Effects of inorganic nitrate and vitamin C co-supplementation on blood pressure and vascular function in younger and older healthy adults: A randomised double-blind crossover trial

Ammar W Ashor; Oliver M Shannon; Anke-Dorothee Werner; Filippo Scialo; Cameron N Gilliard; Katelyn S Cassel; Chris J Seal; D. Zheng; John C Mathers; Mario Siervo

doi:10.1016/j.clnu.2019.03.006

Effects of inorganic nitrate and vitamin C co-supplementation on blood pressure and vascular function in younger and older healthy adults: A randomised double-blind crossover trial

Ammar W Ashor, Oliver M Shannon, Anke-Dorothee Werner, Filippo Scialo, Cameron N Gilliard, Katelyn S Cassel, Chris J Seal, D. Zheng, John C Mathers, Mario Siervo

Research output: Contribution to journal › Article › peer-review

37 Citations (Scopus)

Abstract

Background
Vitamin C and inorganic nitrate have been linked to enhanced nitric oxide (NO) production and reduced oxidative stress. Vitamin C may also enhance the conversion of nitrite into NO.

Aims
We investigated the potential acute effects of vitamin C and inorganic nitrate co-supplementation on blood pressure (BP) and peripheral vascular function. The secondary aim was to investigate whether age modified the effects of vitamin C and inorganic nitrate on these vascular outcomes.

Methods
Ten younger (age 18–40 y) and ten older (age 55–70 y) healthy participants were enrolled in a randomised double-blind crossover clinical trial. Participants ingested a solution of potassium nitrate (7 mg/kg body weight) and/or vitamin C (20 mg/kg body weight) or their placebos. Acute changes in resting BP and vascular function (post-occlusion reactive hyperemia [PORH], peripheral pulse wave velocity [PWV]) were monitored over a 3-h period.

Results
Vitamin C supplementation reduced PWV significantly (vitamin C: −0.70 ± 0.31 m/s; vitamin C placebo: +0.43 ± 0.30 m/s; P = 0.007). There were significant interactions between age and vitamin C for systolic, diastolic, and mean arterial BP (P = 0.02, P = 0.03, P = 0.02, respectively), with systolic, diastolic and mean BP decreasing in older participants and diastolic BP increasing in younger participants following vitamin C administration. Nitrate supplementation did not influence BP (systolic: P = 0.81; diastolic: P = 0.24; mean BP: P = 0.87) or vascular function (PORH: P = 0.05; PWV: P = 0.44) significantly in both younger and older participants. However, combined supplementation with nitrate and vitamin C reduced mean arterial BP (−2.6 mmHg, P = 0.03) and decreased PWV in older participants (PWV: −2.0 m/s, P = 0.02).

Conclusions
The co-administration of a single dose of inorganic nitrate and vitamin C lowered diastolic BP and improved PVW in older participants. Vitamin C supplementation improved PWV in both age groups but decreased systolic and mean BP in older participants only.

Clinical trial registration
Current Controlled Trials (ISRCTN98942199).

Original language	English
Pages (from-to)	708-717
Number of pages	10
Journal	Clinical Nutrition
Volume	39
Issue number	3
Early online date	20 Mar 2019
DOIs	https://doi.org/10.1016/j.clnu.2019.03.006
Publication status	Published - Mar 2020
Externally published	Yes

Bibliographical note

Funder

This study was funded by the Ministry of Higher Education and Scientific Research of Iraq and the British Nutrition Foundation.

Funding

This study was funded by the Ministry of Higher Education and Scientific Research of Iraq and the British Nutrition Foundation.

Funders	Funder number
Ministry of Higher Education and Scientific Research
British Nutrition Foundation
Medical Research Council	MR/P020941/1, MR/L016354/1, MR/N007921/1
Biotechnology and Biological Sciences Research Council	BB/M023311/1, BB/R008167/1, BB/R008167/2

Keywords

Dietary nitrate
Ascorbic acid
Aging
Blood pressure
Vascular function
Arterial stiffness

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10.1016/j.clnu.2019.03.006

Cite this

Ashor, A. W., Shannon, O. M., Werner, A.-D., Scialo, F., Gilliard, C. N., Cassel, K. S., Seal, C. J., Zheng, D., Mathers, J. C., & Siervo, M. (2020). Effects of inorganic nitrate and vitamin C co-supplementation on blood pressure and vascular function in younger and older healthy adults: A randomised double-blind crossover trial. Clinical Nutrition, 39(3), 708-717. https://doi.org/10.1016/j.clnu.2019.03.006

Effects of inorganic nitrate and vitamin C co-supplementation on blood pressure and vascular function in younger and older healthy adults: A randomised double-blind crossover trial. / Ashor, Ammar W; Shannon, Oliver M; Werner, Anke-Dorothee et al.
In: Clinical Nutrition, Vol. 39, No. 3, 03.2020, p. 708-717.

Research output: Contribution to journal › Article › peer-review

Ashor, AW, Shannon, OM, Werner, A-D, Scialo, F, Gilliard, CN, Cassel, KS, Seal, CJ, Zheng, D, Mathers, JC & Siervo, M 2020, 'Effects of inorganic nitrate and vitamin C co-supplementation on blood pressure and vascular function in younger and older healthy adults: A randomised double-blind crossover trial', Clinical Nutrition, vol. 39, no. 3, pp. 708-717. https://doi.org/10.1016/j.clnu.2019.03.006

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title = "Effects of inorganic nitrate and vitamin C co-supplementation on blood pressure and vascular function in younger and older healthy adults: A randomised double-blind crossover trial",

abstract = "BackgroundVitamin C and inorganic nitrate have been linked to enhanced nitric oxide (NO) production and reduced oxidative stress. Vitamin C may also enhance the conversion of nitrite into NO.AimsWe investigated the potential acute effects of vitamin C and inorganic nitrate co-supplementation on blood pressure (BP) and peripheral vascular function. The secondary aim was to investigate whether age modified the effects of vitamin C and inorganic nitrate on these vascular outcomes.MethodsTen younger (age 18–40 y) and ten older (age 55–70 y) healthy participants were enrolled in a randomised double-blind crossover clinical trial. Participants ingested a solution of potassium nitrate (7 mg/kg body weight) and/or vitamin C (20 mg/kg body weight) or their placebos. Acute changes in resting BP and vascular function (post-occlusion reactive hyperemia [PORH], peripheral pulse wave velocity [PWV]) were monitored over a 3-h period.ResultsVitamin C supplementation reduced PWV significantly (vitamin C: −0.70 ± 0.31 m/s; vitamin C placebo: +0.43 ± 0.30 m/s; P = 0.007). There were significant interactions between age and vitamin C for systolic, diastolic, and mean arterial BP (P = 0.02, P = 0.03, P = 0.02, respectively), with systolic, diastolic and mean BP decreasing in older participants and diastolic BP increasing in younger participants following vitamin C administration. Nitrate supplementation did not influence BP (systolic: P = 0.81; diastolic: P = 0.24; mean BP: P = 0.87) or vascular function (PORH: P = 0.05; PWV: P = 0.44) significantly in both younger and older participants. However, combined supplementation with nitrate and vitamin C reduced mean arterial BP (−2.6 mmHg, P = 0.03) and decreased PWV in older participants (PWV: −2.0 m/s, P = 0.02).ConclusionsThe co-administration of a single dose of inorganic nitrate and vitamin C lowered diastolic BP and improved PVW in older participants. Vitamin C supplementation improved PWV in both age groups but decreased systolic and mean BP in older participants only.Clinical trial registrationCurrent Controlled Trials (ISRCTN98942199).",

keywords = "Dietary nitrate, Ascorbic acid, Aging, Blood pressure, Vascular function, Arterial stiffness",

author = "Ashor, {Ammar W} and Shannon, {Oliver M} and Anke-Dorothee Werner and Filippo Scialo and Gilliard, {Cameron N} and Cassel, {Katelyn S} and Seal, {Chris J} and D. Zheng and Mathers, {John C} and Mario Siervo",

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AU - Ashor, Ammar W

AU - Shannon, Oliver M

AU - Werner, Anke-Dorothee

AU - Scialo, Filippo

AU - Gilliard, Cameron N

AU - Cassel, Katelyn S

AU - Seal, Chris J

AU - Zheng, D.

AU - Mathers, John C

AU - Siervo, Mario

PY - 2020/3

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N2 - BackgroundVitamin C and inorganic nitrate have been linked to enhanced nitric oxide (NO) production and reduced oxidative stress. Vitamin C may also enhance the conversion of nitrite into NO.AimsWe investigated the potential acute effects of vitamin C and inorganic nitrate co-supplementation on blood pressure (BP) and peripheral vascular function. The secondary aim was to investigate whether age modified the effects of vitamin C and inorganic nitrate on these vascular outcomes.MethodsTen younger (age 18–40 y) and ten older (age 55–70 y) healthy participants were enrolled in a randomised double-blind crossover clinical trial. Participants ingested a solution of potassium nitrate (7 mg/kg body weight) and/or vitamin C (20 mg/kg body weight) or their placebos. Acute changes in resting BP and vascular function (post-occlusion reactive hyperemia [PORH], peripheral pulse wave velocity [PWV]) were monitored over a 3-h period.ResultsVitamin C supplementation reduced PWV significantly (vitamin C: −0.70 ± 0.31 m/s; vitamin C placebo: +0.43 ± 0.30 m/s; P = 0.007). There were significant interactions between age and vitamin C for systolic, diastolic, and mean arterial BP (P = 0.02, P = 0.03, P = 0.02, respectively), with systolic, diastolic and mean BP decreasing in older participants and diastolic BP increasing in younger participants following vitamin C administration. Nitrate supplementation did not influence BP (systolic: P = 0.81; diastolic: P = 0.24; mean BP: P = 0.87) or vascular function (PORH: P = 0.05; PWV: P = 0.44) significantly in both younger and older participants. However, combined supplementation with nitrate and vitamin C reduced mean arterial BP (−2.6 mmHg, P = 0.03) and decreased PWV in older participants (PWV: −2.0 m/s, P = 0.02).ConclusionsThe co-administration of a single dose of inorganic nitrate and vitamin C lowered diastolic BP and improved PVW in older participants. Vitamin C supplementation improved PWV in both age groups but decreased systolic and mean BP in older participants only.Clinical trial registrationCurrent Controlled Trials (ISRCTN98942199).

AB - BackgroundVitamin C and inorganic nitrate have been linked to enhanced nitric oxide (NO) production and reduced oxidative stress. Vitamin C may also enhance the conversion of nitrite into NO.AimsWe investigated the potential acute effects of vitamin C and inorganic nitrate co-supplementation on blood pressure (BP) and peripheral vascular function. The secondary aim was to investigate whether age modified the effects of vitamin C and inorganic nitrate on these vascular outcomes.MethodsTen younger (age 18–40 y) and ten older (age 55–70 y) healthy participants were enrolled in a randomised double-blind crossover clinical trial. Participants ingested a solution of potassium nitrate (7 mg/kg body weight) and/or vitamin C (20 mg/kg body weight) or their placebos. Acute changes in resting BP and vascular function (post-occlusion reactive hyperemia [PORH], peripheral pulse wave velocity [PWV]) were monitored over a 3-h period.ResultsVitamin C supplementation reduced PWV significantly (vitamin C: −0.70 ± 0.31 m/s; vitamin C placebo: +0.43 ± 0.30 m/s; P = 0.007). There were significant interactions between age and vitamin C for systolic, diastolic, and mean arterial BP (P = 0.02, P = 0.03, P = 0.02, respectively), with systolic, diastolic and mean BP decreasing in older participants and diastolic BP increasing in younger participants following vitamin C administration. Nitrate supplementation did not influence BP (systolic: P = 0.81; diastolic: P = 0.24; mean BP: P = 0.87) or vascular function (PORH: P = 0.05; PWV: P = 0.44) significantly in both younger and older participants. However, combined supplementation with nitrate and vitamin C reduced mean arterial BP (−2.6 mmHg, P = 0.03) and decreased PWV in older participants (PWV: −2.0 m/s, P = 0.02).ConclusionsThe co-administration of a single dose of inorganic nitrate and vitamin C lowered diastolic BP and improved PVW in older participants. Vitamin C supplementation improved PWV in both age groups but decreased systolic and mean BP in older participants only.Clinical trial registrationCurrent Controlled Trials (ISRCTN98942199).

KW - Dietary nitrate

KW - Ascorbic acid

KW - Aging

KW - Blood pressure

KW - Vascular function

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Effects of inorganic nitrate and vitamin C co-supplementation on blood pressure and vascular function in younger and older healthy adults: A randomised double-blind crossover trial

Abstract

Bibliographical note

Funder

Funding

Keywords

Access to Document

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