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一种心血管健康膳食补充剂对高血压前期和I期高血压成人患者的前瞻性安全性评估。

Prospective Safety Evaluation of a Cardiovascular Health Dietary Supplement in Adults with Prehypertension and Stage I Hypertension.

作者信息

Ryan Jennifer Joan, Hanes Douglas Allen, Corroon Jamie, Taylor Jan, Bradley Ryan

机构信息

1 Helfgott Research Institute, National University of Natural Medicine, Portland, OR.

2 Family Medicine and Public Health, University of California, San Diego, La Jolla, CA.

出版信息

J Altern Complement Med. 2019 Feb;25(2):249-256. doi: 10.1089/acm.2018.0311. Epub 2018 Sep 14.

Abstract

OBJECTIVE

To prospectively examine the long-term safety of a cardiovascular health dietary supplement by assessing a comprehensive set of safety measures.

DESIGN

Single-arm, open-label study.

LOCATION

National University of Natural Medicine, Portland, OR.

SUBJECTS

Thirty adults with screening blood pressure readings consistent with prehypertension or stage I hypertension.

INTERVENTION

One caplet per day of a dietary supplement for 6 months. The investigated herbal-mineral supplement contains several ingredients, most notably Rauwolfia serpentina.

OUTCOME MEASURES

Primary measures included b-type natriuretic peptide (NT-proBNP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), estimated glomerular filtration rate (eGFR), electrolytes, and the Patient Health Questionnaire (PHQ-9). Exploratory measures included physical vital signs, cholesterol levels, high-sensitivity cardiac troponin-I, cystatin C, endothelin, interleukin (IL)-6, IL-17a, tumor necrosis factor-α, high-sensitivity C-reactive protein, blood counts, and the Patient Reported Outcome Measure Information System (PROMIS) Sleep Disturbance Short Form 8b.

RESULTS

NT-proBNP, AST, ALT, eGFR, sodium, calcium, magnesium, PHQ-9 score, and the majority of exploratory measures did not change. However, serum potassium increased (p < 0.05), systolic blood pressure decreased (p < 0.0001), and diastolic blood pressure decreased (p < 0.0001). There were no serious adverse events, but 30% of participants withdrew citing potential side effects, most commonly nasal congestion or fatigue; most participants who reported nasal congestion also reported concomitant seasonal allergies. Adherence to the supplement was 90.9%.

CONCLUSIONS

The findings of this study suggest that the investigated dietary supplement is safe for long-term use in adults with prehypertension and stage I hypertension. Additional results of this study, particularly the increase in serum potassium and decreases in systolic and diastolic blood pressure, are promising and suggest that future research on this dietary supplement, or its ingredients, should further explore effects on blood pressure and biologic mechanisms of action, which may involve potassium-sparing and diuretic effects.

摘要

目的

通过评估一套全面的安全措施,前瞻性地研究一种心血管健康膳食补充剂的长期安全性。

设计

单臂、开放标签研究。

地点

俄勒冈州波特兰市的国立自然医学院。

受试者

30名成年人,其筛查血压读数符合高血压前期或I期高血压。

干预措施

每天服用一粒膳食补充剂,持续6个月。所研究的草药 - 矿物质补充剂含有多种成分,最显著的是蛇根木。

观察指标

主要指标包括B型利钠肽(NT - proBNP)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、估算肾小球滤过率(eGFR)、电解质以及患者健康问卷(PHQ - 9)。探索性指标包括身体生命体征、胆固醇水平、高敏心肌肌钙蛋白I、胱抑素C、内皮素、白细胞介素(IL) - 6、IL - 17a、肿瘤坏死因子 - α、高敏C反应蛋白、血细胞计数以及患者报告结局测量信息系统(PROMIS)睡眠障碍简表8b。

结果

NT - proBNP、AST、ALT、eGFR、钠、钙、镁、PHQ - 9评分以及大多数探索性指标均未发生变化。然而,血清钾升高(p < 0.05),收缩压降低(p < 0.0001),舒张压降低(p < 0.0001)。未出现严重不良事件,但30%的参与者因潜在副作用退出,最常见的是鼻塞或疲劳;大多数报告鼻塞的参与者也报告了同时存在季节性过敏。补充剂的依从率为90.9%。

结论

本研究结果表明,所研究的膳食补充剂对于高血压前期和I期高血压成年人长期使用是安全的。本研究的其他结果,特别是血清钾升高以及收缩压和舒张压降低,很有前景,表明未来对这种膳食补充剂或其成分的研究应进一步探索对血压的影响及其生物学作用机制,这可能涉及保钾和利尿作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/431b/6389760/654834cbed3d/fig-1.jpg

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