Hypertension Clinical Trial
Official title:
Dietary Intervention to Investigate the Effects of Blackberry-derived Polyphenols on Cardio-metabolic Risk Factors in Adults
Cardiovascular disease (CVD) is the most common cause of death in Ireland, accounting for 33% of all deaths. Hypertension or elevated blood pressure, is also a significant health problem, however, it is one of the major controllable risk factors associated with CVD. While increased consumption of fruit and vegetables is associated with reduced risk of CVD, evidence is accumulating that consumption of berry fruits in particular, may promote cardiovascular health. Blackberries have a favourable nutritional profile, in that they are rich in dietary fibre, vitamins C, K and folate but low in dietary fat and kilocalories. In addition, blackberries are a rich source of antioxidants, and contain numerous phytochemicals including polyphenols. The aim of this study is to investigate the potential beneficial effects of blackberry consumption on cardiovascular health, in particular, effects on blood pressure.
Dietary factors play a significant role in the prevention and/or treatment of hypertension
and significant efforts are being put in to the development of functional foods with
antihypertensive activity. Blackberries and their intrinsic polyphenols, consumed as part of
a healthy diet, may be of functional interest in both the treatment and prevention of
hypertension and dyslipidaemia. The Cardio-Rubus study presents healthy adults with an
opportunity to participate in a human nutrition study that will assist in identifying
biological effects of blackberry-derived components establishing further the value of
berries as a nutritious, health conducive food.
It is proposed to carry out a crossover, randomized double-blind 18-week supplementation
study in 100 men and women aged 45-70 years with a systolic blood pressure of 130-149 mmHg
but who are otherwise in good health. The proposed sample size is based on systolic blood
pressure data derived from baseline values of 700 adults who participated in RCTs that we
have conducted at UCC over the last 6-7 years. The calculation for sample size is based on
observational data of systolic blood pressure in older pre-hypertensive adults, which showed
a mean (SD) SBP of 135 (3) mmHg. The proposed study is powered to detect a mean drop of 2
mmHg systolic blood pressure at 85% power and with a significance level of 5%. The
calculations support the recruitment of 100 participants in total (n = 41 per group, rounded
up to 50 to account for a 20% attrition rate).
Potential study participants will be recruited by researchers at the School of Food &
Nutritional Sciences and all study visits will take place at the Human Nutrition Studies
Unit, UCC. In addition to the provision of written information, the study protocol will be
clearly and comprehensively discussed with each potential participant prior to enrollment
and their provision of informed written consent. Participants will initially complete a
2-week run in period which involves refraining from the consumption of specified foods items
(predominantly berries and other fruits) until the end of the study. Each participant will
be randomly assigned to receive one of two beverages (either a high dose or low dose
blackberry polyphenol enriched beverage) for a period of 6-weeks (study phase 1) and then
after a 2-week wash-out, the participant will receive the opposite treatment to that which
was provided during study phase 1 for the next 6-weeks (study phase 2). After completion of
study phase 2 there will be a 2-week wash-out followed by a final visit to UCC. Thus, after
screening and enrolment on to the study, there will be a further 5 visits to UCC (at the
baseline and endpoint of each study phase and at the end of the final washout phase). All 5
visits will be fasting morning visits where the nurse will take a small blood sample which
will be analysed for blood lipids, fasting glucose and biomarkers of endothelial function.
Brachial and central blood pressure will be measured as well as an assessment of arterial
stiffness by pulse wave velocity analysis. Body weight, BMI and waist circumference will
also be measured. Each participant's body composition (% body fat & lean mass) will be
assessed by DXA scan.
All information collected is strictly confidential. Samples and questionnaires will be
labelled with a unique identifying code, and participant's names will not be used at any
stage during data collection, database construction or data analysis. Data will be archived
by the principal investigator. In any publications or other documents, participants will not
be identified by name or code numbers. Group summary data will be presented in place of
individual data, further ensuring confidentiality.
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