Why the study?
Does caloric restriction improve blood pressure, heart rate variability, and arterial stiffness in various patient populations?
Does caloric restriction improve blood pressure, heart rate variability, and arterial stiffness in various patient populations?
Caloric restriction is an effective intervention for improving cardiovascular surrogate markers like blood pressure and arterial stiffness across diverse patient populations.
May support caloric restriction for CV surrogate improvement; leaves open safe antihypertensive deprescribing pending RCTs.
Essential hypertension, fast heart rate, low heart rate variability, sympathetic nervous system dominance over parasympathetic, arterial stiffness, endothelial dysfunction and poor flow-mediated arterial dilatation are all associated with cardiovascular mortality and morbidity. This review of randomised controlled trials and other studies demonstrates that caloric restriction (CR) is capable of significantly improving all these parameters, normalising blood pressure (BP) and allowing patients to discontinue antihypertensive medication, while never becoming hypotensive. CR appears to be effective regardless of age, gender, ethnicity, weight, body mass index (BMI) or a diagnosis of metabolic syndrome or type 2 diabetes, but the greatest benefit is usually observed in the sickest subjects and BP may continue to improve during the refeeding period. Exercise enhances the effects of CR only in hypertensive subjects. There is as yet no consensus on the mechanism of effect of CR and it may be multifactorial. Several studies have suggested that improvement in BP is related to improvement in insulin sensitivity, as well as increased nitric oxide production through improved endothelial function. In addition, CR is known to induce SIRT1, a nutrient sensor, which is linked to a number of beneficial effects in the body.
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Nicoll et al. (2018) studied this question.