Cardiovascular Diseases Clinical Trial
Official title:
Effects of Herbal Antioxidants on Cardiovascular Disease in Older Blacks
The purpose of this study is to compare an herbal supplement, nonfood-derived vitamins, and placebo for the care of cardiovascular disease in high risk older African Americans.
Older African Americans suffer from disproportionately high rates of cardiovascular disease
(CVD) morbidity and mortality. In response to the health disparity between older African
Americans and whites, national mandates have called for new research on innovative
approaches to CVD prevention in this high risk population. Oxidative stress has recently
been implicated in the pathogenesis of atherosclerotic CVD. Available evidence from
epidemiological studies, clinical trials, and laboratory mechanistic studies indicate that
antioxidant interventions may be useful in the prevention and treatment of atherosclerotic
CVD in high risk older populations. Furthermore, it has been hypothesized that dietary or
food sources of antioxidant nutrients may be more clinically effective than conventional
nonfood-derived vitamin supplementation. Surveys indicate relatively high rates of
complementary and alternative medicine (CAM) use, including herbal medicines, in older
African Americans. Yet, with the exception of the previous clinical trials of the present
Center team, there have been few controlled studies on CAM therapies in older African
Americans and no previous controlled studies on efficacy and mechanisms of herbal
antioxidants for the prevention of CVD in this high risk population. Preliminary studies
have found that a CAM herbal preparation (MAK) derived from traditional Vedic medicine
demonstrates potent antioxidant and anti-atherogenic effects in laboratory and pilot human
studies. This study will evaluate the effects of this traditional CAM herbal preparation in
older African Americans.
This will be a controlled clinical trial at field site, Howard University Medical Center in
Washington, DC, involving 138 older African American men and women (55 years of age and
older) with documented atherosclerotic CVD who will be randomized to supplementation with
either the traditional CAM herbal preparation (MAK 4+5), conventional vitamin cocktail (E+C)
or placebo for 12 months. Clinical and mechanistic outcomes include carotid artery
atherosclerosis (IMT), endothelial dysfunction (brachial artery reactivity), oxidized LDL,
traditional CVD risk factors (BP, lipids, diet, exercise, smoking, weight) and quality of
life. Participants will continue usual care. The results of this clinical study will provide
much needed understanding of the basic and clinical effects of a traditional herbal
antioxidant preparation on pathophysiological mechanisms of atherosclerotic CVD in this high
risk group. This will facilitate translation of research findings on CAM into clinical
practice for prevention of disease in this underserved and understudied population of high
risk older African Americans.
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Allocation: Randomized, Primary Purpose: Treatment
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