Ascorbic acid reduces blood pressure and arterial stiffness in type 2 diabetes

被引:152
作者
Mullan, BA
Young, IS
Fee, H
McCance, DR
机构
[1] Royal Victoria Hosp, Reg Ctr Endocrinol & Diabet, Belfast BT12 6BA, Antrim, North Ireland
[2] Queens Univ Belfast, Dept Med, Belfast, Antrim, North Ireland
[3] Queens Univ Belfast, Dept Anaesthesia & Intens Care Med, Belfast, Antrim, North Ireland
关键词
blood pressure; antioxidants; arteries; vitamins; diabetes mellitus;
D O I
10.1161/01.HYP.0000039961.13718.00
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Experimental evidence suggests that acute parenteral administration of high-dose ascorbic acid has beneficial vascular effects in type 2 diabetes. We studied the hemodynamic effects of chronic oral supplementation in this condition. Thirty patients, 45 to 70 years of age, with type 2 diabetes, were randomly assigned in a double-blind manner to receive 500 mg ascorbic acid daily by mouth or placebo. Patients were studied at baseline and after 4 weeks of assigned treatment. The central aortic augmentation index (AgIx) and the time to wave reflection (Tr) were derived from radial artery pulse wave analysis data. AgIx and Tr were used as measures of systemic arterial stiffness and aortic stiffness, respectively. Ascorbic acid decreased brachial systolic blood pressure from 142.1 +/- 12.6 (SD) to 132.3 +/- 12.1 mm Hg (difference [95% CI] 9.9 [4.7, 15.0]; P<0.01), brachial diastolic pressure from 83.9 +/- 4.8 to 79.5 +/- 6.0 mmHg (4.4 [1.8, 7.0]; P<0.01), and AgIx from 26.8-5.5% to 22.5-6.8% (4.3 [1.5, 7.1]; P<0.01). Tr increased from 137.1 +/- 12.6 to 143.4 +/- 9.2 ms (-6.3 [-10.1, -2.5]; P<0.01). Placebo had no hemodynamic effects, and this difference between treatments was significant (P<0.01 for blood pressure and Tr, P=0.03 for AgIx). We have therefore shown that after 1 month, oral ascorbic acid lowered arterial blood pressure and improved arterial stiffness in patients with type 2 diabetes. As strict control of blood pressure reduces cardiovascular risk in diabetes, ascorbic acid supplementation may potentially be a useful and inexpensive adjunctive therapy. Larger and longer studies now need to be performed.
引用
收藏
页码:804 / 809
页数:6
相关论文
共 52 条
[1]   ARTERIAL STIFFNESS - A NEW CARDIOVASCULAR RISK FACTOR [J].
ARNETT, DK ;
EVANS, GW ;
RILEY, WA .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1994, 140 (08) :669-682
[2]   Effect of vitamin C on the availability of tetrahydrobiopterin in human endothelial cells [J].
Baker, RA ;
Milstien, S ;
Katusic, ZS .
JOURNAL OF CARDIOVASCULAR PHARMACOLOGY, 2001, 37 (03) :333-338
[3]   Ascorbic acid status and subsequent diastolic and systolic blood pressure [J].
Block, G ;
Mangels, AR ;
Norkus, EP ;
Patterson, BH ;
Levander, OA ;
Taylor, PR .
HYPERTENSION, 2001, 37 (02) :261-267
[4]   ENZYMATIC BASIS FOR ALTERED ASCORBIC-ACID AND DEHYDROASCORBIC ACID LEVELS IN DIABETES [J].
BODE, AM ;
YAVAROW, CR ;
FRY, DA ;
VARGAS, T .
BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS, 1993, 191 (03) :1347-1353
[5]  
Boreham C, 1999, PUBLIC HEALTH, V113, P7, DOI 10.1016/S0033-3506(99)00106-7
[6]   Augmentation of central arterial pressure in type 1 diabetes [J].
Brooks, B ;
Molyneaux, L ;
Yue, DK .
DIABETES CARE, 1999, 22 (10) :1722-1727
[7]   Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease [J].
Brown, BG ;
Zhao, XQ ;
Chait, A ;
Fisher, LD ;
Cheung, MC ;
Morse, JS ;
Dowdy, AA ;
Marino, EK ;
Bolson, EL ;
Alaupovic, P ;
Frohlich, J ;
Albers, JJ ;
Serafini, L ;
Huss-Frechette, E ;
Wang, S ;
DeAngelis, D ;
Dodek, A .
NEW ENGLAND JOURNAL OF MEDICINE, 2001, 345 (22) :1583-1592
[8]  
BUCKBERG GD, 1972, J THORAC CARDIOV SUR, V64, P669
[9]   The role of natural antioxidants in preserving the biological activity of endothelium-derived nitric oxide [J].
Carr, A ;
Frei, B .
FREE RADICAL BIOLOGY AND MEDICINE, 2000, 28 (12) :1806-1814
[10]  
Carr AC, 1999, AM J CLIN NUTR, V69, P1086