title: Effects of handgrip exercise or inorganic nitrate supplementation on 24-h ambulatory blood pressure and peripheral arterial function in overweight and obese middle age and older adults: A pilot RCT.
abstract: BACKGROUND
  Hypertension is a major contributor to the global burden of cardiovascular diseases and its prevalence increases progressively with ageing. Therefore the identification of effective, age-friendly exercise and nutritional interventions which lower blood pressure (BP) is a research priority.
  
  
  OBJECTIVE
  To undertake a pilot RCT examining the efficacy of isometric handgrip exercise (IHGE) and beetroot juice (a rich source of inorganic nitrate) consumption in modifying clinic and 24-h ambulatory BP (24-h ABP), peripheral arterial function and plasma asymmetric dimethylarginine (ADMA) in older overweight and obese adults.
  
  
  METHODS
  Thirty middle age and older adults (62±5 years) were randomised to: (a) bilateral IHGE at 50% of maximal voluntary contraction (8 min/day), (b) 140 ml/day of concentrated beetroot juice, or (c) no-intervention (control group), for 7 days. All groups followed a standardised diet to control nitrate intake. Clinic and 24-h ABP, peripheral arterial function quantified by pulse wave velocity (PWV) and arterial volume distensibility were assessed before and after intervention.
  
  
  METHODS
  Clinical ageing research unit, Newcastle University.
  
  
  RESULTS
  At baseline, there were no between-group differences in age, handgrip strength, clinic or 24-h ABP, BMI, waist circumference, fat mass, physical activity level, energy intake or urinary and plasma nitrate concentrations. After intervention, there were no significant effects on clinic systolic and diastolic BP or 24-h ABP, PWV (p=0.54), arterial volume distensibility (p=0.89), or ADMA (p=0.45).
  
  
  CONCLUSIONS
  IHGE or beetroot juice consumption for 7 days did not affect BP or peripheral arterial function in overweight and obese middle age and older adults. Ageing may reduce the effects of these interventions on vascular function and studies are needed to test this hypothesis.
authors: Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK. Electronic address: jose.lara@ncl.a.uk.
authors: Jose
authors: J
authors: Lara
authors: Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
authors: Ikponmwonsa
authors: I
authors: Ogbonmwan
authors: Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
authors: Clio
authors: C
authors: Oggioni
authors: Health & Wellbeing Academy, Faculty of Medical Science, Anglia Ruskin University, Chelmsford, UK.
authors: Dingchang
authors: D
authors: Zheng
authors: Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK; School of Agriculture, Food and Rural Development, Newcastle University, Newcastle upon Tyne, UK.
authors: Othman
authors: O
authors: Qadir
authors: Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
authors: Ammar
authors: A
authors: Ashor
authors: Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK; School of Agriculture, Food and Rural Development, Newcastle University, Newcastle upon Tyne, UK.
authors: Kirsten
authors: K
authors: Brandt
authors: Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
authors: John C
authors: JC
authors: Mathers
authors: Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK; Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
authors: Mario
authors: M
authors: Siervo
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood; D027461:Beta vulgaris; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D019587:Dietary Supplements; D015444:Exercise; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000503:physiopathology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000008:administration & dosage* / Q000097:blood / Q000652:urine; D009765:Obesity / Q000503:physiopathology; D050177:Overweight / Q000503:physiopathology; D008517:Phytotherapy; D011673:Pulsatile Flow; D016896:Treatment Outcome
chemical_list: D009566:Nitrates; C487735:dimethylarginine; D001120:Arginine
keywords: Beetroot juice; Blood pressure; Handgrip exercise; Nitrates