title: Effects of total dietary polyphenols on plasma nitric oxide and blood pressure in a high cardiovascular risk cohort. The PREDIMED randomized trial.
abstract: OBJECTIVE
  Hypertension is one of the main cardiovascular risk factors in the elderly. The aims of this work were to evaluate if a one-year intervention with two Mediterranean diets (Med-diet) could decrease blood pressure (BP) due to a high polyphenol consumption, and if the decrease in BP was mediated by plasma nitric oxide (NO) production.
  
  
  RESULTS
  An intervention substudy of 200 participants at high cardiovascular risk was carried out within the PREDIMED trial. They were randomly assigned to a low-fat control diet or to two Med-diets, one supplemented with extra virgin olive oil (Med-EVOO) and the other with nuts (Med-nuts). Anthropometrics and clinical parameters were measured at baseline and after one year of intervention, as well as BP, plasma NO and total polyphenol excretion (TPE) in urine samples. Systolic and diastolic BP decreased significantly after a one-year dietary intervention with Med-EVOO and Med-nuts. These changes were associated with a significant increase in TPE and plasma NO. Additionally, a significant positive correlation was observed between changes in urinary TPE, a biomarker of TP intake, and in plasma NO (Beta = 4.84; 95% CI: 0.57-9.10).
  
  
  CONCLUSIONS
  TPE in spot urine sample was positively correlated with plasma NO in Med-diets supplemented with either EVOO or nuts. The statistically significant increases in plasma NO were associated with a reduction in systolic and diastolic BP levels, adding to the growing evidence that polyphenols might protect the cardiovascular system by improving the endothelial function and enhancing endothelial synthesis of NO.
authors.affiliation: Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Spain; CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain.
authors.forename: A
authors.initials: A
authors.lastname: Medina-Remón
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Nutrition and Food Science Department, XaRTA, INSA, Pharmacy School, University of Barcelona, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Tresserra-Rimbau
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Pons
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Tur
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Research Group on Community Nutrition & Oxidative Stress, University of the Balearic Islands, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Martorell
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Lipid Clinic, Endocrinology and Nutrition Service, IDIBAPS, Hospital Clinic, Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Ros
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, and Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Buil-Cosiales
authors.affiliation: Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Spain; CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain.
authors.forename: E
authors.initials: E
authors.lastname: Sacanella
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Cardiovascular Risk and Nutrition Research Group, IMIM-Institut de Recerca Hospital del Mar, Barcelona, Spain.
authors.forename: M I
authors.initials: MI
authors.lastname: Covas
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Department of Preventive Medicine and Public Health, Nutrition and Food Sciences, School of Medicine, University of Valencia, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Corella
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Human Nutrition Unit, School of Medicine, IISPV, University Rovira i Virgili, Reus, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Salas-Salvadó
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Department of Epidemiology, School of Medicine, University of Malaga, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Gómez-Gracia
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Nutrition and Lipids Metabolism, Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Sevilla, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Ruiz-Gutiérrez
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Department of Family Medicine, Primary Care Division of Sevilla, Esperanza Macarena Health Center, Sevilla, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Ortega-Calvo
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Institut Universitari d'Investigació en Ciències de la Salut(IUNICS), Palma de Mallorca, Spain.
authors.forename: M
authors.initials: M
authors.lastname: García-Valdueza
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Clinical Trials Unit, Hospital Universitario de Araba(HUA), Vitoria, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Arós
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Department of Biochemistry and Molecular Biology Service of Clinical Analysis, Hospital General Universitario, Universitat de Valencia, Spain.
authors.forename: G T
authors.initials: GT
authors.lastname: Saez
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Research Institute of Biomedical and Health Sciences of Las Palmas, IUIBS, University of Las Palmas de Gran Canaria, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Serra-Majem
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Lipid and Vascular Risk Unit, Department of Internal Medicine, Hospital Universitari de Bellvitge, University of Barcelona, Spain.
authors.forename: X
authors.initials: X
authors.lastname: Pinto
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Mina Primary Care Center, University of Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Vinyoles
authors.affiliation: Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Spain; CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain.
authors.forename: R
authors.initials: R
authors.lastname: Estruch
authors.affiliation: CIBER: CB06/03, CB12/03 Fisiopatología de la Obesidad y la Nutrición(CIBERobn), Instituto de Salud Carlos III(ISCIII), Spain; Nutrition and Food Science Department, XaRTA, INSA, Pharmacy School, University of Barcelona, Barcelona, Spain. Electronic address: lamuela@ub.edu.
authors.forename: R M
authors.initials: RM
authors.lastname: Lamuela-Raventos
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000652:urine; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015331:Cohort Studies; D031211:Corylus / Q000737:chemistry; D018752:Diet, Fat-Restricted; D038441:Diet, Mediterranean; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000178:diet therapy* / Q000378:metabolism / Q000503:physiopathology; D031324:Juglans / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood*; D009754:Nuts / Q000737:chemistry; D000069463:Olive Oil; D050177:Overweight / Q000150:complications / Q000178:diet therapy* / Q000378:metabolism / Q000503:physiopathology; D010938:Plant Oils / Q000737:chemistry / Q000627:therapeutic use*; D059808:Polyphenols / Q000032:analysis / Q000627:therapeutic use / Q000652:urine; D027861:Prunus / Q000737:chemistry; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D000069463:Olive Oil; D010938:Plant Oils; D059808:Polyphenols; D009569:Nitric Oxide
keywords: Blood pressure; Nitric oxide; PREDIMED study; Polyphenols; Urinary polyphenol