Serum Levels of Advanced Glycation End-products After Dietary Intervention in Hypertensive Patients
Serum Levels of Advanced Glycation End-products After Dietary Intervention in Hypertensive Patients: Study Protocol of a Randomized Clinical Trial.
Cardiovascular disease (CVD) is considered the main cause of mortality in the western world. There are many factors that contribute to the onset and progression of cardiovascular disease, including hypertension. Hypertension is a multi-factorial condition that includes nutritional disorders in its causality line. It is believed that advanced glycation end-products (AGEs) is one of the pathophysiological causes that explain the occurrence of high blood pressure in diabetic patients. This study has the role of describing the protocol of a randomized clinical trial aiming to evaluate changes in serum levels of end products of advanced glycation after an intervention for eating habit changes in hypertensive individuals.
The investigators designed a randomized clinical trial, with non-blinded assessment of outcomes. Participants will be recruited from the outpatient clinic for hypertension of a public hospital in Porto Alegre, aged from 40 to 80 years old and without diabetes. Hypertension is defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or antihypertensive medication use. Participants will be assigned to one of two groups. The intervention group will receive monthly educational intervention sessions for low salt diet, high in fruits and vegetables, and low in processed foods for a period of 6 months. Besides these, the intervention group will receive a standard telephone interview every two weeks to motivate them to follow the diet. The control group will receive the usual counseling for low sodium diet in monthly appointment with a dietitian, following the hypertension care clinic protocol.
This study aims to investigate if there are significant changes in serum levels of advanced glycation end products, after the nutritional intervention with diet guidance in fruits, vegetables, low in sodium and processed foods in hypertensive patients because several studies have shown that less processed food rich in antioxidants with low sodium content, play an important role in reducing levels of AGEs which are precursors of vascular inflammation and progression of cardiovascular diseases.
Studieöversikt
Status
Betingelser
Intervention / Behandling
Detaljerad beskrivning
There will be a randomized, non-blinded, parallel-group clinical trial comparing serum AGESs level in patients randomized to receive an educational program of diet counseling or the usual care.
Study population: Hypertensive patients attending the outpatient clinic for hypertension treatment at a university-affiliated hospital in southern Brazil.
Intervention group - Nutritional counseling implemented by a dietitian for a low sodium diet rich in fruits, vegetables, low fat dairy foods, and low in processed foods. Patients will be evaluated every month.
Control group - usual care of hypertensive patients. Patients will be evaluated after 6 months.
Studietyp
Inskrivning (Förväntat)
Fas
- Fas 2
Kontakter och platser
Studieorter
-
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RS
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Porto Alegre, RS, Brasilien, 900035-903
- Rekrytering
- Leila Beltrami Moreira
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Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria:
- It will be included patients aged between 40 and 80 years old,
- diagnosed with hypertension defined by systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg,
- or the use of drugs for hypertension; patients not following nutritional counseling in the last 6 months.
Exclusion Criteria:
- will be patients with inflammatory diseases, receiving chemotherapy treatment,
- diagnosed with diabetes mellitus,
- referred for nutritional counseling or unable to conduct the interview and to participate in the intervention program,
- pregnant women and nursing mothers.
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
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Aktiv komparator: intervention group
Nutritional counseling implemented by a dietitian for a low sodium diet rich in fruits, vegetables, low fat dairy foods, and low in processed foods.
|
Nutritional counseling implemented by a dietitian for a low sodium diet rich in fruits, vegetables, low fat dairy foods, and low in processed foods.
|
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Sham Comparator: control group
usual care of hypertensive patients.
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usual care of hypertensive patients.
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Vad mäter studien?
Primära resultatmått
Resultatmått |
Tidsram |
|---|---|
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reduction of serum levels of AGEs
Tidsram: 6 months
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6 months
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Sekundära resultatmått
Resultatmått |
Tidsram |
|---|---|
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Changes from baseline and six months in blood pressure
Tidsram: 6 months
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6 months
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Samarbetspartners och utredare
Utredare
- Huvudutredare: Leila B Moreira, MD PHD, Hospital de Clinicas de Porto Alegre
Publikationer och användbara länkar
Allmänna publikationer
- Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ; National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003 May 21;289(19):2560-72. doi: 10.1001/jama.289.19.2560. Epub 2003 May 14. Erratum In: JAMA. 2003 Jul 9;290(2):197.
- Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002 Dec 14;360(9349):1903-13. doi: 10.1016/s0140-6736(02)11911-8. Erratum In: Lancet. 2003 Mar 22;361(9362):1060.
- d'Almeida KS, Souza GC, Rabelo-Silva ER. Validity and reliability of the Dietary Sodium Restriction Questionnaire (DSRQ). Nutr Hosp. 2013 Sep-Oct;28(5):1702-9. doi: 10.3305/nh.2013.28.5.6679.
- Prasad C, Imrhan V, Marotta F, Juma S, Vijayagopal P. Lifestyle and Advanced Glycation End Products (AGEs) Burden: Its Relevance to Healthy Aging. Aging Dis. 2014 Jun 1;5(3):212-7. doi: 10.14336/AD.2014.0500212. eCollection 2014 Jun.
- Ward MS, Fortheringham AK, Cooper ME, Forbes JM. Targeting advanced glycation endproducts and mitochondrial dysfunction in cardiovascular disease. Curr Opin Pharmacol. 2013 Aug;13(4):654-61. doi: 10.1016/j.coph.2013.06.009. Epub 2013 Jul 16.
- Gul A, Rahman MA, Salim A, Simjee SU. Advanced glycation end-products in senile diabetic and non-diabetic patients with cardiovascular complications. Age (Dordr). 2008 Dec;30(4):303-9. doi: 10.1007/s11357-008-9072-1. Epub 2008 Sep 3.
- Erdine S, Ari O, Zanchetti A, Cifkova R, Fagard R, Kjeldsen S, Mancia G, Poulter N, Rahn KH, Rodicio JL, Ruilope LM, Staessen J, van Zwieten P, Waeber B, Williams B. ESH-ESC guidelines for the management of hypertension. Herz. 2006 Jun;31(4):331-8. doi: 10.1007/s00059-006-2829-3.
- Nobre F. [Introduction: Brazilian guidelines on hypertension VI. Brazilian Society of Cardiology, Brazilian Society of Hypertension, Brazilian Society of Nephrology]. J Bras Nefrol. 2010 Sep;32 Suppl 1:III. doi: 10.1590/s0101-28002010000500002. No abstract available. Portuguese.
- Vasdev S, Stuckless J, Richardson V. Role of the immune system in hypertension: modulation by dietary antioxidants. Int J Angiol. 2011 Dec;20(4):189-212. doi: 10.1055/s-0031-1288941.
- Bodiga VL, Eda SR, Bodiga S. Advanced glycation end products: role in pathology of diabetic cardiomyopathy. Heart Fail Rev. 2014 Jan;19(1):49-63. doi: 10.1007/s10741-013-9374-y.
- Dhar I, Dhar A, Wu L, Desai KM. Methylglyoxal, a reactive glucose metabolite, increases renin angiotensin aldosterone and blood pressure in male Sprague-Dawley rats. Am J Hypertens. 2014 Mar;27(3):308-16. doi: 10.1093/ajh/hpt281. Epub 2014 Jan 16.
- Finot PA. Historical perspective of the Maillard reaction in food science. Ann N Y Acad Sci. 2005 Jun;1043:1-8. doi: 10.1196/annals.1333.001.
- Kwak EJ, Lim SI. The effect of sugar, amino acid, metal ion, and NaCl on model Maillard reaction under pH control. Amino Acids. 2004 Aug;27(1):85-90. doi: 10.1007/s00726-004-0067-7. Epub 2004 Feb 27.
- Poulsen MW, Bak MJ, Andersen JM, Monosik R, Giraudi-Futin AC, Holst JJ, Nielsen J, Lauritzen L, Larsen LH, Bugel S, Dragsted LO. Effect of dietary advanced glycation end products on postprandial appetite, inflammation, and endothelial activation in healthy overweight individuals. Eur J Nutr. 2014;53(2):661-72. doi: 10.1007/s00394-013-0574-y. Epub 2013 Aug 9.
- Wu ET, Liang JT, Wu MS, Chang KC. Pyridoxamine prevents age-related aortic stiffening and vascular resistance in association with reduced collagen glycation. Exp Gerontol. 2011 Jun;46(6):482-8. doi: 10.1016/j.exger.2011.02.001. Epub 2011 Feb 18.
- Barbosa JH, Oliveira SL, Seara LT. [The role of advanced glycation end-products (AGEs) in the development of vascular diabetic complications]. Arq Bras Endocrinol Metabol. 2008 Aug;52(6):940-50. doi: 10.1590/s0004-27302008000600005. Portuguese.
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