EFFECTS OF LIFESTYLE ADVICE ASSOCIATED WITH BEETROOT-BASED NUTRACEUTICAL ON 24-HOUR BLOOD PRESSURE IN A POPULATION WITH HIGH-NORMAL BLOOD PRESSURE OR GRADE 1 HYPERTENSION

Abstract

Objective: 2018 ESH hypertension guideline supports life-style changes as initial approach to be taken in both subjects with high-normal blood pressure (BP) and patients with grade 1 hypertension and low cardiovascular (CV) risk. Among many nutraceuticals, most with unproven or unlikely benefits, bioactive substances enriched with nitrates, sources of nitric oxide (i.e. red beets) exert proven vasodilator effects and may decrease BP levels. Aim: to evaluate the effect of lifestyle advice and beetroot-based nutraceutical on 24-h BP in a population with high-normal BP or grade 1 hypertension and low CV risk. Design and method: Longitudinal study on 43 consecutive subjects referred to two hypertension centers. A 24-h ambulatory BP monitoring (ABPM) was performed at baseline and after 3 month the introduction of lifestyle advice and beetroot-based nutraceutical [Cosmony, Servier, a nutraceutical based on Beta vulgaris L. (500 mg of dry beetroot extract)]. Results: Mean age: 49.9±10.7 years. Male prevalence: 53.5%. Median follow-up: 98 (92-121) days. Overweight/obese prevalence: 58.1%. The 62.8% of subjects had a grade 1 hypertension. At baseline, 24-h BP, daytime BP and night-time BP were 127.2±6.8/79.6±5.6 mmHg, 131.3±7.5/83.4±5.5 mmHg and 117.8±7.7/70.2±5.0 mmHg, respectively. At follow-up, all BPs showed a statistically significant decrease (all p<0.005), except for diastolic night-time BP (p = 0.074) (-3.4±5.9/-2.2±3.7 mmHg for 24h BP; -3.9±6.0/-3.0±4.0 for daytime BP and -3.3±7.4/-1.3±4.7 for night-time BP). The percentage of subject with daytime BP <130/85 mmHg had increased from 25.6% at baseline to 48.8% at follow-up. The decrease in BP was independent of gender and overweight/obesity, whereas it was more evident in the group of grade 1 hypertensives compared with the group with high-normal BP. Conclusions: Lifestyle advice in association with a nutraceutical, source of nitric oxide, may be a valid initial non-pharmacological therapy in subjects with high-normal BP or grade 1 hypertension and low CV risk.