Conor P Kerley
Connolly Hospital, Ireland
Title: Dietary nitrate: novel, innovative roles in common, diverse cardiometabolic disorders
Biography
Biography: Conor P Kerley
Abstract
Statement of the Problem: Despite medical advance, cardiometabolic pathologies, including cardiac and respiratory diseases are major causes of premature morbidity and mortality worldwide. Cost effective, safe and sustainable therapies are urgently required.
Nitric oxide (NO) is a potent vasodilator. NO synthesis can be facilitated in vivo by reduction of dietary nitrate (NO3-) to NO independent of NO synthase, possibly providing therapeutic effect. Multiple cardiometabolic pathologies are associated with perturbations in NO, including hypertension (HTN) and obstructive sleep apnoea syndrome (OSAS). To extend findings from our preliminary studies (1,2), we hypothesized that dietary NO3- may have utility in HTN and OSAS.
We conducted 2 separate double-blind, randomized, placebo-controlled, crossover trials of daily NO3- supplementation (concentrated beetroot juice) compared to placebo (PL; matching nitrate-depleted beetroot juice) for 14d among a group of well-characterized, treated yet uncontrolled hypertensives(3) and subjects with newly diagnosed OSAS(4).
We recruited 20 uncontrolled hypertensives (mean age=63y, mean BMI=31kg/m2, mean no. of antihypertensives=2) as well as 12 adults with severe OSAS (mean apnoea-hypnoea index=74, mean age=52y, mean BMI=31kg/m2). Assessments were conducted on three occasions, baseline (day 1), midpoint, (day 15) and endpoint (day 29) - before and after each intervention period and included plasma nitrate as well as 24h ambulatory blood pressure (table 1).
Daily dietary nitrate was well-tolerated, safe, led to increased plasma NO metabolites and decreased BP profiles in uncontrolled hypertensives and OSAS. Dietary nitrate has potential as a novel therapeutic, adjunct strategy in difficult to treat BP.. In a review review, we wrote that ‘increased green vegetables consumption may provide similar/ superior benefits to nitrate supplementation in a cheaper, safer, and potentially tastier context’ (5). Considering the low cost and safety profile of foods containing dietary nitrate, this concept appears promising as an adjunct therapeutic strategy for elevated blood pressure