Endothelial Function In Individuals Research Articles

Eight weeks of treatment with mineralocorticoid receptor blockade does not alter vascular function in individuals with and without type 2 diabetes.

Aldosterone has been suggested to be involved in the microvascular complications observed in type 2 diabetes. We aimed to investigate the effect of mineralocorticoid receptor (MR) blockade on endothelial function in individuals with type 2 diabetes compared to healthy controls. We included 12 participants with type 2 diabetes and 14 controls. We measured leg hemodynamics at baseline and during femoral arterial infusion of acetylcholine and sodium nitroprusside before and 8 weeks into treatment with MR blockade (eplerenone). Acetylcholine infusion was repeated with concomitant n-acetylcysteine (antioxidant) infusion. No difference in leg blood flow or vascular conductance was detected before or after the treatment with MR blockade in both groups and there was no difference between groups. Infusion of n-acetylcysteine increased baseline blood flow and vascular conductance, but did not change the vascular response to acetylcholine before or after treatment with MR blockade. Skeletal muscle eNOS content was unaltered by MR blockade and no difference between groups was detected. In conclusion, we found no effect of MR blockade endothelial function in individuals with and without type 2 diabetes. As the individuals with type 2 diabetes did not have vascular dysfunction, these results might not apply to individuals with vascular dysfunction.

Acute Effects of Coffee Consumption on Blood Pressure and Endothelial Function in Individuals with Hypertension on Antihypertensive Drug Treatment: A Randomized Crossover Trial.

Coffee is a complex brew that contains several bioactive compounds and some of them can influence blood pressure (BP) and endothelial function (EF), such as caffeine and chlorogenic acids (CGAs). This study aimed to evaluate the acute effects of coffee on BP and EF in individuals with hypertension on drug treatment who were habitual coffee consumers. This randomized crossover trial assigned 16 adults with hypertension to receive three test beverages one week apart: caffeinated coffee (CC; 135mg caffeine, 61mg CGAs), decaffeinated coffee (DC; 5mg caffeine, 68mg CGAs), and water. BP was continuously evaluated from 15min before to 90min after test beverages by digital photoplethysmography. Reactive hyperemia index (RHI) assessed by peripheral arterial tonometry evaluated EF before and at 90min after test beverages. At the same time points, microvascular reactivity was assessed by laser speckle contrast imaging. Repeated-measures-ANOVA evaluated the effect of time, the effect of beverage, and the interaction between time and beverage (treatment effect). Although the intake of CC produced a significant increase in BP and a significant decrease in RHI, these changes were also observed after the intake of DC and were not significantly different from the modifications observed after the consumption of DC and water. Microvascular reactivity did not present significant changes after the 3 beverages. CC in comparison with DC and water neither promoted an acute increase in BP nor produced an improvement or deleterious effect on EF in individuals with hypertension on drug treatment who were coffee consumers.

Advancements in the Regulation of Different-Intensity Exercise Interventions on Arterial Endothelial Function.

Normal-functioning endothelium is crucial to maintaining vascular homeostasis and inhibiting the development and progression of cardiovascular diseases such as atherosclerosis. Exercise training has been proven effective in regulating arterial endothelial function, and the effect of this regulation is closely related to exercise intensity and the status of arterial endothelial function. With this review, we investigated the effects of the exercise of different intensity on the function of arterial endothelium and the underlying molecular biological mechanisms. Existing studies indicate that low-intensity exercise improves arterial endothelial function in individuals who manifest endothelial dysfunction relative to those with normal endothelial function. Most moderate-intensity exercise promotes endothelial function in individuals with both normal and impaired arterial endothelial function. Continuous high-intensity exercise can lead to impaired endothelial function, and high-intensity interval exercise can enhance both normal and impaired endothelial function. In addition, it was demonstrated that the production of vasomotor factors, oxidative stress, and inflammatory response is involved in the regulation of arterial endothelial function under different-intensity exercise interventions. We posit that this synthesis will then provide a theoretical basis for choosing the appropriate exercise intensity and optimize the prescription of clinical exercise for persons with normal and impaired endothelium.

Effect of aerobic and resistance exercise training on endothelial function in individuals with overweight and obesity: a systematic review with meta-analysis of randomized clinical trials

The objective of this systematic review was to examine the effects of exercise training on endothelial function in individuals with overweight and obesity. Our review study included only randomized controlled trials (RCTs) involving adults (≥ 18 years of age) with body mass index (BMI) ≥ 25.0 kg/m2. Our search was conducted in the electronic bases MEDLINE (PubMed), Cochrane, LILACS and EMBASE and in the gray literature. We performed random-effects analyses for effect estimates and used 95% prediction intervals (95% PI) for estimating the uncertainty of the study results. There were selected 10 RCTs involving 14 groups (n = 400). The quality assessment of studies using Cochrane risk-of-bias 2 (RoB 2) tool identified some concerns. Exercise training resulted in improved flow-mediated dilation (FMD) in individuals with overweight and obesity (p < 0.001) compared to the no-exercise control group. This effect of training modalities on FMD was seen for aerobic training (p < 0.001) but not for resistance training (p = 0.051). There was no difference in FMD in response to exercise training by BMI classification (overweight, obesity, overweight + obesity), p = 0.793. The present results are consistent with the notion that aerobic exercise training elicits favorable adaptations in endothelial function in individuals with overweight and obesity. Our findings should be interpreted with caution because of the small number of studies included in this review.

The Impact of Obesity on C1q/TNF-Related Protein-9 Expression and Endothelial Function following Acute High-Intensity Interval Exercise vs. Continuous Moderate-Intensity Exercise.

C1q-TNF-related protein-9 (CTRP9) increases endothelial nitric oxide synthase and reduces vasoconstrictors. There is limited information regarding exercise-mediated CTRP9 in obesity. The purpose of this study was to compare high-intensity interval exercise (HIIE) and continuous moderate-intensity exercise (CME) on the CTRP9 response and an indicator of endothelial function (FMD) in obese participants. Sixteen young male participants (9 obese and 7 normal-weight) participated in a counterbalanced and caloric equated experiment: HIIE (30 min, 4 intervals of 4 min at 80-90% of VO2 max with 3 min rest between intervals) and CME (38 min at 50-60% VO2 max). Serum CTRP9 and FMD were measured prior to, immediately following exercise, and 1 h and 2 h into recovery. CTRP9 was significantly increased immediately following acute HIIE and CME in both groups (p = 0.003). There was a greater CME-induced FMD response at 2 h into recovery in obese participants (p = 0.009). A positive correlation between CTRP9 and FMD percent change was observed in response to acute CME when combined with both obese and normal-weight participants (r = 0.589, p = 0.016). The novel results from this study provide a foundation for additional examination of the mechanisms of exercise-mediated CTRP9 on endothelial function in individuals with obesity.

Cardiac autonomic activity, endothelial function and physical fitness in type 2 diabetic patients

Objective: To investigate the association between cardiac autonomic activity, endothelial function, and physical fitness in patients with type 2 diabetes mellitus (T2DM). Methods: Twenty-seven patients with T2DM were studied, with a mean age of 57 ± 9 years and a mean disease duration of 7.4 ± 5 years. The assessment of physical fitness was performed using the Shuttle Walking Test (SWT), cardiac autonomic modulation by heart rate variability (HRV), and endothelial function was assessed by flow-mediated dilation (FMD) of the brachial artery through ultrasound imaging. Results: The main finding of this study was that some HRV indices (SDNN, RMSSD, and HF) were significantly correlated with endothelial function in individuals with T2DM, with R values between 0.51 and 0.57 (p &lt; 0, 05), for all relationships. Additionally, an association was found between the distance covered in the SWT and the basal diameter of the brachial artery (R = 0.59; p = 0.01). Conclusion: Our data demonstrate that some HRV indices are associated with DMF, indicating an interaction between these two systems. Furthermore, our findings suggest a correlation between physical fitness and endothelial function in individuals with T2DM.

Abstract 12372: Acute Supplementation of Lactobacillus plantarum 299v Improves Vascular Endothelial Function in Adults With Stable Coronary Artery Disease (CAD)

Introduction: We have shown that dietary supplementation of L. plantarum 299v (Lp299v) over a six-week period in men with stable CAD improves endothelial function and reduces systemic inflammation. Prior ex vivo work with human resistance vessels suggests that this effect is at least partially mediated by non-genomic actions of post-probiotic supplementation plasma constituents. Whether acute supplementation with Lp299v favorably impacts in vivo endothelial function is not known. We investigated the impact of Lp299v on acute changes to endothelial function in individuals with stable CAD or CAD risk factors and hypothesized that endothelial function would improve within 24 hours. Methods: 9 adult subjects with stable CAD or at least one traditional CAD risk factor were recruited. Baseline dietary information was collected. Subjects consumed 3 oz. of Lp299v (20x10^9 CFU) after an overnight fast, and brachial artery flow mediated dilation (FMD) was used to measure vascular endothelial function at baseline, 2 hours, and 24 hours following supplementation. Lipids, glucose, and insulin levels were obtained at these timepoints. Data were analyzed using paired t-tests and chi square tests as appropriate. Results: No significant changes were seen in blood pressure, heart rate, lipid levels, or insulin at the 2-hour or 24-hour timepoints, compared to baseline. A nonsignificant trend of improved brachial artery FMD from the 0 to 2-hr timepoints (3.57±0.62% to 4.04±0.71%, p=0.63, n=9) persisted to the 24-hour timepoint (3.57±0.62% to 5.01±0.85%, p=0.23, n=9). There was a statistically significant decrease in glucose at the 2-hr timepoint (p=0.04), likely related to continued fasting, which was not seen at a 24hr timepoint (p=0.72). Conclusions: A single dose of Lp299v supplement did not result in a statistically significant improvement of endothelial function within the first 24 hours. However, the number of subjects tested was small and the FMD data at 24 hours suggests that Lp299v could improve endothelial function through non-genomic mechanisms. This could be more definitively determined with a larger study.

Tea consumption and its effects on primary and secondary prevention of coronary artery disease: Qualitative synthesis of evidence from randomized controlled trials.

There is a general interest in understanding how the consumption of tea impacts cardiovascular function in individuals at risk of developing cardiovascular disease (CVD). The current review focuses on evidence from randomized controlled trials (RCTs) reporting on associations between tea consumption and endothelial function, in the primary and secondary prevention of coronary artery disease (CAD). PubMed, EMBASE, and Google Scholar databases/search engines were used to identify eligible studies. Included studies had to report on the impact of tea supplementation of endothelial function or CAD related markers. In addition to flow-mediated dilation (FMD), makers of oxidative stress and inflammation such as oxidized low-density lipoprotein and C-reactive protein were considered as determinants of endothelial function. A total of 34 RCTs met the inclusion criteria, and these reported on the impact of tea consumption on endothelial function in individuals at risk of CVD or patients with CAD. The current qualitative synthesis of literature demonstrates that beyond enhancing nitric oxide bioavailability and lowering blood pressure, regular consumption of tea and its active ingredients such as epigallocatechin gallate may be beneficial in reducing markers of oxidative stress and inflammation. Moreover, the reduction of oxidized low-density lipoprotein and C-reactive protein levels, could be a sign of improved endothelial function in individuals at increased risk of developing CVD. The cumulative evidence also suggests that the development of epigallocatechin gallate as a nutraceutical or enriching foods with this bioactive compound could be a feasible strategy to improve endothelial function and lower CVD-risk. However, well-designed RCTs are still necessary to confirm long-term benefits of tea consumption on vascular health.

Acute blood glucose and vascular endothelial responses to passive heating in individuals with type 2 diabetes

IntroductionInsulin resistance and hyperglycemia predispose individuals with type 2 diabetes mellitus (T2DM) to endothelial dysfunction and a greater risk of cardiovascular diseases. Numerous animal studies suggest that heat exposure improves glucose control and human studies suggest that it improves markers of vascular health. However, the physiological responses to heat exposure remain understudied in individuals with T2DM, particularly within a therapeutic context.ObjectiveTo characterize blood glucose and vascular endothelial responses to heat exposure in T2DM and determine if heating acutely improves glucose control and endothelial function in this population.MethodsOn separate randomized days, six adults (2 males/4 females, 60 ± 12 years) with T2DM (≥1 year, HbA1c: 7.0 ± 0.5%, fasting glucose: 7.79 ± 1.13 mmol/L) were immersed in control (34°C, 90 minutes) or hot (40–41°C, core temperature ≥38.5°C for 60 minutes) water. Participants were fasted (12 hours) and withheld anti‐diabetic medication (≥24 hours). Blood glucose and insulin as well as brachial artery shear rates were measured at baseline, during immersion and 45–60 minutes after immersion. Brachial artery flow‐mediated dilation (FMD) was measured at baseline and 45 minutes after immersion. Blood glucose control was evaluated during an oral glucose tolerance test (OGTT, 75 g) 60 minutes after immersion. Core (Tcore, rectal) and mean skin (Tskin) temperatures, heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressures were measured throughout the protocol.ResultsCompared to control, hot water immersion increased Tcore (+1.44°C [1.05, 1.83], P&lt;0.01), Tskin (+2.36°C [1.21, 3.51], P&lt;0.01), HR (+35 bpm [26, 43], P&lt;0.01), and decreased DBP (−7 mmHg [−2, −13], P&lt;0.01) and SBP (−9 mmHg [−1, −16], P=0.03). Hot water immersion increased antegrade (+71 s−1 [35, 107], P&lt;0.01) and decreased retrograde (−15 s−1 [0.9, 3], P=0.06) shear rates. Nonetheless, FMD was unchanged during both control (−0.74% [−4.33, 2.86], P=0.81) and hot (−1.93% [−5.53, 1.66], P=0.30) water immersion. Blood glucose decreased progressively throughout the control protocol (−1.3 mmol/L [−0.8, −1.9], P&lt;0.01), whereas hot water immersion attenuated this decrease (+0.1 mmol/L [−0.5, +0.6], P=0.93). Hot water immersion did not alter glucose (P=0.17) and insulin (P=0.99) area under the curve during the OGTT.ConclusionThese preliminary results suggest that the physiological responses associated with heat exposure do not translate into acute improvements in blood glucose control or brachial artery endothelial function in individuals with T2DM.Support or Funding InformationCardiometabolic Health, Diabetes and Obesity Research Network and Diabetes Quebec.

Orange juice combined to a healthy-eating pattern improved endothelial function and reduced global risk of CHD in metabolic syndrome patients

AbstractCurrent evidence has shown that orange juice flavonoids have antihypertensive, lipid lowering, insulin sensitizing, antioxidant and antinflammatory properties, which are correlated with antiatherogenic activity. The objective of this study was to verify whether regular administration of 100% pure orange juice (OJ), as a source of antioxidant and bioactive compounds, associated with a healthy dietary pattern improves endothelial and vascular function and reduces Global Risk of Coronary Heart Disease (Global Risk of CHD). Obese volunteers (n = 68) with metabolic syndrome were randomly assigned to the control (n = 34) or OJ (n = 34) groups, and all of them were counseled and followed up to maintain a healthy-eating pattern for 12 weeks. In addition, OJ group participants drank 500 ml of 100% orange juice daily in two servings of 250 mL each between meals. After the intervention, a significant reduction of 2% in anthropometric measurements (body weight and fat) was observed in both groups, with no change in lean mass. In the OJ group, a significant reduction of total cholesterol (-9.4%) was detected, whereas the controls reduced only HDL-C (-9%). In both groups there was a significant reduction in systolic and diastolic blood pressure (-8% and -9%, respectively) and an increase in antioxidant capacity (1%). Only the OJ group reduced vascular markers ICAM (-14%) and VCAM (-15%) and inflammatory markers TNF-alpha (-20%) and hsPCR (-22%) (p &lt; 0.05). Both groups reduced IL-6 (-45%), improved brachial artery flow-mediated dilatation (BA-FMD), and reduced carotid artery intima-media thickness (CA-IMT) by 10% (p &lt; 0.05). Daily consumption of orange juice, along with a healthy-eating pattern, was able to reduce cardiovascular risk factors related to systemic inflammation and endothelial function in individuals with metabolic syndrome. A significant reduction in the prevalence of the high-risk of CHD was observed in 47% of subjects who consumed a healthy diet, while 70% of patients who had a healthy eating pattern along with orange juice reverted to low CHD risk, showing the additional benefit of regular intake of 100% orange juice. This was probably due to the action of antioxidant compounds present in high concentrations in orange juice, such as vitamin C and citrus flavonoids

SAT-141 Effect of Vildagliptin versus Glibenclamide on Glycemic Variability and Endothelial Function in Individuals with Type 2 Diabetes and Hypertension: A Randomized Controlled Trial

Introduction: Glycemic variability has been considered as an important factor in the development of cardiovascular disease (CVD) in type 2 diabetes mellitus (T2DM). High glycemic variability causes endothelial dysfunction and increased oxidative stress. Among the drugs for T2DM, dipeptidyl peptidase-4 (DPP-4) inhibitors improve endothelial function and decrease glycemic variability. Objectives: To investigate the effects of vildagliptin, a DPP-4 inhibitor, compared with glibenclamide on the glycemic variability and endothelial function of patients with T2DM and hypertension (HT). Methods: Prospective, randomized, open, drug-controlled study. Fifty patients older than 35 years with T2DM and HT without CVD were randomized to receive vildagliptin (n=25) or glibenclamide (n=25), in addition to metformin in both groups. Laboratory tests and analysis of endothelial function were performed before and 12 weeks after treatment. Endothelial function, defined by the reactive hyperemia index (RHI), was analyzed by peripheral artery tonometry (endo-PAT2000). The glycemic variability was evaluated by capillary glycemia with intermittent monitoring device, 6 measures/day, for 3 days, before and after 12 weeks of treatment. The calculation of the standard deviation (SD) of the means of glycemia was used to evaluate the glycemic variability. Results: Glycemic variability decreased in the vildagliptin group, defined by median of SD: before 35.2 mg/dL (13.9 - 59.7) vs 30.7 mg/dL (16.1 - 64.3) after treatment (p=0.037) and did not change with glibenclamide, 37.6 (16.0 - 54.9) vs 37.5 mg/dL (16.5 - 80.03) (p=NS). Glycated hemoglobin was similar in both groups at baseline and decreased after 12 weeks, not significantly (8.3% ± 1.0 vs 8.0% ± 1.34, p=0.18 for vildagliptin, 7.9% ± 0.9 vs 7.5% ± 1.4, p=0.17 for glibenclamide). The fasting glycemia decreased in the vildagliptin (166 ± 38.7 mg/dL vs 147.5 ± 42.6 mg/dL, p=0.01) and glibenclamide groups (164 ± 43.5 mg/dL vs. 139 ± 54 mg/dL, p=0.01), with no difference between them. There were no changes in the RHI before and after treatment in both groups (2.34 ± 0.58 vs 2.24 ± 0.60, for vildagliptin, p=NS; 2.36 ± 0.51 vs 2.33 ± 0.49, p=NS for glibenclamide) and there was no difference between groups. There was no correlation between glycemic variability and RHI. Conclusions: Vildagliptin reduces glycemic variability, but has no action on endothelial function, evaluated by endo-PAT2000.

Effects of exercise training on endothelial function in individuals with hypertension: a systematic review with meta-analysis

A slight increase (1%) in endothelial function is associated with reduction of cardiovascular risks by 13% in individuals with cardiovascular disease risk, including those with hypertension. Thus, we conducted a systematic review and meta-analysis to assess the efficacy of exercise training on endothelial function in individuals with hypertension.We included randomized clinical trials (RCTs) with adult participants diagnosed with hypertension undergoing exercise training (≥4 weeks), and the primary outcome was endothelial function, measured by flow-mediated dilatation (FMD). Five studies comprising a total of 362 participants (252 exercise and 110 controls; 59.3 years old, ranged from 52.0 to 67.2 years) were included in the meta-analysis. The pooled mean estimate indicated increased FMD after exercise training of 1.45 (P = .001), and 95% confidence interval −0.11 to 3.00 compared with control comparators. The studies were characterized by significant heterogeneity (χ2 = 23.34, P < .001, I2 = 70%). The present results are consistent with the notion that aerobic exercise training elicits favorable adaptations in endothelial function in individuals with hypertension. However, more studies are needed to make more definitive conclusions.

HIPPOCAMPAL CEREBRAL BLOOD FLOW DEPENDS ON SYSTEMIC ENDOTHELIAL FUNCTION IN INDIVIDUALS WITH MILD COGNITIVE IMPAIRMENT

Objective: Dementia has been recently viewed as a predominantly vascular disorder. Indeed, reduced brain NO availability causes increased ß-amyloid deposition by several mechanisms, including hypoperfusion. We sought to investigate the relationship between cerebral blood flow in the hippocampal and parahippocampal regions (CBF-hipp and CBF-parahipp), crucial areas for memory and processing of non-verbal/spatial information, and systemic endothelial function in individuals with mild cognitive impairment (MCI), a subclinical condition predisposing to dementia.Design and method: CBF-hipp and CBF-parahipp were evaluated by magnetic resonance imaging (arterial spin labeling, GE HDxt 1.5 T Signa Neuro-optimized System) and systemic endothelial function by flow-mediated dilation (FMD) in the brachial artery. Results: Complete data about CBF and FMD at enrollment were available for 66 individuals with MCI and 32 without (non-MCI). The two groups were matched for age (75 ± 5 vs 74 ± 5years, p = 0.22), sex (men 45 vs 50%, p = 0.18) and mean BP (96 ± 10 vs 97 ± 9 mmHg, p = 0.41). FMD was significantly lower in MCI than in non-MCI (2.93 ± 2.18 vs 3.74 ± 2.03%, p = 0.02); CBF-hipp (64.3 ± 9.43 vs 69.5 ± 7.03 ml/100 gr/min, p = 0.002) and CBF-parahipp (66.3 ± 8.02 vs 70.0 ± 8.12 ml/100 gr/min, p = 0.002) were significantly lower in MCI as well. Among MCI, FMD was significantly correlated with CBF- parahipp (r = 0.26,p = 0.03) and CBF-hipp (r = 0.32,p = 0.009). In multiple regression models, including age, sex, mean BP, BMI, brachial artery diameter as confounders, FMD remained an independent determinant of CBF-parahipp (beta = 0.93, r2 = 0.063, p = 0.04) and CBF-hipp (beta = 1.31, r2 = 0.089, p = 0.01). Nor CBF-parahipp (r = −0.13, p = 0.48) neither CBF-hipp (r = 0.05, p = 0.80) were correlated with FMD in non-MCI group. Conclusions: An independent association between hippocampal and parahippocampal CBF and systemic endothelial function is present in individuals with MCI.

Flavonoid-Rich Apple Improves Endothelial Function in Individuals at Risk for Cardiovascular Disease: A Randomized Controlled Clinical Trial.

The cardioprotective effects of apples are primarily attributed to flavonoids, found predominantly in the skin. This study aimed to determine if acute and/or chronic (4 weeks) ingestion of flavonoid-rich apples improves endothelial function, blood pressure (BP), and arterial stiffness in individuals at risk for cardiovascular diseases (CVD). In this randomized, controlled cross-over trial, acute and 4 week intake of apple with skin (high flavonoid apple, HFA) is compared to intake of apple flesh only (low flavonoid apple, LFA) in 30 participants. The primary outcome is endothelial function assessed using flow-mediated dilation (FMD) of the brachial artery, while main secondary outcomes are 24 h ambulatory BP and arterial stiffness. Other outcomes include fasting serum glucose and lipoprotein profile, plasma heme oxygenase-1 (Hmox-1), F2 -isoprostanes, flavonoid metabolites, and plasma and salivary nitrate (NO3- ) and nitrite (NO2- ) concentrations. Compared to LFA control, the HFA results in a significant increase in FMD acutely (0.8%, p<0.001) and after 4 weeks chronic intake (0.5%, p<0.001), and in plasma flavonoid metabolites (p<0.0001). Other outcomes are not altered significantly. A lower risk of CVD with higher apple consumption could be mediated by the beneficial effect of apple skin on endothelial function, both acutely and chronically.

Hippocampal cerebral blood flow depends on systemic endothelial function in individuals with mild cognitive impairment: The Train the Brain-Mind the vessel study

BackgroundDementia has been recently viewed as a predominantly vascular disorder. Indeed, reduced brain NO availability causes increased ß-amyloid deposition by several mechanisms, including hypoperfusion.PurposeTo investigate the relationship between cerebral blood flow in the hippocampal and parahippocampal regions (CBF-hipp and CBF-parahipp), crucial areas for memory and processing of non-verbal/spatial information, and systemic endothelial function in individuals with mild cognitive impairment (MCI), a subclinical condition predisposing to dementia.MethodsCBF-hipp and CBF-parahipp were evaluated by magnetic resonance imaging (arterial spin labeling, GE HDxt 1.5 T Signa Neuro-optimized System) and systemic endothelial function by flow-mediated dilation (FMD) in the brachial artery.ResultsComplete data about CBF and FMD at enrollment were available for 66 individuals with MCI and 32 without (non-MCI). The two groups were matched for age (75 ± 5 vs 74 ± 5 years, p = 0.22), sex (men 45 vs 50%, p = 0.18) and mean BP (96 ± 10 vs 97 ± 9 mmHg, p = 0.41). FMD was significantly lower in MCI than in non-MCI (2.93 ± 2.18 vs 3.74 ± 2.03%, p = 0.02); CBF-hipp (64.3 ± 9.43 vs 69.5 ± 7.03 ml/100 gr/min, p = 0.002) and CBF-parahipp (66.3 ± 8.02 vs 70.0 ± 8.12 ml/100 gr/min, p = 0.002) were significantly lower in MCI as well. Among MCI, FMD was significantly correlated with CBF-parahipp (r = 0.26, p = 0.03) and CBF-hipp (r = 0.32, p = 0.009). In multiple regression models, including age, sex, mean BP, BMI, brachial artery diameter as confounders, FMD remained an independent determinant of CBF-parahipp (beta = 0.93, r2 = 0.063, p = 0.04) and CBF-hipp (beta = 1.31, r2 = 0.089, p = 0.01). Nor CBF-parahipp (r = −0.13, p = 0.48) neither CBF-hipp (r = 0.05, p = 0.80) were correlated with FMD in non-MCI group.ConclusionsAn independent association between hippocampal and para-hippocampal CBF and systemic endothelial function is present in individuals with MCI.

Carbohydrate restriction with postmeal walking effectively mitigates postprandial hyperglycemia and improves endothelial function in type 2 diabetes.

Postprandial hyperglycemia has deleterious effects on endothelial function. Restricting carbohydrate intake and postmeal walking have each been shown to reduce postprandial hyperglycemia, but their combination and subsequent effects on endothelial function have not been investigated. Here, we sought to examine the effect of blunting postprandial hyperglycemia by following a low-carbohydrate diet, with or without postmeal walking exercise, on markers of vascular health in type 2 diabetes (T2D). In a randomized crossover design, individuals with T2D ( n = 11) completed three 4-day controlled diet interventions consisting of 1) low-carbohydrate diet alone (LC), 2) low-carbohydrate diet with 15-min postmeal walks (LC + Ex), and 3) low-fat control diet (CON). Fasting blood samples and brachial artery flow-mediated dilation (%FMD) were measured before and after each intervention. Total circulating microparticles (MPs), endothelial MPs, platelet MPs, monocyte-platelet aggregates, and adhesion molecules were assessed as biomarkers of vascular health. There was a significant condition × time interaction for %FMD ( P = 0.01), with post hoc tests revealing improved %FMD after LC + Ex (+0.8 ± 1.0%, P = 0.02), with no change after LC or CON. Endothelial MPs were significantly reduced with the LC diet by ~45% (from 99 ± 60 to 44 ± 31 MPs/μl, P = 0.02), with no change after LC + Ex or CON (interaction: P = 0.04). Total MPs were lower (main effect time: P = 0.02), whereas monocyte-platelet aggregates were higher (main effect time: P < 0.01) after all interventions. Plasma adhesion molecules and C-reactive protein were unaltered. Attenuating postprandial hyperglycemic excursions using a low-carbohydrate diet combined with postmeal walking appears to be an effective strategy to improve endothelial function in individuals with T2D. NEW & NOTEWORTHY Carbohydrate restriction and postmeal walking lower postprandial hyperglycemia in individuals with type 2 diabetes. Here, we show that the combination significantly improved endothelial function and that carbohydrate restriction alone reduced circulating endothelial microparticles in individuals with type 2 diabetes. Listen to this article's corresponding podcast at http://ajpheart.podbean.com/e/low-carb-diet-and-exercise-improve-endothelial-health/ .

Effects of dietary nitrate supplementation on the response to extremity cooling and endothelial function in individuals with cold sensitivity. A double blind, placebo controlled, crossover, randomised control trial

Individuals with cold sensitivity have low peripheral skin blood flow and skin temperature possibly due to reduced nitric oxide (NO•) bioavailability. Beetroot has a high concentration of inorganic nitrate and may increase NO-mediated vasodilation. Using a placebo-controlled, double blind, randomised, crossover design, this study tested the hypotheses that acute beetroot supplementation would increase the rate of cutaneous rewarming following a local cold challenge and augment endothelium-dependent vasodilation in cold sensitive individuals.Thirteen cold sensitive participants completed foot and hand cooling (separately, in 15 °C water for 2 min) with spontaneous rewarming in 30 °C air whilst skin temperature and cutaneous vascular conductance (CVC) were measured (Baseline). On two further separate visits, participants consumed 140 ml of either concentrated beetroot juice (nitrate supplementation) or nitrate-depleted beetroot juice (Placebo) 90 min before resting seated blood pressure was measured. Endothelial function was assessed by measuring CVC at the forearm, finger and foot during iontophoresis of 1% w/v acetylcholine followed by foot and hand cooling as for Baseline.Plasma nitrite concentrations significantly increased in nitrate supplementation compared to Placebo and Baseline (502 ± 246 nmol L−1; 73 ± 45 nmol L−1; 74 ± 49 nmol L−1 respectively; n = 11; P < 0.001). Resting blood pressure and the response to foot and hand cooling did not differ between conditions (all P > 0.05). Nitrate supplementation did not alter endothelial function in the forearm, finger or foot (all P > 0.05) compared to Placebo.Despite a physiologically meaningful rise in plasma nitrite concentrations, acute nitrate supplementation does not alter extremity rewarming, endothelial function or blood pressure in individuals with cold sensitivity.

P3443Hippocampal cerebral blood flow depends on systemic endothelial function in individuals with mild cognitive impairment: the Train the Brain-Mind the vessel study

P3443Hippocampal cerebral blood flow depends on systemic endothelial function in individuals with mild cognitive impairment: the Train the Brain-Mind the vessel study

Flavonoid-rich apple improves endothelial function in individuals at risk for cardiovascular disease

Flavonoid-rich apple improves endothelial function in individuals at risk for cardiovascular disease

Effects of Mangifera indica (Careless) on Microcirculation and Glucose Metabolism in Healthy Volunteers.

A commercial Mangifera indica fruit powder (Careless) showed beneficial acute effects on microcirculation in a randomized, double-blind, crossover pilot study. Here, long-term effects on microcirculation and glucose metabolism were investigated in a double-blind, randomized, placebo-controlled, 3-arm parallel-design study in healthy individuals. A daily dose of 100 mg or 300 mg of the fruit powder was compared to placebo after supplementation for 4 weeks. Microcirculation and endothelial function were assessed by the Oxygen-to-see System and pulse amplitude tonometry, respectively. Glucose metabolism was assessed under fasting and postprandial conditions by capillary glucose and HbA1c values.Microcirculatory reactive hyperemia flow increased, especially in the 100 mg group (p = 0.025). The 300 mg of the M.indica fruit preparation reduced postprandial glucose levels by trend if compared to placebo (p = 0.0535) accompanied by significantly lower HbA1c values compared to baseline. Furthermore, 300 mg intake significantly improved postprandial endothelial function in individuals with decreased endothelial function after high-dose glucose intake (p = 0.0408; n = 11).In conclusion, the study suggests moderate beneficial effects of M.indica fruit preparation on microcirculation, endothelial function, and glucose metabolism.