Key result
Polyphenol and L-citrulline supplementation fails to reduce 24-hour ambulatory diastolic blood pressure in prehypertension.
Why the study?
Although polyphenols and L-citrulline may help control blood pressure, their combined impact on ambulatory blood pressure in individuals at risk of cardiovascular disease remained unknown.
Does combined polyphenol extract and L-citrulline supplementation reduce 24-h ambulatory diastolic BP in adults with prehypertension?
RCT (n=73)
Double-blind
1:1 block randomized
No
Does combined polyphenol extract and L-citrulline supplementation reduce 24-h ambulatory diastolic BP in adults with prehypertension?
p-value: p=>0.10
Combined polyphenol and L-citrulline supplementation does not significantly lower ambulatory blood pressure in prehypertensive adults overall, though it may have a sex-specific blood pressure lowering effect in women.
Does not support supplementation for prehypertension; challenges efficacy and leaves sex-specific effects open for further RCTs.
Increased blood pressure (BP), vascular dysfunction and inflammation are involved in the etiology of cardiovascular disease (CVD). Although several dietary components such as polyphenols and L-citrulline may help to control BP, their combined impact on ambulatory BP in individuals at risk of CVD remains unknown. The objective of this research was to investigate the short-term impact of supplementation with a combination of polyphenol extract and L-citrulline on ambulatory BP, endothelial function and inflammation. In a randomized double-blind parallel trial, 73 men and women with prehypertension were supplemented with a placebo (cellulose, n = 34, Plac) or 548 mg/day of polyphenols and 2 g/day of L-citrulline (n = 35, Suppl) for 6 weeks. The primary outcome of this study was the difference between groups in 24-h ambulatory diastolic BP (DBP) at week six. Secondary outcomes were a difference between groups at week six in ambulatory systolic BP (SBP), casual BP, serum lipids and high-sensitivity C-reactive protein (hs-CRP) concentrations and skin advanced glycation end products (AGEs). Potential interaction of treatment with sex was examined. Suppl had no impact on mean ambulatory SBP and DBP (p > 0.10 vs. placebo). Daytime and 24-h SBP were reduced with Suppl in women (p ≤ 0.01), but not in men (p ≥ 0.27). A non-significant reduction in AGEs was observed after Suppl compared to Plac among all participants (p = 0.07) and there was no difference in the concentrations of blood lipids (p > 0.20) or CRP (p = 0.36) between treatments at week six. Therefore, supplementation with polyphenol extract and L-citrulline for 6 weeks has no impact on ambulatory BP, blood lipids and CRP in adults with prehypertension. However, the polyphenol extract/L-citrulline supplement may reduce ambulatory SBP in women, but not in men. These preliminary results need further research efforts towards further documenting this sex-dependent BP response to supplementation with polyphenols and L-citrulline.
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Vors et al. (2021) conducted an RCT in Prehypertension (n=73). Polyphenol extract and L-citrulline vs. Placebo (cellulose) was evaluated on Difference between groups in 24-h ambulatory diastolic blood pressure (DBP) at week six (p=>0.10). Supplementation with polyphenol extract and L-citrulline for 6 weeks did not significantly affect 24-h ambulatory diastolic blood pressure in adults with prehypertension compared to placebo.
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