Key result
Combining vitamin C and grape-seed polyphenols raises SBP ~5 mmHg versus placebo in treated hypertensives.
Why the study?
Dietary antioxidants such as vitamin C and polyphenols may influence blood pressure and endothelial function by reducing oxidative stress, but their effects in hypertensive individuals are unclear.
Do vitamin C and grape-seed polyphenols, alone or in combination, reduce blood pressure and improve endothelial function in treated hypertensive individuals?
RCT (n=69)
Double-blind
factorial
Do vitamin C and grape-seed polyphenols, alone or in combination, reduce blood pressure and improve endothelial function in treated hypertensive individuals?
Mean Difference: 4.8
p-value: p=< 0.0001
The combination of vitamin C and grape-seed polyphenols paradoxically increases blood pressure in treated hypertensive individuals, suggesting caution with these supplements.
Warrants caution against combined vitamin C and grape-seed polyphenols in treated hypertension; challenges assumptions of BP benefit from these antioxidants.
BACKGROUND: There is growing evidence that oxidative stress contributes to the pathogenesis of hypertension and endothelial dysfunction. Thus, dietary antioxidants may beneficially influence blood pressure (BP) and endothelial function by reducing oxidative stress. OBJECTIVE: To determine if vitamin C and polyphenols, alone or in combination, can lower BP, improve endothelial function and reduce oxidative stress in hypertensive individuals. DESIGN: A total of 69 treated hypertensive individuals with a mean 24-h ambulatory systolic blood pressure > or = 125 mmHg participated in a randomized, double-blind, placebo-controlled, factorial trial. Following a 3-week washout, participants received 500 mg/day vitamin C, 1000 mg/day grape-seed polyphenols, both vitamin C and polyphenols, or neither for 6 weeks. At baseline and post-intervention, 24-h ambulatory BP, ultrasound-assessed endothelium-dependent and -independent vasodilation of the brachial artery, and markers of oxidative damage, (plasma and urinary F2-isoprostanes, oxidized low-density lipoproteins and plasma tocopherols), were measured. RESULTS: A significant interaction between grape-seed and vitamin C treatments for effects on BP was observed. Vitamin C alone reduced systolic BP versus placebo (-1.8 +/- 0.8 mmHg, P = 0.03), while polyphenols did not (-1.3 +/- 0.8 mmHg, P = 0.12). However, treatment with the combination of vitamin C and polyphenols increased systolic BP (4.8 +/- 0.9 mmHg versus placebo; 6.6 +/- 0.8 mmHg versus vitamin C; 6.1 +/- 0.9 mmHg versus polyphenols mmHg, each P < 0.0001) and diastolic BP (2.7 +/- 0.6 mmHg, P < 0.0001 versus placebo; 1.5 +/- 0.6 mmHg, P = 0.016 versus vitamin C; 3.2 +/- 0.7 mmHg, P < 0.0001 versus polyphenols). Endothelium-dependent and -independent vasodilation, and markers of oxidative damage were not significantly altered. CONCLUSION: Although the mechanism remains to be elucidated, these results suggest caution for hypertensive subjects taking supplements containing combinations of vitamin C and polyphenols.
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Ward et al. (2005) conducted an RCT in Hypertension (n=69). Vitamin C and grape-seed polyphenols vs. Placebo, vitamin C alone, or polyphenols alone was evaluated on Systolic blood pressure (MD 4.8, p=< 0.0001). The combination of vitamin C and grape-seed polyphenols significantly increased systolic blood pressure by 4.8 ± 0.9 mmHg compared to placebo (P<0.0001) in treated hypertensive individuals.
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