Sodium nitrate supplementation improves blood pressure reactivity in patients with peripheral artery disease

Abstract

Background & aims: Peripheral artery disease (PAD) is characterized by elevated blood pressure (BP), low nitric oxide availability (NO), and exaggerated pressor responses to sympatho-excitatory stressors. Inorganic nitrate reduces peripheral BP in healthy and chronically diseased populations. The objective of this study was to investigate the effects of eight-weeks of sodium nitrate (NaNO3) supplementation on indices of BP in PAD patients.

Methods: 21 patients with PAD were recruited to participate in this study, undergoing 8-weeks of NaNO3 (n = 13; 73 ± 9 years) or placebo (n = 8; 69 ± 10 years) supplementation. BP responsiveness to a cold pressor test (CPT) were examined prior to and following the supplementation period. The systolic BP response (change from rest) during the first (26 ± 10 vs. 19 ± 11 mmHg) and second minutes (32 ± 10 vs. 26 ± 12 mmHg) of CPT were reduced following NaNO3 (P < 0.05 for both) but not after placebo (first minute: 22 ± 10 vs. 24 ± 10 mmHg, P = 0.30; second minute 26 ± 10 vs 27 ± 10 mmHg, P = 0.72) supplementation.

Conclusion: Our data suggest that eight-weeks of NaNO3 supplementation reduces BP responsiveness to sympatho-excitatory stimuli.

Clinical trials registration number: NCT01983826.

Keywords: Blood pressure; Inorganic nitrate; Nitric oxide; Peripheral arterial disease.

Conflict of interest statement

Declaration of competing interest The authors have no competing interests or conflicts to report.

Copyright © 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

Figures

Figure 1:

Change (Δ) from baseline in A. systolic blood pressure (SBP), B. diastolic blood pressure (DBP), and C. mean arterial pressure (MAP) during the first (left column) and last minute (right column) of cold pressor testing pre- and post-supplementation. NaNO3; sodium nitrate. Group data (bars) are mean±SD with circles representing individual responses. *P<0.05 pre-vs. post.