: 38.7 ± 1.9 vs. CG: 35.3 ± 3.3y), as well as body mass index (OSAG: 33.2 ± 0.8 vs. CG: 33.3 ± 0.7kg/m2); % body fat (OSAG: 31.5 ± 1.15 vs. CG: 35.7 ± 0.7kg/m2); and waist circumference (OSAG: 106.2 ± 2 vs. CG: 106.8 ± 2.9cm). Participants in OSAG presented higher values of neck circumference (42.3 ± 0.9 vs. 38.9 ± 1.2cm; P=0.03) and glucose (95.8 ± 3.5 vs. 82.5 ±3.1mg/dL; p=0.01). Subjects with and without OSA had similar levels (p>0,05) of total cholesterol (OSAG: 204.7 ± 10.5 vs. CG: 217.2 ± 13.3mg/dL), HDL-cholesterol (OSAG: 48.1 ± 5.3 vs. CG: 49.5 ± 2.9mg/dL), LDL-cholesterol (OSAG: 129.56± 9.5 vs. CG: 138,3 ± 12.1mg/dL), trigycerides (OSAG: 156.1 ± 24.5 vs. GC: 146.8 ± 19.5mg/dL) and diastolic BP (OSAG: 77.8 ± 2.5 vs. CG: 78.6 ± 2.1mmHg). Mean values of systolic BP presented a tendency to be higher in OSAG (127.4 ± 2.8 vs. 120.7±2mmHg; p=0.07). Endothelial function evaluated by reactive hyperemia index was similar in both groups (OSAG: 1.98 ± 0.14 vs. CG: 1.94 ± 0.14; p=0.86).Conclusions: The findings of the present study suggest that in obese subjects OSA occurs more frequently in men and is associated with higher values of neck circumference and of serum glucose. [ABSTRACT FROM AUTHOR]