Clinical evaluation of blood pressure lowering, endothelial function improving, hypolipidemic and anti-inflammatory effects of pomegranate juice in hypertensive subjects.

Pomegranate (Punica granatum L.) juice (PJ) contains different types of antioxidants and bioactive polyphenols and has been reported to promote cardiovascular health through several mechanisms. The present study aimed to examine the effects of 2-week intake of fresh PJ on blood pressure, flow-mediated dilatation (FMD), serum lipid profile and concentrations of inflammatory and endothelial function biomarkers. Twenty-one hypertensive patients (aged 30-67 years) were recruited into the trial and assigned to receive either PJ (150 ml/day in a single occasion between lunch and dinner; n = 11) or the same amount of water (n = 10) for a period of 2 weeks. Systolic (SBP) and diastolic (DBP) pressures together with FMD and serum concentrations of lipid profile parameters, apolipoproteins A and B, intracellular adhesion molecule-1 (ICAM-1), vascular endothelial adhesion molecule 1 (VCAM-1), E-selectin, high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were measured at baseline and at the end of trial. PJ consumption was associated with significant reductions in SBP (p = 0.002) and DBP (p = 0.038) but not FMD (p > 0.05). Serum levels of VCAM-1 (p = 0.008) were significantly reduced by PJ while those of E-selectin were elevated (p = 0.039). However, no significant effect was observed from PJ on serum levels of ICAM-1, hs-CRP, lipid profile parameters, apolipoproteins and IL-6 in any of the study groups (p > 0.05). Consumption of PJ for 2 weeks has effective hypotensive effects, and may improve endothelial function by decreasing serum concentrations of VCAM-1. These findings suggest PJ as a beneficial cardioprotective supplement for hypertensive subjects.

Effect of empagliflozin on left ventricular volumes in type 2 diabetes or prediabetes heart failure patients with reduced ejection fraction.

OBJECTIVE: Sodium-glucose cotransporter 2 (SGLT2) inhibitors, such as empagliflozin are antidiabetic drugs that have recently been reported to have cardio-protective action; however, their effect on cardiac structure and function in heart failure with reduced ejection fraction (HFrEF) has not yet been determined. This study evaluates the efficacy of empagliflozin on left ventricular (LV) volumes in type 2 diabetes or prediabetes patients with HFrEF. METHODS: This randomised, double-blind, trial study was conducted on 104 patients with type 2 diabetes or prediabetes with HFrEF referred to Imam Khomeini and Golestan hospitals in Ahvaz, Iran. The patients were randomised to receive empagliflozin (10 mg once daily) in addition to standard treatments of HFrEF or receive only standard treatments (control group) for six months. During the six months of follow-up, changes in LV volumes, LVEF, hospitalisation for heart failure (HF) were evaluated. RESULTS: Empagliflozin reduced LVEDVI and LVESVI by 10.0 and 8.0 mL/m2 (p < 0.0001). Furthermore, a significant increase in LVEF was observed in the empagliflozin group (p < 0.0001) without any significant change in the control group (p = 0.389). The hospitalisation rate was lower in the empagliflozin group than the control group (3.8% vs. 23.1%; p = 0.008). CONCLUSIONS: Empagliflozin is effective in reducing LV volumes and hospitalisation rate in patients with type 2 diabetes and prediabetes and HFrEF. Therefore, treatment with empagliflozin for six months was associated with a significant reduction in adverse cardiovascular outcomes in these patients.

Association of particulate air pollution and secondhand smoke on endothelium-dependent brachial artery dilation in healthy children.

BACKGROUND: This study aimed to determine the association of particulate matters with endothelial function, measured by flow mediated dilation (FMD) of brachial artery, in children with or without exposure to secondhand smoke. METHODS: This cross-sectional study was conducted from January to March 2011 in Isfahan, which is the second large and air-polluted city in Iran. The areas of the city with lowest and highest air pollution were determined, and in each area, 25 prepubescent boys with or without exposure to daily tobacco smoke in home were selected, i.e. 100 children were studied in total. RESULTS: FMD was significantly smaller in those living in high-polluted area and those exposed to secondhand smoke. Multiple linear regression analysis, adjusted for age and body mass index, showed that both passive smoking status and living area in terms of particulate air pollution were effective determinants of the brachial artery diameter. The standardized coefficient of passive smoking status was -0.36 (SD = 0.09, P < 0.0001) showing negative association with percent increase in FMD. Likewise, the percent increase in brachial artery diameter was lower in passive smoker children. Similar relationship was documented for PM(10) concentration with a regression coefficient of -0.32 (SD = 0.04, P < 0.0001). Without considering passive smoking variable, PM(10) concentration has significant independent effect on FMD level. CONCLUSION: Our findings provide evidence on the association of environmental factors on endothelial dysfunction from early life. Studying such associations among healthy children may help identify the underlying mechanisms. The clinical implications of environmental factors on early stages of atherosclerosis should be confirmed in longitudinal studies.

Effect of fresh orange juice intake on physiological characteristics in healthy volunteers.

Background. Impaired endothelial function is a predictor of cardiovascular events. Orange juice (OJ) is rich in dietary flavonoids and could inhibit oxidative stress and inflammatory responses. We examined the effects of commercial (COJ) and fresh orange juice (FOJ) on endothelial function and physiological characteristics in healthy humans. Materials and Methods. Twenty-two healthy volunteers years were enrolled in a single blind randomized crossover controlled trial. The two groups consumed either COJ for the first 4 weeks and then FOJ (CFOJ, 4 weeks), or FOJ for the first 4 weeks and then COJ (FCOJ, 4 weeks). We assessed endothelial function by measuring flow-mediated dilation, serum concentrations of lipids, apolipoproteins A and B (apo A-1 and apo B), and inflammatory markers such as vascular endothelial adhesion molecule 1 (VCAM-1), E-selectin, high-sensitivity C-reactive protein (hs-CRP), and interleukin-6. Results. Consumption of both juices decreased VCAM, hs-CRP, and E-selectin but increased apo A-1. A decline in LDL occurred in the FOJ group. There were no differences between the characteristics of two groups, with the exception of apo A-1 levels that were increased with both forms of OJ. The largest variations occurred with hs-CRP, VCAM in both groups. Conclusion. Consumption of COJ and FOJ produced beneficial effects on the physiological characteristics of healthy volunteers. Although these results could encourage the consumption of OJ, intervention studies are needed to determine the long-term effects of these types of OJ on metabolic and cardiovascular endpoints.