P.55 Dietary Nitrate Prevents Progression of Carotid Subclinical Atherosclerosis Through BP-Independent Mechanisms in Patients with or at Risk of Type 2 Diabetes Mellitus: Results from the Double-Blind, Randomized-Controlled, Factorial Vasera Trial

DOI

10.2991/artres.k.201209.065How to use a DOI?

Keywords

Nitrate; intima-media thickness

Abstract

Background: Epidemiological and animal studies suggest the potential of dietary nitrate (NO 3−) to inhibit atherogenesis. Spironolactone may improve arterial stiffness. We tested if 6 months’ intervention with dietary nitrate and spironolactone could affect carotid subclinical atherosclerosis and stiffness versus placebo/doxazosin, to control for blood pressure (BP), in a population with or at risk of type 2 diabetes [1].

Methods: A subgroup of participants in our double-blind, randomized-controlled, factorial VaSera trial were randomized to nitrate-containing beetroot juice or nitrate-depleted juice, and spironolactone or doxazosin. Ultrasound for carotid diameter (CD, mm) and intima-media thickness (CIMT, mm) was performed at baseline, 3- and 6-months.

Carotid stiffness (CS, m/s) was estimated from aortic pulse pressure (Arteriograph^®) and carotid lumen area. Data was analysed by modified intention-to-treat and mixed-model effect, adjusted for confounders.

Results: 93 participants had a baseline evaluation; 86% had follow-up data. No statistical interactions occurred between the juice and drug arms. BP was similar between the juices and between the drugs. CIMT was significantly lower following nitrate-containing, compared with placebo juice [−0.06 (95% Confidence Interval −0.12, −0.01), p = 0.022], with no effect on CD. CS reduction was similar between juices [−0.38(−0.67, −0.10) with placebo, −0.13 (−0.42, 0.16) with active juice] and the drugs [−0.30(−0.58, −0.02) with doxazosin, −0.21(−0.51, 0.09), with spironolactone]. No differences were detected between spironolactone or doxazosin on CIMT and CD.

Conclusion: 6 months’ intervention with dietary nitrate influences vascular remodelling, but not carotid stiffness or diameter. Neither spironolactone nor doxazosin had a BP-independent effect on carotid structure and function.

Copyright

© 2020 Association for Research into Arterial Structure and Physiology. Publishing services by Atlantis Press International B.V.

Open Access

This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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TY  - JOUR
AU  - Franca Morselli
AU  - Luca Faconti
AU  - Charlotte E Mills
AU  - Steve Morant
AU  - Philip J Chowienczyk
AU  - J Kennedy Cruickshank
AU  - Andrew J Webb
AU  - Alessandro Cavarape
PY  - 2020
DA  - 2020/12/31
TI  - P.55 Dietary Nitrate Prevents Progression of Carotid Subclinical Atherosclerosis Through BP-Independent Mechanisms in Patients with or at Risk of Type 2 Diabetes Mellitus: Results from the Double-Blind, Randomized-Controlled, Factorial Vasera Trial
JO  - Artery Research
SP  - S77
EP  - S77
VL  - 26
IS  - Supplement 1
SN  - 1876-4401
UR  - https://doi.org/10.2991/artres.k.201209.065
DO  - 10.2991/artres.k.201209.065
ID  - Morselli2020
ER  -