P.55 Dietary Nitrate Prevents Progression of Carotid Subclinical Atherosclerosis Through BP-Independent Mechanisms in Patients with or at Risk of Type 2 Diabetes Mellitus: Results from the Double-Blind, Randomized-Controlled, Factorial Vasera Trial
Background Epidemiological and animal studies suggest the potential of dietary nitrate (NO 3 − ) to inhibit atherogenesis. Spironolactone may improve arterial stiffness. We tested if 6 months’ intervention with dietary nitrate and spironolactone could affect carotid subclinical atherosclerosis and s...
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Published in | Artery research Vol. 26; no. Suppl 1; p. S77 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Dordrecht
Springer Netherlands
01.12.2020
Springer Nature B.V BMC |
Subjects | |
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Abstract | Background
Epidemiological and animal studies suggest the potential of dietary nitrate (NO
3
−
) to inhibit atherogenesis. Spironolactone may improve arterial stiffness. We tested if 6 months’ intervention with dietary nitrate and spironolactone could affect carotid subclinical atherosclerosis and stiffness versus placebo/doxazosin, to control for blood pressure (BP), in a population with or at risk of type 2 diabetes [
1
].
Methods
A subgroup of participants in our double-blind, randomized-controlled, factorial VaSera trial were randomized to nitrate-containing beetroot juice or nitrate-depleted juice, and spironolactone or doxazosin. Ultrasound for carotid diameter (CD, mm) and intima-media thickness (CIMT, mm) was performed at baseline, 3- and 6-months.
Carotid stiffness (CS, m/s) was estimated from aortic pulse pressure (Arteriograph®) and carotid lumen area. Data was analysed by modified intention-to-treat and mixed-model effect, adjusted for confounders.
Results
93 participants had a baseline evaluation; 86% had follow-up data. No statistical interactions occurred between the juice and drug arms. BP was similar between the juices and between the drugs. CIMT was significantly lower following nitrate-containing, compared with placebo juice [−0.06 (95% Confidence Interval −0.12, −0.01),
p
= 0.022], with no effect on CD. CS reduction was similar between juices [−0.38(−0.67, −0.10) with placebo, −0.13 (−0.42, 0.16) with active juice] and the drugs [−0.30(−0.58, −0.02) with doxazosin, −0.21(−0.51, 0.09), with spironolactone]. No differences were detected between spironolactone or doxazosin on CIMT and CD.
Conclusion
6 months’ intervention with dietary nitrate influences vascular remodelling, but not carotid stiffness or diameter. Neither spironolactone nor doxazosin had a BP-independent effect on carotid structure and function. |
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AbstractList | Background: Epidemiological and animal studies suggest the potential of dietary nitrate (NO 3−) to inhibit atherogenesis. Spironolactone may improve arterial stiffness. We tested if 6 months’ intervention with dietary nitrate and spironolactone could affect carotid subclinical atherosclerosis and stiffness versus placebo/doxazosin, to control for blood pressure (BP), in a population with or at risk of type 2 diabetes [1]. Methods: A subgroup of participants in our double-blind, randomized-controlled, factorial VaSera trial were randomized to nitrate-containing beetroot juice or nitrate-depleted juice, and spironolactone or doxazosin. Ultrasound for carotid diameter (CD, mm) and intima-media thickness (CIMT, mm) was performed at baseline, 3- and 6-months. Carotid stiffness (CS, m/s) was estimated from aortic pulse pressure (Arteriograph®) and carotid lumen area. Data was analysed by modified intention-to-treat and mixed-model effect, adjusted for confounders. Results: 93 participants had a baseline evaluation; 86% had follow-up data. No statistical interactions occurred between the juice and drug arms. BP was similar between the juices and between the drugs. CIMT was significantly lower following nitrate-containing, compared with placebo juice [−0.06 (95% Confidence Interval −0.12, −0.01), p = 0.022], with no effect on CD. CS reduction was similar between juices [−0.38(−0.67, −0.10) with placebo, −0.13 (−0.42, 0.16) with active juice] and the drugs [−0.30(−0.58, −0.02) with doxazosin, −0.21(−0.51, 0.09), with spironolactone]. No differences were detected between spironolactone or doxazosin on CIMT and CD. Conclusion: 6 months’ intervention with dietary nitrate influences vascular remodelling, but not carotid stiffness or diameter. Neither spironolactone nor doxazosin had a BP-independent effect on carotid structure and function. Background Epidemiological and animal studies suggest the potential of dietary nitrate (NO 3 − ) to inhibit atherogenesis. Spironolactone may improve arterial stiffness. We tested if 6 months’ intervention with dietary nitrate and spironolactone could affect carotid subclinical atherosclerosis and stiffness versus placebo/doxazosin, to control for blood pressure (BP), in a population with or at risk of type 2 diabetes [ 1 ]. Methods A subgroup of participants in our double-blind, randomized-controlled, factorial VaSera trial were randomized to nitrate-containing beetroot juice or nitrate-depleted juice, and spironolactone or doxazosin. Ultrasound for carotid diameter (CD, mm) and intima-media thickness (CIMT, mm) was performed at baseline, 3- and 6-months. Carotid stiffness (CS, m/s) was estimated from aortic pulse pressure (Arteriograph®) and carotid lumen area. Data was analysed by modified intention-to-treat and mixed-model effect, adjusted for confounders. Results 93 participants had a baseline evaluation; 86% had follow-up data. No statistical interactions occurred between the juice and drug arms. BP was similar between the juices and between the drugs. CIMT was significantly lower following nitrate-containing, compared with placebo juice [−0.06 (95% Confidence Interval −0.12, −0.01), p = 0.022], with no effect on CD. CS reduction was similar between juices [−0.38(−0.67, −0.10) with placebo, −0.13 (−0.42, 0.16) with active juice] and the drugs [−0.30(−0.58, −0.02) with doxazosin, −0.21(−0.51, 0.09), with spironolactone]. No differences were detected between spironolactone or doxazosin on CIMT and CD. Conclusion 6 months’ intervention with dietary nitrate influences vascular remodelling, but not carotid stiffness or diameter. Neither spironolactone nor doxazosin had a BP-independent effect on carotid structure and function. BackgroundEpidemiological and animal studies suggest the potential of dietary nitrate (NO3− ) to inhibit atherogenesis. Spironolactone may improve arterial stiffness. We tested if 6 months’ intervention with dietary nitrate and spironolactone could affect carotid subclinical atherosclerosis and stiffness versus placebo/doxazosin, to control for blood pressure (BP), in a population with or at risk of type 2 diabetes [1].MethodsA subgroup of participants in our double-blind, randomized-controlled, factorial VaSera trial were randomized to nitrate-containing beetroot juice or nitrate-depleted juice, and spironolactone or doxazosin. Ultrasound for carotid diameter (CD, mm) and intima-media thickness (CIMT, mm) was performed at baseline, 3- and 6-months.Carotid stiffness (CS, m/s) was estimated from aortic pulse pressure (Arteriograph®) and carotid lumen area. Data was analysed by modified intention-to-treat and mixed-model effect, adjusted for confounders.Results93 participants had a baseline evaluation; 86% had follow-up data. No statistical interactions occurred between the juice and drug arms. BP was similar between the juices and between the drugs. CIMT was significantly lower following nitrate-containing, compared with placebo juice [−0.06 (95% Confidence Interval −0.12, −0.01), p = 0.022], with no effect on CD. CS reduction was similar between juices [−0.38(−0.67, −0.10) with placebo, −0.13 (−0.42, 0.16) with active juice] and the drugs [−0.30(−0.58, −0.02) with doxazosin, −0.21(−0.51, 0.09), with spironolactone]. No differences were detected between spironolactone or doxazosin on CIMT and CD.Conclusion6 months’ intervention with dietary nitrate influences vascular remodelling, but not carotid stiffness or diameter. Neither spironolactone nor doxazosin had a BP-independent effect on carotid structure and function. |
Author | Faconti, Luca Morselli, Franca Chowienczyk, Philip J Cruickshank, J Kennedy Morant, Steve Webb, Andrew J Mills, Charlotte E Cavarape, Alessandro |
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Cites_doi | 10.1111/bcp.14194 |
ContentType | Journal Article |
Copyright | Association for Research into Arterial Structure and Physiology 2020 Association for Research into Arterial Structure and Physiology 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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References | Mills, Govoni, Faconti, Casagrande, Morant, Crickmore (CR1) 2020; 86 CE Mills (2601065_CR1) 2020; 86 |
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Snippet | Background
Epidemiological and animal studies suggest the potential of dietary nitrate (NO
3
−
) to inhibit atherogenesis. Spironolactone may improve arterial... BackgroundEpidemiological and animal studies suggest the potential of dietary nitrate (NO3− ) to inhibit atherogenesis. Spironolactone may improve arterial... Background: Epidemiological and animal studies suggest the potential of dietary nitrate (NO 3−) to inhibit atherogenesis. Spironolactone may improve arterial... |
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SubjectTerms | Atherosclerosis Conference Abstract Diabetes intima-media thickness Nitrate Nitrates |
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Title | P.55 Dietary Nitrate Prevents Progression of Carotid Subclinical Atherosclerosis Through BP-Independent Mechanisms in Patients with or at Risk of Type 2 Diabetes Mellitus: Results from the Double-Blind, Randomized-Controlled, Factorial Vasera Trial |
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