- •Effects of one-year intervention with a traditional Med-diet supplemented with either extra virgin olive oil or nuts.
- •Decrease in blood pressure (BP) was mediated by plasma nitric oxide (NO) production.
- •Total polyphenol excretion in spot urine was positively correlated with plasma NO.
- •Mediterranean diets may help to decrease BP due to a high polyphenol consumption.
Background and aim
Hypertension is one of the main cardiovascular risk factors in the elderly. The aims of this work were to evaluate if a one-year intervention with two Mediterranean diets (Med-diet) could decrease blood pressure (BP) due to a high polyphenol consumption, and if the decrease in BP was mediated by plasma nitric oxide (NO) production.
Methods and results
An intervention substudy of 200 participants at high cardiovascular risk was carried out within the PREDIMED trial. They were randomly assigned to a low-fat control diet or to two Med-diets, one supplemented with extra virgin olive oil (Med-EVOO) and the other with nuts (Med-nuts). Anthropometrics and clinical parameters were measured at baseline and after one year of intervention, as well as BP, plasma NO and total polyphenol excretion (TPE) in urine samples. Systolic and diastolic BP decreased significantly after a one-year dietary intervention with Med-EVOO and Med-nuts. These changes were associated with a significant increase in TPE and plasma NO. Additionally, a significant positive correlation was observed between changes in urinary TPE, a biomarker of TP intake, and in plasma NO (Beta = 4.84; 95% CI: 0.57–9.10).
TPE in spot urine sample was positively correlated with plasma NO in Med-diets supplemented with either EVOO or nuts. The statistically significant increases in plasma NO were associated with a reduction in systolic and diastolic BP levels, adding to the growing evidence that polyphenols might protect the cardiovascular system by improving the endothelial function and enhancing endothelial synthesis of NO.
Abbreviations:BMI (body mass index), BP (blood pressure), CHD (coronary heart disease), CI (confidence interval), DASH (Dietary-Approaches-to-Stop-Hypertension), EVOO (extra virgin olive oil), FFQ (food frequency questionnaire), GAE (gallic acid equivalent), Med-diet (Mediterranean diet), Med-EVOO (Mediterranean diet-extra virgin olive oil), Med-nuts (Mediterranean diet-nuts), NO (Nitric oxide), PREDIMED (prevention with Mediterranean diet study), SD (standard deviations), TP (total polyphenols), TPE (total polyphenols excreted)
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Published online: September 18, 2014
Accepted: September 1, 2014
Received in revised form: August 26, 2014
Received: July 7, 2014
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