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

Franca Morselli; Luca Faconti; Charlotte E Mills; Steve Morant; Philip J Chowienczyk; J Kennedy Cruickshank; Andrew J Webb; Alessandro Cavarape

doi:10.2991/artres.k.201209.065

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Volume 26, Issue Supplement 1, December 2020, Pages S77 - S77

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

Authors

Franca Morselli¹^{, *}, Luca Faconti¹, Charlotte E Mills²^{, 3}, Steve Morant⁴, Philip J Chowienczyk¹, J Kennedy Cruickshank², Andrew J Webb¹, Alessandro Cavarape⁵

¹King’s College London

²King’s College London, School of Life Course Sciences

³University of Reading, Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy

⁴Medicines Monitoring Unit (MEMO), University of Dundee

⁵Universita’ degli Studi di Udine

^*Corresponding author. Email: franca.morselli@kcl.ac.uk

Corresponding Author

Franca Morselli

Available Online 31 December 2020.

DOI: 10.2991/artres.k.201209.065 How 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/).

REFERENCE

[1]CE Mills, V Govoni, L Faconti, ML Casagrande, SV Morant, H Crickmore, et al., A randomised, factorial trial to reduce arterial stiffness independently of blood pressure: Proof of concept? The VaSera trial testing dietary nitrate and spironolactone., Br J Clin Pharmacol, Vol. 86, 2020, pp. 891-902.

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Journal: Artery Research
Volume-Issue: 26 - Supplement 1
Pages: S77 - S77
Publication Date: 2020/12/31
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.2991/artres.k.201209.065 How to use a DOI?
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/).

Cite this article

ris enw bib

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  -

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