Hypertension research studies for holistic treatments

Background:
Stevioside, a natural glycoside isolated from the plant Stevia rebaudiana Bertoni, has been used as a commercial sweetening agent in Japan and Brazil for>20 years. Previous animal and human studies have indicated that stevioside has an antihypertensive effect. OBJECTIVES:
This study was undertaken to investigate the long-term (2-year) efficacy and tolerability of stevioside in patients with mild essential hypertension. Secondary objectives were to determine the effects of stevioside on left ventricular mass index (LVMI) and quality of life (QOL).
METHODS:
This was a multicenter, randomized, double-blind, placebo-controlled trial in Chinese men and women aged between 20 and 75 years with mild essential hypertension (systolic blood pressure [SBP] 140-159 mm Hg and diastolic blood pressure [DBP] 90-99 mm Hg). Patients took capsules containing 500 mg stevioside powder or placebo 3 times daily for 2 years. Blood pressure was measured at monthly clinic visits; patients were also encouraged to monitor blood pressure at home using an automated device. LVMI was determined by 2-dimensional echocardiography at baseline and after 1 and 2 years of treatment. QOL was assessed using the Medical Outcomes Study 36-Item Short-Form Health Survey. Electrocardiographic, laboratory, and QOL parameters were assessed at the beginning of treatment, and at 6 months, 1 year, and 2 years.
Results:
One hundred seventy-four patients (87 men, 87 women) were enrolled in the study, and 168 completed it: 82 (42 men, 40 women; mean [SD] age, 52 [7] years) in the stevioside group and 86 (44 women, 42 men; mean age, 53 [7] years) in the placebo group. After 2 years, the stevioside group had significant decreases in mean (SD) SBP and DBP compared with baseline (SBP, from 150 [7.3] to 140 [6.8] mm Hg; DBP, from 95 [4.2] to 89 [3.2] mm Hg; P

Vascular endothelial function is crucial to cardiovascular function and thus to blood perfusion to the heart and throughout the body. A number of substances are produced and secreted by vascular endothelial cells, the most important of which is nitric oxide, a potent regulator of vascular function. Nitric oxide diffuses from endothelial cells into underlying smooth muscle, causing relaxation, which results in vasodilation. When this process is inhibited or inadequate the arteries cannot dilate as necessary, resulting in hypertonicity and reduced blood flow. Such endothelial dysfunction also causes increased platelet and monocyte adhesiveness and smooth muscle proliferation, processes thought to be at the genesis of atherosclerotic plaque formation. Since L-arginine is the body’s only substrate for nitric oxide synthesis, adequate L-arginine must be present for proper nitric oxide production. In this open label trial, a group of 29 asymptomatic individuals were given L-arginine (1,050 mg, as Perfusia-SR, a sustained-release preparation) twice daily (total 2.1 g daily) for one week. Systolic blood pressure was reduced in 62 percent of participants compared to baseline, with a non-significant mean decrease in all patients of 4 mm Hg. Diastolic blood pressure was reduced in 69 percent of participants, with a mean reduction of 3.7 mm Hg (p = 0.005). In the 10 individuals who were borderline or hypertensive (systolic>130 or diastolic>85), there was a mean systolic reduction of 11 mm Hg (p = 0.05), while normotensives (n = 19) had a mean systolic decrease of only 0.22 mm Hg. Diastolic blood pressure was decreased a non-significant 4.9 mm Hg in borderline or hypertensives and 4.5 mm Hg in normotensives (p = 0.026). Vascular elasticity relates to endothelial function, and can be measured non-invasively. At baseline and follow-up, vascular compliance was assessed via digital pulse wave analysis (DPA; Meridian Medical). After one week, pulse wave analysis showed a significant increase in large artery compliance (mean 23% improvement; p = 0.02) and a non-significant increase in small artery compliance (mean 23% improvement; p = 0.15). This study demonstrates blood pressure reductions, especially in patients with borderline or frank hypertension, as well as improved vascular compliance – an indicator of improved endothelial function and perfusion – after a one-week trial of sustained-release L-arginine. Poor endothelial function due to inadequate endothelial nitric oxide production is present in hypertension, as well as in numerous other aspects of cardiovascular , including angina, erectile dysfunction, cerebrovascular , and peripheral vascular . This is the first study showing a moderate dose of sustained-release L-arginine can improve endothelial function and blood pressure.

Background:
Antihypertensive medication use has been associated with an increased risk of falls in some but not all studies. Few data are available on the short-term risk of falls after antihypertensive medication initiation and intensification. METHODS AND
Results:
We examined the association between initiating and intensifying antihypertensive medication and serious fall injuries in a case-crossover study of 90?127 Medicare beneficiaries who were ?65 years old and had a serious fall injury between July 1, 2007, and December 31, 2012, based on emergency department and inpatient claims. Antihypertensive medication initiation was defined by a prescription fill with no fills in the previous year. Intensification was defined by the addition of a new antihypertensive class, and separately, titration by the addition of a new class or increase in dosage of a current class. Exposures were ascertained for the 15 days before the fall (case period) and six 15-day earlier periods (control periods). Overall,272, 1508, and 3113 Medicare beneficiaries initiated, added a new class of antihypertensive medication or titrated therapy within 15 days of their serious fall injury. The odds for a serious fall injury was increased during the 15 days after antihypertensive medication initiation (odds ratio, 1.36 [95% confidence interval, 1.19-1.55]), adding a new class (odds ratio, 1.16 [95% confidence interval, 1.10-1.23]), and titration [odds ratio, 1.13 [95% confidence interval, 1.08-1.18]). These associations were attenuated beyond 15 days. CONCLUSIONS: Antihypertensive medication initiation and intensification was associated with a short-term, but not long-term, increased risk of serious fall injuries among older adults.

OBJECTIVE:
Some studies have demonstrated the beneficial effects of Spirulina maxima (Arthrospira maxima) consumption on glycemic, lipid, and blood pressure parameters. The aim of this study was to investigate the effect of Spirulina maxima on body weight, blood pressure, and endothelial function. PATIENTS AND
METHODS:
In this randomized double-blind placebo-controlled trial, 40 patients with hypertension but lacking evidence of cardiovascular were enrolled to receive daily either 2.0 g Hawaiian spirulina or placebo for three months. Anthropometric parameters, systolic blood pressure (SBP), diastolic blood pressure (DBP), and stiffness index (SI) using digital plethysmography were measured before and after the intervention.
Results:
After three months, there was no change in body mass index (BMI) or weight in either the spirulina or the placebo group. However, a significant reduction in SBP and SI was observed. The patients in the spirulina group showed significant reductions in BMI (26.9± 3.1 vs. 25.0 ± 2.7 kg/m2, p = 0.0032), weight (75.5 ± 11.8 vs. 70.5 ± 10.3 kg, p

A placebo-controlled, double-blind, parallel group study was performed with 58 patients to investigate effects of French maritime pine bark extract, Pycnogenol, on patients with hypertension. Supplementation of the patients with 100 mg Pycnogenol over a period of 12 weeks helped to reduce the dose of the calcium antagonist nifedipine in a statistically significant manner. The intake of Pycnogenol decreased endothelin-1 concentrations significantly compared to placebo while concentrations of 6-keto prostaglandin F1a in plasma were significantly higher compared to placebo. Values for nitric oxide (NO) in plasma increased in both groups, but the differences were not significant. Angiotensin II concentrations in plasma were lowered in the placebo group to a larger extent than in the Pycnogenol group. Heart rate, electrolytes and blood urea nitrogen were not changed during treatment in both groups of patients. Unwanted effects observed in both groups were of mild and transient nature, such as gastrointestinal problems, vertigo, headache and nausea. Differences in rate of side effects were not statistically significant between the two groups. Study results support a supplementation with Pycnogenol for mildly hypertensive patients.

AIM OF THE STUDY: Tanacetum vulgare L. (Asteraceae/Compositae) is principally used in traditional Moroccan medicine as antihypertensive remedy. The aim of the present study was to investigate the in vitro vascular activity of the aqueous extract of Tanacetum vulgare L. MATERIALS AND
METHODS:
The activity of Tanacetum vulgare L. extract was tested on contractile response of Wistar rat aorta to high KCl and noradrenaline and on endothelium-dependent relaxation evoked by acetylcholine.
Results:
The addition of Tanacetum extract during the plateau phase of noradrenaline-evoked contraction produced a rapid relaxation that reached a maximum of 30% of the contraction and was suppressed by the NO synthase inhibitor N(G)-nitro-l-arginine. At higher extract concentrations this rapid relaxation was followed by a slowly developing, N(G)-nitro-l-arginine-resistant, relaxing effect. Tanacetum extract also depressed KCl-evoked contraction by 30% at maximum. This effect was abolished in the presence of N(G)-nitro-l-arginine. The endothelium-dependent relaxation induced by acetylcholine was depressed in the presence of Tanacetum extract in the bathing solution.
Conclusion:
This study indicates that the aqueous extract of Tanacetum possesses NO-mediated and NO-independent vasorelaxing properties in vitro.