Acute effects of an oral nitric oxide supplement on blood pressure, endothelial function, and vascular compliance in hypertensive patients

Abstract

This blinded placebo-controlled crossover study evaluated the acute effects of an orally disintegrating lozenge that generates nitric oxide (NO) in the oral cavity on blood pressure (BP) response, endothelial function, and vascular compliance in unmedicated hypertensive patients. Thirty patients with clinical hypertension were recruited and enrolled in a blinded placebo-controlled clinical trial in an outpatient setting. Average baseline BP in 30 patients was 144±3/91±1 mm Hg. NO supplementation resulted in a significant decrease of 4 mm Hg in resting systolic BP (P<.003) and a significant decrease of 5 mm Hg in diastolic BP (P<.002) from baseline and placebo after 20 minutes. In addition, there was a further statistically significant reduction by 6 mm Hg in both systolic and diastolic pressure after 60 minutes (P<.0001 vs baseline). After a half hour of a single dose, there was a significant improvement in vascular compliance as measured by augmentation index and, after 4 hours, a statistically significant improvement in endothelial function as measured by the EndoPAT (Itamar Medical, Franklin, MA). A single administration of an oral active NO supplement appears to acutely lower BP, improve vascular compliance, and restore endothelial function in patients with hypertension.

©2014 Wiley Periodicals, Inc.

Figures

Figure 1

Study design. BP indicates blood pressure.

Figure 2

Administration of a single dose of the nitric oxide (NO)–donating lozenge significantly reduces both systolic and diastolic blood pressure after 20 and 60 minutes compared with baseline. *Statistical comparison compared with baseline; #statistical comparison between 20 and 60 minutes. Compared with placebo, the NO‐donating lozenge led to a significant reduction in diastolic blood pressure at 20 minutes and a significant reduction in systolic and diastolic blood pressure after 60 minutes. @Statistical comparison to placebo determined by two‐tailed t test. Data are presented as average±standard error of the mean of 30 patients in the Neo40 group and 10 in the crossover placebo group.

Figure 3

(A) Administration of a single nitric oxide–donating lozenge causes a statistically significant increase in luminal diameter of the left common carotid artery (LCCA; P=.00001). (B) Representative ultrasound of the increase in LCCA at baseline and 10 minutes after a single lozenge. Data are presented as average±standard error of the mean in 10 patients.

Figure 4

Administration of a single nitric oxide–donating lozenge improved endothelial function after 4 hours. Data are presented as average±standard error of the mean in 30 patients. *P<.05.