Internal Medicine and Geriatrics, ESH Excellence Hypertension Centre, IRCCS INRCA, 60127 Ancona, Italy.
Department of Clinical and Molecular Sciences, Centre for Obesity, University "Politecnica delle Marche", 60126 Ancona, Italy.
Nutrients. 2023 Dec 13;15(24):5099. doi: 10.3390/nu15245099.
(1) Background: Lifestyle changes, eventually coupled with a nutraceutical, are recommended strategies for managing high-normal blood pressure (BP) patients with low-moderate cardiovascular (CV) risk. In a real-life clinical setting, we evaluated the effects of generic written lifestyle advice, extrapolated from the 2018 ESC/ESH guidelines, and a beetroot-based nutraceutical on 24 h BP in a population with a high-normal office BP and low-moderate CV risk. (2) Methods: A longitudinal observational study was conducted in two ESH Hypertension Excellence Centres on 43 consecutive subjects with high-normal BP according to repeated office BP (OBP) measurements and a low-moderate CV risk based on SCORE2/SCORE2-OP. Additionally, 24 h ambulatory BP monitoring (ABPM) was carried out at baseline and three months after lifestyle changes, according to generic written advice from the 2018 ESC/ESH guidelines, coupled with a nutraceutical containing 500 mg of dry beetroot extract. (3) Results: The mean age was 50 ± 11 years, with male prevalence (54%). The prevalence of overweight/obesity was 58%. The mean OBP was 135 ± 3/85 ± 3 mmHg. At baseline, the mean 24 h BP, daytime BP, and night-time BP were 127 ± 7/80 ± 6 mmHg, 131 ± 8/83 ± 6 mmHg, and 118 ± 8/70 ± 5 mmHg, respectively, BP profiles compatible with hypertension status in some subjects. After a median follow-up of 98 (92-121) days, all BPs, except night-time diastolic BP, were significantly decreased: -3 ± 6/-2 ± 4 mmHg for 24 h BP, -3.9 ± 6.0/-3.0 ± 4.0 mmHg for daytime BP, and -3.3 ± 7.4/-1.3 ± 4.7 mmHg for night-time BP, respectively. No significant clinical changes in body weight were detected. BP decreased independently of baseline BP levels, sex, smoking status, and body mass index, while a more substantial BP decrease was observed in older patients. (4) Conclusions: Our exploratory study shows, for the first time, that written generic lifestyle advice taken from the ESC/ESH hypertension guidelines coupled with a beetroot-based nutraceutical may represent a valid initial non-pharmacological approach in subjects with a high-normal office BP and low-moderate CV risk, even without personalized diet interventions.
(1) 背景：对于心血管（CV）风险较低的血压（BP）偏高正常患者，生活方式的改变，最终结合营养保健品，是被推荐的管理策略。在现实的临床环境中，我们评估了从 2018 年 ESC/ESH 指南中推断出来的通用书面生活方式建议和一种甜菜根营养保健品对具有偏高正常诊室 BP 和低-中度 CV 风险的人群 24 小时 BP 的影响。（2）方法：在两个 ESH 高血压卓越中心进行了一项纵向观察性研究，纳入了 43 名根据重复诊室 BP（OBP）测量和基于 SCORE2/SCORE2-OP 的低-中度 CV 风险而被诊断为偏高正常 BP 的连续患者。此外，根据 2018 年 ESC/ESH 指南的通用书面建议，在生活方式改变后进行了三个月的 24 小时动态血压监测（ABPM），并同时服用了一种含有 500 毫克干甜菜根提取物的营养保健品。（3）结果：平均年龄为 50 ± 11 岁，男性患病率（54%）。超重/肥胖的患病率为 58%。平均 OBP 为 135 ± 3/85 ± 3 mmHg。基线时，平均 24 小时 BP、白天 BP 和夜间 BP 分别为 127 ± 7/80 ± 6 mmHg、131 ± 8/83 ± 6 mmHg 和 118 ± 8/70 ± 5 mmHg，一些患者的 BP 谱与高血压状态相符。中位随访 98（92-121）天后，所有 BP，除夜间舒张压外，均显著降低：24 小时 BP 降低 3 ± 6/-2 ± 4 mmHg，白天 BP 降低 3.9 ± 6.0/-3.0 ± 4.0 mmHg，夜间 BP 降低 3.3 ± 7.4/-1.3 ± 4.7 mmHg。未检测到体重的显著临床变化。BP 的降低与基线 BP 水平、性别、吸烟状况和体重指数无关，而在年龄较大的患者中，BP 的降低更为明显。（4）结论：我们的探索性研究首次表明，从 ESC/ESH 高血压指南中提取的通用书面生活方式建议与一种基于甜菜根的营养保健品相结合，可能代表一种有效的初始非药物治疗方法，适用于具有偏高正常诊室 BP 和低-中度 CV 风险的患者，即使没有个性化的饮食干预。
