Antihypertensive Benefits Research Articles

Experiences, acceptability and feasibility of an isometric exercise intervention for stage 1 hypertension: embedded qualitative study in a randomised controlled feasibility trial

BackgroundHealthy lifestyle changes for patients with stage 1 hypertension are recommended before antihypertensive medication. Exercise has antihypertensive benefits; however, low adoption and high attrition are common. Patients need easily adoptable, effective and manageable exercise interventions that can be sustained for life. We present participant and stakeholder perceptions of an isometric exercise intervention for stage 1 hypertension delivered in the National Health Service (NHS, UK).MethodsAn embedded qualitative study within a randomised-controlled feasibility study included intervention arm participants (n = 10), healthcare professionals from participating NHS sites (n = 3) and non-participating NHS sites (n = 5) taking part in semi-structured interviews to explore feasibility of delivering an isometric exercise intervention within the study design and an NHS context. Data was analysed using reflective thematic analysis.ResultsThree themes were identified: study deliverability; motivators and barriers; support for study participation. Findings indicated that the study was well designed. Health benefits, unwillingness to take medication, altruism and interest in the study helped motivation and adherence. Study support received was good, but healthcare professionals were insecure in intervention delivery with regular training/supervision needed. Perception of health improvement was mixed, but, in some, uptake of wider lifestyle changes resulted from participation. Stakeholders felt that current service challenges/demand would make implementation challenging.ConclusionsDespite participant positivity, delivery of an isometric intervention in an NHS setting was considered challenging given the current service demand, although possible with robust effectiveness evidence. Findings support further effectiveness data and implementation development of the isometric exercise intervention.Trial registrationISRCTN, ISRCTN13472393. Registered 18 September 2020.

Identification, screening and molecular mechanisms of natural stable angiotensin-converting enzyme (ACE) inhibitory peptides from foxtail millet protein hydrolysates: a combined in silico and in vitro study.

The stability of bioactive peptides under various food processing conditions is the basis for their use in industrial manufacturing. This study aimed to identify natural ACE inhibitors with excellent stability and investigate their physicochemical properties and putative molecular mechanisms. Five novel ACE inhibitory peptides (QDPLFPL, FPGVSPF, SPAQLLPF, LVPYRP, and WYWPQ) were isolated and identified using RP-HPLC and Nano LC-MS/MS with foxtail millet protein hydrolysates as the raw material. These peptides are non-toxic and exhibit strong ACE inhibitory activity in vitro (IC50 values between 0.13 mg mL-1 and 0.56 mg mL-1). In addition to QDPLFPL, FPGVSPF, SPAQLLPF, LVPYRP, and WYWPQ have excellent human intestinal absorption. Compared to FPGVSPF and SPAQLLPF, the stable helical structure of LVPYRP and WYWPQ allows them to maintain high stability under conditions that mimic gastrointestinal digestion and various food processing (temperatures, pH, sucrose, NaCl, citric acid, sodium benzoate, Cu2+, Zn2+, K+, Mg2+, Ca2+). The results of molecular docking and molecular dynamics simulation suggest that LVPYRP has greater stability and binding capacity to ACE than WYWPQ. LVPYRP might attach to the active pockets (S1, S2, and S1') of ACE via hydrogen bonds and hydrophobic interactions, then compete with Zn2+ in ACE to demonstrate its ACE inhibitory activity. The binding of LVPYRP to ACE enhances the rearrangement of ACE's active structural domains, with electrostatic and polar solvation energy contributing the most energy to the binding. Our findings suggested that LVPYRP derived from foxtail millet protein hydrolysates has the potential to be incorporated into functional foods to provide antihypertensive benefits.

Influence of Particle Size and Extraction Methods on Phenolic Content and Biological Activities of Pear Pomace.

The main goal of this research was to investigate how particle size influences the characteristics of pear (Pyrus Communis L.) pomace flour and to examine the impact of different pre-treatment methods on the phenolic content and associated bioactivities. Pear pomace flour was fractionated into different particle sizes, namely 1 mm, 710 µm, 180 µm, 75 µm and 53 µm. Then two extraction methods, namely maceration with methanol and two-step extraction with hexane via Soxhlet followed by ultrasound extraction with methanol, were tested. Total phenolic and total flavonoid contents ranged from 375.0 to 512.9 mg gallic acid/100 g DW and from 24.7 to 34.6 mg quercetin/100 g DW, respectively. Two-step extraction provided antioxidant activity up to 418.8 (in FRAP assay) and 340.0 mg Trolox/100 g DW (in DPPH assay). In order to explore various bioactive properties, this study assessed the inhibitory effects of enzymes, specifically α-amylase and β-glucosidase (associated with antidiabetic effects), as well as angiotensin-converting enzyme (linked to potential antihypertensive benefits). Additionally, the research investigated antibacterial potential against both Gram-negative (E. coli) and Gram-positive (S. aureus) bacteria, revealing significant results (p < 0.05), particularly in the case of the two-step extraction method. This investigation underscores the substantial value of certain food industry wastes, highlighting their potential as bioactive ingredients within the framework of a circular economy.

Abstract P237: Bainiku-ekisu Attenuates Cardiac Remodeling In Angiotensin Ii-infused Mice

A fruit of the Prunus mume is a traditional food in Japan. Recently, bainiku-ekisu, an infused juice concentrate of Japanse Prunus mume , is attracting attention as a health promoting supplement. Angiotensin II (AngII) plays a central role in development of hypertension. It has been reported that bainiku-ekisu treatment attenuates the growth-promoting signaling induced by AngII in vascular smooth muscle cells. However, whether bainiku-ekisu has any effect on an animal model of hypertension remains unknown. Therefore, this study was designed to explore the potential anti-hypertensive benefit of bainiku-ekisu utilizing a mouse model of hypertension with AngII infusion. 8- to 10-week-old male C57BL6 mice were randomly divided into four groups and infused with Ang II (1 μg/kg/min) for 2 weeks via osmotic mini-pump or sham-operated, and given 1% BE containing water (BEW) or normal water (control) for 2 weeks. Blood pressure was evaluated every other day by tail cuff measurement and at 2 weeks by telemetry. Cardiac hypertrophy was assessed by heart-to-body weight ratio. After 2 weeks, mice were euthanized, and the aorta and heart collected. Extracted aortas and hearts were fixed and used for histological studies to evaluate vascular remodeling. Increase in heart-to-body weight ratios by Ang II were unaltered by BEW. Aortic medial hypertrophy was observed in control mice (n=5) after 2 weeks of Ang II infusion, which was attenuated in BEW group (96 μm vs. 71 μm, respectively, p&lt;0.01). Control mice with angiotensin II infusion showed cardiac matrix deposition, which was attenuated in BEW group. In addition, attenuation of hypertension was observed in Ang II-infused mice with BEW treatment. We also observed attenuation of protein synthesis induced by AngII with BE incubation in cultured aortic VSMC. In conclusion, BEW prevented Ang II-induced vascular remodeling and hypertension. Potential cardiovascular health benefit to taking BE as a functional food should be further studied.

Application of Molecular Dynamics Simulations to Determine Interactions between Canary Seed (Phalaris canariensis L.) Bioactive Peptides and Skin-Aging Enzymes.

Food bioactive peptides are well recognized for their health benefits such as antimicrobial, antioxidant, and antihypertensive benefits, among others. Their drug-like behavior has led to their potential use in targeting skin-related aging factors like the inhibition of enzymes related with the skin-aging process. In this study, canary seed peptides (CSP) after simulated gastrointestinal digestion (<3 kDa) were fractioned by RP-HPLC and their enzyme-inhibition activity towards elastase and tyrosinase was evaluated in vitro. CSP inhibited elastase (IC50 = 6.2 mg/mL) and tyrosinase (IC50 = 6.1 mg/mL), while the hydrophobic fraction-VI (0.2 mg/mL) showed the highest inhibition towards elastase (93%) and tyrosinase (67%). The peptide fraction with the highest inhibition was further characterized by a multilevel in silico workflow, including physicochemical descriptor calculations, antioxidant activity predictions, and molecular dynamics-ensemble docking towards elastase and tyrosinase. To gain insights into the skin permeation process during molecular dynamics simulations, based on their docking scores, five peptides (GGWH, VPPH, EGLEPNHRVE, FLPH, and RPVNKYTPPQ) were identified to have favorable intermolecular interactions, such as hydrogen bonding of polar residues (W, H, and K) to lipid polar groups and 2-3 Å van der Waals close contact of hydrophobic aliphatic residues (P, V, and L). These interactions can play a critical role for the passive insertion of peptides into stratum corneum model skin-membranes, suggesting a promising application of CSP for skin-aging treatments.

Infused juice concentrate of Japanese plum Prunus mume attenuates inflammatory vascular remodeling in a mouse model of hypertension induced by angiotensin II.

Fruit from the Prunus mume tree is a traditional food in Japan. Recently, bainiku-ekisu, an infused juice concentrate of Japanese Prunus mume, is attracting attention as a health promoting supplement. Angiotensin II (Ang II) plays a central role in development of hypertension. It has been reported that bainiku-ekisu treatment attenuates the growth-promoting signaling induced by Ang II in vascular smooth muscle cells. However, whether bainiku-ekisu has any effect on an animal model of hypertension remains unknown. Therefore, this study was designed to explore the potential anti-hypertensive benefit of bainiku-ekisu utilizing a mouse model of hypertension with Ang II infusion. Male C57BL/6 mice were infused with Ang II for 2 weeks and given 0.1% bainiku-ekisu containing water or normal water for 2 weeks with blood pressure evaluation. After 2 weeks, mice were euthanized, and the aortas were collected for evaluation of remodeling. Aortic medial hypertrophy was observed in control mice after Ang II infusion, which was attenuated in bainiku-ekisu group with Ang II infusion. Bainiku-ekisu further attenuated aortic induction of collagen producing cells and immune cell infiltration. Development of hypertension induced by Ang II was also prevented by bainiku-ekisu. Echocardiograph indicated protection of Ang II-induced cardiac hypertrophy by bainiku-ekisu. In vascular fibroblasts, bainiku-ekisu attenuated vascular cell adhesion molecule-1 induction, an endoplasmic reticulum stress marker, inositol requiring enzyme-1α phosphorylation, and enhancement in glucose consumption in response to Ang II. In conclusion, Bainiku-ekisu prevented Ang II-induced hypertension and inflammatory vascular remodeling. Potential cardiovascular health benefit to taking bainiku-ekisu should be further studied.

Parboiled Germinated Brown Rice Improves Cardiac Structure and Gene Expression in Hypertensive Rats.

Hypertension leads to oxidative stress, inflammation, and fibrosis. The suppression of these indicators may be one treatment approach. Parboiled germinated brown rice (PGBR), obtained by steaming germinated Jasmine rice, reduces oxidative stress and inflammation in vivo. PGBR contains more bioactive compounds than brown rice (BR) and white rice (WR). Anti-hypertensive benefits of PGBR have been predicted, but research is lacking. The anti-hypertensive effects of PGBR were investigated in the downstream gene network of hypertension pathogenesis, including the renin-angiotensin system, fibrosis, oxidative stress production, and antioxidant enzymes in N-nitro-L-arginine methyl ester (L-NAME)-induced hypertensive rats. To strengthen our findings, the cardiac structure was also studied. PGBR-exposed rats showed significant reductions in systolic blood pressure (SBP) compared to the hypertensive group. WR did not reduce SBP because of the loss of bioactive compounds during intensive milling. PGBR also reduced the expression of the angiotensin type 1 receptor (AT1R), transforming growth factor-β (TGF-β), and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (NOX4), which contribute to the renin-angiotensin system, fibrosis, and oxidative stress production, respectively. Losartan (Los, an anti-hypertensive drug)-treated rats also exhibited similar gene expression, implying that PGBR may reduce hypertension using the same downstream target as Los. Our data also indicated that PGBR reduced cardiac lesions, such as the cardiomyopathy induced by L-NAME. This is the first report on the anti-hypertensive effects of PGBR in vivo by the suppression of the renin response, fibrosis, and improved cardiac structure.

Low intensity stimulation of aortic baroreceptor afferent fibers as a potential therapeutic alternative for hypertension treatment

Carotid baroreceptor stimulation has been clinically explored for antihypertensive benefits, but neuromodulation of aortic baroreceptor afferents remains unexplored for potential translation into the clinic. Published studies have used supramaximal stimulations, which are unphysiological and energy inefficient. The objective of the present study was to identify optimal low-charge nerve stimulation parameters that would provide a clinically-relevant (20–30 mmHg) decrease in mean arterial pressure (MAP) in anesthetized spontaneously hypertensive rats. Stimulations of 20 s were delivered to the left aortic depressor nerve (ADN) of these rats using low ranges of pulse amplitudes (≤ 0.6 mA), widths (≤ 0.5 ms) and frequencies (≤ 5 Hz). We also assessed the effects of continuous (20 s) versus intermittent (5 s ON/3 s OFF and 5 s ON/3 s OFF for 20 s) stimulation on MAP, heart rate (HR), mesenteric (MVR) and femoral (FVR) vascular resistance using low (5 Hz) and high (15 Hz) frequencies. Lower pulse amplitudes (0.2 mA) produced 9 ± 2 to 18 ± 2 mmHg decreases in MAP. Higher pulse amplitudes (0.4 mA) produced a median MAP reduction of 28 ± 4 mmHg at 0.2 ms and 5 Hz, with no added benefit seen above 0.4 mA. Continuous and intermittent low frequency stimulation at 0.4 mA and 0.2 ms produced similar sustained decreases in MAP, HR, MVR and FVR. Continuous high frequency stimulation at 0.4 mA and 0.2 ms produced larger reductions in MAP, HR, MVR and FVR compared with all low frequency and/or intermittent high frequency stimulations. We conclude from these findings that “low intensity intermittent” electrical stimulation is an effective alternate way for neuromodulation of the aortic baroreceptor afferents and to evoke a required restoration of MAP levels in spontaneously hypertensive rats. This approach enables low energy consumption and markedly lowers the excessive decreases in MAP and hemodynamic disturbances elicited by continuous high-charge injection protocols.

The benefits of antihypertensive drugs in patients with high blood pressure and glaucoma

Systemic hypertension, atherosclerosis and vasospasm have been recognized as potential factors that are capable of increasing the risk of glaucoma. Several other factors may contribute to the development and progression of the disease, including systemic drugs used to treat other pathologies. Numerous studies have examined the effect of antihypertensive medication on glaucoma, due to their property of modifying vascular events. Effective hypotensive drugs that lower blood pressure reduce the complications of high blood pressure, including changes in intraocular pressure (IOP). It has been shown that the most significant decrease in IOP was registered in patients taking calcium channel blockers, beta-adrenoblockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers and diuretics. The renin-angiotensin system plays a critical role in the pathophysiology of various ocular diseases by causing inflammation, oxidative stress and angiogenesis. All components are currently present in eye structures and play an important role in ocular pathology: diabetic retinopathy, age-related macular degeneration, glaucoma, retinitis pigmentosa. The use of angiotensin converting enzyme inhibitors and angiotensin receptor blockers reduces the formation of aqueous humor, increases uveoscleral flow, reduces intraocular pressure and has a protective effect by reducing the inflammatory process, oxidative stress and angiogenesis.

Improving Phenolic Bioactive-Linked Functional Qualities of Sweet Potatoes Using Beneficial Lactic Acid Bacteria-Based Biotransformation Strategy

Beneficial lactic acid bacteria (LAB) based fermentation is an effective biotransformation strategy to preserve and improve the human health-supporting functional qualities of plant-based food substrates. In this study, a food grade strain of Lactiplantibacillus plantarum was recruited to improve the retention, stability, and bioavailability of phenolic bioactives to enhance the antioxidant, anti-hyperglycemic, and anti-hypertensive functional qualities of three flesh-colored sweet potato varieties, Murasaki (off-white-fleshed), Evangeline (orange-fleshed), and NIC-413 (purple-fleshed). Liquid (cold water) extracts of the sweet potatoes, which are relevant for food grade applications, were fermented for 72 h at 37 °C. Total soluble phenolic content, phenolic profile, antioxidant, anti-hyperglycemic, and anti-hypertensive benefits relevant functional properties of fermented and unfermented sweet potato extracts were evaluated at 0, 24, 48, and 72 h time points using in vitro assay models. Overall, high total soluble phenolic content and total antioxidant activity were observed at 24 h, retaining this high level even after 72 h of fermentation. Additionally, moderate to high α-amylase, α-glucosidase, and angiotensin-I-converting enzyme inhibitory activities were observed in the fermented sweet potato extracts. The results suggested that LAB-based fermentation is an effective post-harvest processing strategy for a higher retention of phenolic bioactives and concurrently improves the human health protective bioactive functional qualities of sweet potatoes.

Antihypertensive Effect of Amaranth Hydrolysate Is Comparable to the Effect of Low-Intensity Physical Activity

Background and objectives: Both antihypertensive peptide intake and physical activity help to control blood pressure. Our aim was to evaluate the impact of consuming amaranth antihypertensive peptides on systolic blood pressure (SBP) in normotensive rats and the magnitude and relevance of the peptide-induced antihypertensive effect in spontaneously hypertensive rats (SHR). Materials and Methods: Treatments (alcalase-generated amaranth protein hydrolysate, captopril, or water) were given by gavage and the SBP measured by the tail-cuff method. Physical activity was performed five days/week (for twenty weeks). Results: The normotensive rats’ SBP (mmHg, average/group) remained unaffected after amaranth antihypertensive peptide supplementation (121.8) (p &gt; 0.05 vs controls). In SHR, the SBP was lowered by 24.6 (sedentary/supplemented at two weeks), 42.0 (sedentary/supplemented at eight weeks), and 31.5 (exercised/non-supplemented at eight weeks) (p &lt; 0.05 vs sedentary/non-supplemented). The combination of supplementation and physical activity lowered the SBP by 36.2 and 42.7 (supplemented/exercised at two weeks and eight weeks, respectively) (p &lt; 0.05 vs sedentary/non-supplemented), but it did not have additional antihypertensive benefits (p &gt; 0.05 vs sedentary/supplemented at eight weeks or exercised/non-supplemented at eight weeks). Conclusions: Amaranth antihypertensive peptide supplementation has no impact on SBP in normotensive rats. This supplementation develops sustained antihypertensive benefits in SHR, which are similar to the antihypertensive effect developed after eight- or twenty-week low-intensity physical activity. These findings have implications for developing safe and effective peptide-based functional foods.

A double-blind, randomized, crossover trial protocol of whole hemp seed protein and hemp seed protein hydrolysate consumption for hypertension

BackgroundPrimary hypertension accounts for almost 95% of all cases of high blood pressure and is a major modifiable risk factor for cardiovascular diseases. Lifestyle interventions have been shown to prevent hypertension. One of the prominent potential therapeutic lifestyle strategies to prevent or manage hypertension is increasing dietary protein as a macronutrient or as bioactive peptides. An emerging plant-based protein source that may have anti-hypertensive properties is hemp seed.Methods/designA randomized, double-blind, crossover clinical trial will be conducted on 35 hypertensive participants aged 18–75 years, with a BMI between 18.5 and 40 kg/m2, systolic blood pressure (SBP) between 130 and 160 mmHg and diastolic blood pressure (DBP) ≤ 110 mmHg. The trial will be conducted for a period of 22 weeks and will consist of three treatment periods of 6 weeks, separated by 2-week washout periods. The treatments will be consumed twice a day and consist of 25 g casein, hemp seed protein (HSP), or HSP plus HSP hydrolysate (HSP+). The primary outcome of this trial is 24-h SBP, measured on the first day of first phase and the last day of each phase. Office-measured blood pressure, pulse-wave velocity and augmentation index and anthropometrics will be determined at the first and last days of each period. Also, body composition will be assessed by dual x-ray absorptiometry (DXA) scan on the first day of the first phase and within the last 2 days of each treatment period. Blood samples will be collected on the first and last 2 days of each treatment phase whereas urine samples will be collected on the first day of the first phase plus the last day of each phase to be analyzed for specific biomarkers.DiscussionThis trial protocol is designed to evaluate the hypotensive potential of consuming whole HSP, and HSP+, in comparison to casein protein. This study will be the first trial investigating the potential anti-hypertensive benefit of dietary hemp protein plus bioactive peptide consumption in humans.Trial registrationNational Clinical Trial (NCT), ID: NCT03508895. Registered on 28 June 2018. Retrospectively registered on the publicly accessible Registry Databank at ClinicalTrials.gov (http://ClinicalTrials.gov).

Influence of pre-treatment blood pressure levels on antihypertensive drug benefits in diabetics: the roadmap experience

Purpose: Most guidelines for treatment of hypertension in the setting of diabetes recommend a blood pressure (BP) target of <130/80 mmHg. However, uncertainty exists about the extent, effectiveness and safety of lowering BP in diabetics. To expand the evidence on this issue, we analysed data from the Randomised Olmesartan and Diabetes MicroAlbuminuria Prevention (ROADMAP) study population.Material: Substudy with blood pressure readings.Methods: The response after initiation of therapy and adequacy of BP control across patients with different BP levels at baseline were analysed.Results: BP at randomisation was 136.2(15.3)/80.6(9.5) [mean (SD)] mmHg with a range of 87–213/37–123 mmHg. At 1 year, mean BP was 127 (11.9)/75 (8.1) mmHg and the overall control rate (<130/80 mmHg) exceeded 61% in this population. The mean reductions in systolic [−9.4 (15.4) mmHg] and diastolic BP [−5.4 (9.5) mmHg] were highly dependent on the BP stage at Visit 1. At 1 year, treatment decreased the prevalence of patients with baseline BP levels of >160/100 from 9 to 2%[[mean BP change −31 (15.7)/ −14 (9.8) mmHg]] and of 140–159/90–99 mmHg from 32 to 11% [[mean BP change −16(12.7)/ −8.9 (8.7) mmHg]], with corresponding increases in the prevalence of patients with baseline BP levels of 120–139/80–99 from 48 to 65% [[mean BP change −4.1 (10.6)/ −3.1 (7.8) mmHg]]and of <120/80 from 11 to 22% [[mean BP change +5.9 (11.8)/+2.5 (8.6) mmHg]]. These effects did not change significantly thereafter and were maintained throughout follow-up.Conclusion: Blood pressure control is feasible in patients with diabetes without nephropathy, independent of baseline BP values. Asymmetric BP-lowering in the first year after starting therapy represents a true antihypertensive effect with sustainable shifts in BP severity.

Antihypertensive and Antioxidant Properties of Moringa Oleifera Seed Enzymatic Protein Hydrolysate and Ultrafiltration Fractions

The aim of this study was to evaluate the in vitro antioxidant and antihypertensive as well as potential cardioprotective properties of peptides generated from enzymatic hydrolysis of Moringa oleifera seed. Moringa protein isolate was digested with alcalase and the hydrolysate fractionated by ultrafiltration using 1, 3, 5, and 10 kDa molecular weight cut-off membranes. Results showed that membrane separation led to decreased free radical (DPPH, hydroxyl) scavenging but enhanced ferric reducing antioxidant power and metal ion chelation properties. The 1–3 kDa peptide fraction was the most active against angiotensin converting enzyme and renin with 6.70% and 24.62% increases, respectively when compared to the hydrolysate. Oral administration (200 mg/kg body weight) to spontaneously hypertensive rats (SHR) resulted in significant decreases in systolic (SBP), diastolic and mean arterial (MAP) blood pressure for the hydrolysates and peptide fractions when compared to the negative control. The 1–3 kDa peptide fraction also showed the greatest (–35 mm Hg) in SBP along with fastest (2 h) reduction of SBP and MAP in the SHR. The hydrolysate produced the most persistent SBP reduction with up to –34 mm Hg after 24 h. However, the longer peptides (&gt;10 kDa) were the most effective (–78 beats per min) in reducing SHR heart rate. The results suggest that the alcalase-hydrolyzed M. oleifera seed peptides could function as potential ingredients for the formulations of functional foods and nutraceuticals with antihypertensive benefits.

Variation in minimum desired cardiovascular disease-free longevity benefit from statin and antihypertensive medications: a cross-sectional study of patient and primary care physician perspectives

ObjectiveExpressing therapy benefit from a lifetime perspective, instead of only a 10-year perspective, is both more intuitive and of growing importance in doctor–patient communication. In cardiovascular disease (CVD) prevention, lifetime...

Efficacy and safety of baroreflex activation therapy for treatment of resistant hypertension: a systematic review and meta-analysis

ABSTRACTTo provide definite evidence for the anti-hypertensive benefit of Baroreflex Activation Therapy (BAT) for resistant hypertension, we performed a systematic review and meta-analysis to evaluate the efficacy and safety of BAT. Electronic searches were conducted in PubMed, EMBASE, The Cochrane Library and Web of Science. Two reviewers independently determined the eligibility of studies and extracted the data. The quality of all included studies was evaluated by the use of the Newcastle Ottawa Scale (NOS). Disagreements were settled through discussion. Twelve studies, included one randomized clinical trials (RCTs) and eleven prospective studies were eligible for qualitative analysis and five prospective studies were selected for meta-analysis. The data of analysis showed office systolic blood pressure (SBP)(WMD = −24.01, 95% CI = −28.65 to −19.36, P= 0.753I2 = 0.0%) and diastolic blood pressure (DBP)(WMD = −12.53, 95% CI = −15.82 to −9.24,P = 0.893,I2 = 0.893) decreased by BAT treatment.The effect on SBP was both significant in the Barostim neo TM device (WMD = −22.49, 95% CI = −29.13 to 15.84, P= 0.443; I2 = 0.0%) and Rheos System (WMD = 25.46, 95% CI = −31.96 to −18.96, P= 0.703; I2 = 0.0%). Our study found office BP were significantly decreased by BAT treatment, but available evidence is limited by risk of bias, small sample size, and few RCTs. Thus, there is presently insufficient evidence to fully evaluate the efficacy and safety of BAT for Patients with Resistant Hypertension. Additional high-quality RCT research with long-term follow-up is required.

Dietary ginger and turmeric rhizomes prevent oxidative stress and restore delta-aminolevulinic acid dehydratase activity in L-NAME treated rats

The inhibition of endothelial nitric oxide synthase (eNOS) activity has been implicated in the production of reactive oxygen species (ROS) thereby depleting antioxidant status. Thus, the current study investigated the effect of ginger and turmeric rhizomes on delta-aminolevulinic acid dehydratase (δ-ALA-D) activity in L-NAME treated rats. Animals were treated with dietary turmeric or ginger (4%) before induction with nitric oxide (NO) inhibitor (L-NAME, 40 mg/kg/day). The results revealed that ginger and turmeric rhizomes caused a significant (p < .05) increased in renal and hepatic δ-ALA-D activity as well as enzymatic (superoxide dismutase [SOD] and catalase [CAT] activities) and nonenzymatic antioxidant (nonprotein thiols) levels with a concomittant decreased in renal (creatinine and urea) and hepatic (AST, ALT, and γ-glutamyltranspeptidase) function biomarkers in L-NAME treated rats. This finding suggests that the increase in δ-ALA-D activity and antioxidants status by dietary ginger and turmeric rhizomes could provide a possible mechanism of action for their antihypertensive potential. Practical applications Ginger and turmeric rhizomes have been reported to prevent hypertension via depletion of ROS but the exact mechanism remains unclear. However, the present findings revealed an increase in δ-ALA-D activity and antioxidants status by these rhizomes which could provide a possible mechanism of action for their antihypertensive benefit.

Postexercise Hypotension After Aquatic Exercise in Older Women With Hypertension: A Randomized Crossover Clinical Trial

Hypertension can be prevented and modified with lifestyle interventions that include regular exercise. Aquatic exercise is widely recommended for older adults for a variety of health benefits, but few studies have assessed the immediate ambulatory blood pressure (BP) response to aquatic exercise, a response termed postexercise hypotension (PEH). Thus, we assessed PEH after a session of aquatic exercise in physically active, older women with hypertension. Twenty-four women 70.0 ± 3.9 years with a resting systolic (SBP)/diastolic (DBP) BP of 124.0/72.3 mm Hg and body mass index of 29.8 ± 4.1 kg/m2 were randomly assigned to participate in a 45-minute session of moderate intensity, water-based exercise (WATER) and a 45-minute land control session (CONTROL). All experimental sessions started at 9 am sharply with 7 days between them. Subjects left the experiments wearing an ambulatory BP monitor for the next 21 hours. SBP was lower by 5.1 ± 1.0 mm Hg after WATER than CONTROL over 21 hours (P < 0.001), over awake hours by 5.7 ± 1.1 mm Hg (P < 0.001), and sleep hours by 4.5 ± 0.4 mm Hg (P = 0.004). DBP was lower following WATER compared to CONTROL: 1.2 ± 0.3 mm Hg over 21 hours (P = 0.043); 0.9 ± 0.6 mm Hg over awake hours (P = 0.101); and 1.4 ± 0.9 mm Hg over sleep hours (P = 0.039). Aquatic exercise elicited PEH (~5 mm Hg) over 21 hours, BP reductions that are comparable in magnitude to land aerobic exercise. The immediate antihypertensive benefits of acute aquatic exercise should continue to be explored in future studies.

Abstract 062: Vascular Dysfunction and Hypertension are Prevented by a Novel PPARγ Target Gene, RhoBTB1

RhoBTB1 is a novel peroxisome proliferator-activated receptor gamma (PPARγ) target gene expressed in smooth muscle cells (SMC) which may mediate some of the vascular protective and antihypertensive benefits of PPARγ. Here, we tested the hypothesis that RhoBTB1 can prevent angiotensin II (ANG)-induced hypertension. RhoBTB1 expression in aorta from C57BL/6 mice was decreased by 54±9% (n=16) in response to ANG infusion (490 ng/min/kg, 2 weeks). To test if RhoBTB1 expression is protective, we generated double transgenic mice with tamoxifen-inducible, Cre-dependent overexpression of RhoBTB1 specifically in SMC (S-RhoBTB1). S-RhoBTB1 and non-transgenic (NT) mice were treated with tamoxifen (Tx; 75 mg/kg, ip, 5 days) or vehicle (corn oil) and then ANG was infused. Although RhoBTB1 expression was decreased in ANG-infused control mice (p&lt;0.01, n=8-10), RhoBTB1 expression in Tx-treated S-RhoBTB1 mice infused with ANG was restored to a level similar to NT treated with saline (n=11). Overexpression of RhoBTB1 did not alter baseline blood pressure (BP) in the absence of ANG (n=7-8). However, the increase in BP induced by ANG was significantly attenuated by RhoBTB1 restoration in S-RhoBTB1 mice with Tx compared to ANG-infused control mice (either NT with Tx, NT with corn oil, or S-RhoBTB1 with corn oil) in which RhoBTB1 was not restored (Systolic BP, 159±5 in control mice vs 132±6 mmHg in S-RhoBTB1 mice with Tx, p&lt;0.01, n=7-8). We also observed increased heart weight in ANG-infused control mice, which was prevented in S-RhoBTB1 mice treated with Tx (p&lt;0.05, n=8). Thoracic aorta and basilar artery from ANG-infused control mice exhibited impaired acetylcholine-induced endothelial-dependent relaxation (Aorta, 48±2%, p&lt;0.01, n=6-8), which was prevented by restoration of RhoBTB1 in SMC (Aorta, 76±5%, p&lt;0.01, n=6-8). Thoracic aorta from ANG-infused control mice also displayed decreased sodium nitroprusside-induced endothelial-independent relaxation with a right-shifted dose-response (76±9%, p&lt;0.01, n=8), which was also prevented in tamoxifen-treated S-RhoBTB1 mice (95±10%, p&lt;0.01, n=8). We conclude that the novel PPARγ target gene, RhoBTB1, functions in SMC to specifically facilitate vasodilation and mediates a protective anti-hypertensive effect.

Abstract P110: Low Intensity Stimulation of Aortic Baroreceptors as a Potential Therapeutic Alternative for Hypertension Treatment

Carotid baroreceptor stimulation has been clinically explored for antihypertensive benefits but aortic baroreceptor modulation remains untouched for clinical translation. Published studies use large current/voltage amplitudes (10V), longer pulse widths (2 ms) or ultra-high frequencies (70-100 Hz). These are energy inefficient neuromodulation methods. Our main goal was to identity optimal nerve stimulation parameters that would provide a sustained drop in mean arterial pressure (MAP) of ~30 mmHg. We stimulated aortic depressor nerve (ADN) in spontaneously hypertensive rats (SHR, n =4) at low ranges of frequencies, pulse amplitudes and pulse widths. Under urethane anesthesia, left ADN was stimulated for 20 seconds at varying frequencies (1, 2.5 and 5 Hz) and pulse amplitudes (0.2, 0.4 and 0.6 mA) at 0.1, 0.2 or 0.5 ms pulse width. A frequency-dependent depressor response was seen at all pulse amplitudes and widths used. Lower pulse amplitudes (0.2 mA) produced ~18 mmHg MAP drop at all pulse widths tested. Higher pulse amplitude (0.4 and 0.6 mA) produced similar drop in MAP of ~34 mmHg. The return to baseline values was relatively prolonged with higher charge injection with 32 seconds at 0.2 mA (0.1 or 0.2 ms at 5 Hz, maximum effect size: -18 mmHg) versus 42 seconds at 0.4 or 0.6 mA (0.1, 0.2 or 0.5 ms at 5 Hz, maximum effect size: -34 mmHg). There was no added benefit of pulse amplitudes beyond 0.4 mA. We conclude that low intensity stimulation is an effective alternate way to neuromodulation of the ADN. This will enable low energy consumption for neuromodulation. Future studies will study impact of these parameters in conscious SHR rats.