Funamoto Masafumi, Sunagawa Yoichi, Katanasaka Yasufumi, Kato Toru, Funada Junichi, Ajiro Yoichi, Komiyama Maki, Akao Masaharu, Yasoda Akihiro, Yamakage Hajime, Satoh-Asahara Noriko, Wada Hiromichi, Ikeda Yasumasa, Morimoto Tatsuya, Hasegawa Koji
Division of Translational Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan.
Division of Molecular Medicine, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan.
Eur Heart J Open. 2022 Sep 10;2(5):oeac057. doi: 10.1093/ehjopen/oeac057. eCollection 2022 Sep.
Hypertension is a strong risk factor for heart failure with preserved ejection fraction. Curcumin has p300-specific histone acetyltransferase inhibitory activity, suppresses cardiomyocyte hypertrophy and fibrosis, and significantly reduces myocardial brain natriuretic peptide (BNP) expression without altering blood pressure in a rat model of hypertensive heart disease. This double-blind, placebo-controlled, randomized study, for the first time, aimed to examine the efficacy of a high-absorption curcumin for the prevention of hypertensive heart disease in humans.
Patients exhibiting initial signs of hypertensive heart disease with left ventricular ejection fraction ≥60% and stable blood pressure <140/90 mmHg orally took a double-blinded capsule (either a 90 mg curcumin capsule or placebo) twice daily for 24 weeks. The primary endpoint was per cent changes in left ventricular diastolic function (/') from baseline to 6 months after administration. The secondary endpoint was the per cent change in plasma BNP levels. The /' ratio per cent change from baseline to 6 months after administration was similar between the placebo ( = 69) and the curcumin ( = 73) groups. The per cent change in plasma BNP levels was significantly lower in the curcumin group than in the placebo group. In patients <65 years, BNP per cent changes were significantly lower in the curcumin group than in the placebo group, but similar between groups in ≥65 years (<65 vs. ≥65 years: for interaction = 0.011).
A high-absorption curcumin agent did not affect the /' ratio, rather it significantly inhibited the increase in plasma BNP levels in patients with initial signs of hypertensive heart disease.
高血压是射血分数保留的心力衰竭的一个重要危险因素。姜黄素具有p300特异性组蛋白乙酰转移酶抑制活性，可抑制心肌细胞肥大和纤维化，并在高血压性心脏病大鼠模型中显著降低心肌脑钠肽（BNP）表达，而不改变血压。这项双盲、安慰剂对照、随机研究首次旨在检验高吸收性姜黄素预防人类高血压性心脏病的疗效。
左心室射血分数≥60%且血压稳定<140/90 mmHg的高血压性心脏病初始症状患者，每天口服两次双盲胶囊（90 mg姜黄素胶囊或安慰剂），持续24周。主要终点是给药后6个月与基线相比左心室舒张功能（/'）的百分比变化。次要终点是血浆BNP水平的百分比变化。安慰剂组（n = 69）和姜黄素组（n = 73）给药后6个月与基线相比的/'比值百分比变化相似。姜黄素组血浆BNP水平的百分比变化显著低于安慰剂组。在<65岁的患者中，姜黄素组的BNP百分比变化显著低于安慰剂组，但在≥65岁的患者中两组相似（<65岁与≥65岁：交互作用P = 0.011）。
高吸收性姜黄素制剂不影响/'比值，而是显著抑制有高血压性心脏病初始症状患者的血浆BNP水平升高。
