IRCCS Neuromed Pozzilli Italy.
Department of Pharmacy University of Salerno Fisciano Italy.
J Am Heart Assoc. 2020 Mar 3;9(5):e014923. doi: 10.1161/JAHA.119.014923. Epub 2020 Feb 20.
Background High blood pressure (BP) has long been recognized as a major health threat and, particularly, a major risk factor for stroke, cardiovascular disease, and end-organ damage. However, the identification of a novel, alternative, integrative approach for the control of BP and cardiovascular protection is still needed. Methods and Results Sixty-nine uncontrolled hypertension patients, aged 40 to 68 years, on antihypertensive medication were enrolled in 2 double-blind studies. Forty-five were randomized to placebo or a new nutraceutical combination named AkP05, and BP, endothelial function, and circulating nitric oxide were assessed before and at the end of 4 weeks of treatment. Twenty-four patients were randomized to diuretic or AkP05 for 4 weeks and underwent a cardiopulmonary exercise test to evaluate the effects of AkP05 on functional capacity of the cardiovascular, pulmonary, and muscular systems. Vascular and molecular studies were undertaken on mice to characterize the action of the single compounds contained in the AkP05 nutraceutical combination. AkP05 supplementation reduced BP, improved endothelial function, and increased nitric oxide release; cardiopulmonary exercise test revealed that AkP05 increased maximum O uptake, stress tolerance, and maximal power output. In mice, AkP05 reduced BP and improved endothelial function, evoking increased nitric oxide release through the PKCα/Akt/endothelial nitric oxide synthase pathway and reducing reactive oxygen species production via NADPH-oxidase inhibition. These effects were mediated by synergism of the single compounds of AkP05. Conclusions This is the first study reporting positive effects of a nutraceutical combination on the vasculature and exercise tolerance in treated hypertensive patients. Our findings suggest that AkP05 may be used as an adjunct for the improvement of cardiovascular protection and to better control BP in uncontrolled hypertension.
背景
高血压（BP）长期以来一直被认为是主要的健康威胁，尤其是中风、心血管疾病和终末器官损伤的主要危险因素。然而，仍然需要一种新的、替代的、综合的方法来控制血压和心血管保护。
方法和结果
69 名年龄在 40 至 68 岁之间、正在服用抗高血压药物的未控制高血压患者参加了 2 项双盲研究。其中 45 名患者随机分为安慰剂组或一种名为 AkP05 的新的营养保健品组，在治疗前和治疗 4 周后评估血压、内皮功能和循环一氧化氮。24 名患者随机分为利尿剂或 AkP05 组，进行心肺运动试验，以评估 AkP05 对心血管、肺和肌肉系统的功能能力的影响。对小鼠进行血管和分子研究，以表征 AkP05 营养保健品组合中所含单一化合物的作用。AkP05 补充剂降低血压、改善内皮功能和增加一氧化氮释放；心肺运动试验显示，AkP05 增加了最大氧气摄取量、应激耐受性和最大功率输出。在小鼠中，AkP05 通过 PKCα/Akt/内皮型一氧化氮合酶途径降低血压和改善内皮功能，从而增加一氧化氮释放，并通过抑制 NADPH 氧化酶减少活性氧的产生。这些作用是由 AkP05 的单一化合物的协同作用介导的。
结论
这是第一项报道营养保健品组合对治疗高血压患者血管和运动耐量产生积极影响的研究。我们的研究结果表明，AkP05 可作为改善心血管保护和更好控制未控制高血压的辅助药物。
