Eight weeks of nitrate supplementation improves blood flow and reduces the exaggerated pressor response during forearm exercise in peripheral artery disease
Eight weeks of nitrate supplementation improves blood flow and reduces the exaggerated pressor response during forearm exercise in peripheral artery disease
复制标题
DOI：
10.1152/ajpheart.00015.2018
复制
发表时间：
2018-07-01
影响因子：
4.8
通讯作者：
Casey, Darren P.
中科院分区：
文献类型：
--
作者：
Kruse, Nicholas T.;Ueda, Kenichi;Casey, Darren P.
外周动脉疾病（PAD）的特征是下肢运动时血流（BF）减少和血压（升压）升高。虽然PAD在上肢很明显，但没有研究确定PAD上肢运动期间的BF和升压反应。新出现的证据表明，无机硝酸盐补充剂可以作为一种替代的饮食策略，以提高一氧化氮的生物利用度，改善运动BF和运动过程中的升压反应。本研究调查了1）PAD患者（n = 21）相对于健康年龄匹配的对照受试者（n = 16）对前臂运动的BF和升压反应，以及2）8周的NaNO 3补充是否影响PAD患者对前臂运动的BF和升压反应。中度至重度PAD患者被随机分配至NaNO 3（1 g/天，n = 13）治疗组或安慰剂（微晶纤维素，n = 8）治疗组。在轻度（类似于3.5 kg）和中度（类似于7 kg）握力运动期间测量肱动脉前臂BF（FBF;通过多普勒）和血压（通过手指体积描记法）。与健康对照组相比，在3.5 kg和7 kg条件下，PAD患者的FBF（相对于基线）的绝对变化减少（3.5 kg条件除外），BP反应增加（均P < 0.05）。与接受安慰剂的患者相比，接受NaNO 3补充8周的PAD患者血浆硝酸盐和亚硝酸盐升高，运动（7 kg）Delta FBF改善（从141 +/- 17至172 +/- 20 ml/min），平均动脉压反应降低（从13 +/- 1至9 +/- 1 mmHg，P < 0.05）。这些结果表明，BF限制和夸张的升压反应，中度强度的前臂运动PAD患者与8周的NaNO 3 supplementation.NEW和值得注意的外周动脉疾病（PAD）的结果在夸张的升压反应和减少下肢运动时的血流量，然而，PAD在上肢的影响仍然是未知的。这些结果表明，8周的无机硝酸盐补充改善了PAD患者的血流限制和对中等强度前臂运动的过度升压反应。
Peripheral artery disease (PAD) is characterized by a reduced blood flow (BF) and an elevated blood pressure (pressor) response during lower extremity exercise. Although PAD is evident in the upper extremities, no studies have determined BF and pressor responses during upper extremity exercise in PAD. Emerging evidence suggests that inorganic nitrate supplementation may serve as an alternative dietary strategy to boost nitric oxide bioavailability, improving exercising BF and pressor responses during exercise. The present study investigated 1) BF and pressor responses to forearm exercise in patients with PAD (n = 21) relative to healthy age-matched control subjects (n = 16) and 2) whether 8 wk of NaNO3 supplementation influenced BF and pressor responses to forearm exercise in patients with PAD. Patients with moderate to severe PAD were randomly assigned to a NaNO3(1 g/day, n = 13)-treated group or a placebo (microcrystalline cellulose, n = 8)-treated group. Brachial artery forearm BF (FBF; via Doppler) and blood pressure (via finger plethysmography) were measured during mild-intensity (similar to 3.5-kg) and moderate-intensity (similar to 7-kg) handgrip exercise. The absolute change (from baseline) in FBF was reduced (except in the 3.5-kg condition) and BP responses were increased in patients with PAD compared with healthy control subjects in 3.5- and 7-kg conditions (all P < 0.05). Plasma nitrate and nitrite were elevated, exercising (7-kg) Delta FBF was improved (from 141 +/- 17 to 172 +/- 20 ml/min), and mean arterial pressure response was reduced (from 13 +/- 1 to 9 +/- 1 mmHg, P < 0.05) in patients with PAD that received NaNO3 supplementation for 8 wk relative to those that received placebo. These results suggest that the BF limitation and exaggerated pressor response to moderate-intensity forearm exercise in patients with PAD are improved with 8 wk of NaNO3 supplementation.NEW & NOTEWORTHY Peripheral artery disease (PAD) results in an exaggerated pressor response and reduced blood flow during lower limb exercise; however, the effect of PAD in the upper limbs has remained unknown. These results suggest that 8 wk of inorganic nitrate supplementation improves the blood flow limitation and exaggerated pressor response to moderate-intensity forearm exercise in PAD.