In collaboration with Scientific Association of Iranian Medicinal Plants

Document Type : Research Paper

Authors

1 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, and Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Cardiology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Medical Plants Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran

4 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Hypertension is a major risk factor for cardiovascular disease which is failure in endothelial function and increased arterial stiffness. Pomegranate juice is rich in bioactive polyphenols with antioxidant and cardioprotective functions. Twenty-one hypertensive patients (aged 30-67 years) were recruited into the trial and assigned to receive either PJ (150 ml/day in a single occasion between lunch and dinner; n=11) or the same amount of water (n=10) for a period of two weeks. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and flow-mediated dilation (FMD), along with serum concentrations of lipid profile parameters and apolipoproteins A and B were measured at baseline and two weeks after PJ consumption. Statistical analysis was conducted using paired t-test for continuous variables. PJ consumption was associated with significant reductions in SBP (p=0.002) and DBP (p=0.038) but not FMD (p>0.05). However, no significant effect was observed from PJ on serum levels of lipid profile parameters and apolipoproteins. PJ has promising acute hypotensive properties. Consumption of PJ could be considered in the context of both dietary and pharmacological interventions for hypertension.

Keywords

Asgary, S. and Keshvari, M., 2012. Effects of Citrus sinensis juice on blood pressure. ARYA Atherosclerosis, 9(1): 98-101.
- Aviram, M. and Dornfeld, L., 2001. Pomegranate juice consumption inhibits serum angiotensin converting enzyme activity and reduces systolic blood pressure. Atherosclerosis, 158: 195-198.
- Aviram, M., Rosenblat, M., Gaitini, D., Nitecki, S., Hoffman, A., Dornfeld, L., Volkova, N., Presser, D., Attias, J., Liker, H. and Hayek, T., 2004. Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation. Clinical Nutrition, 23: 423-433.
- Basu, A. and Penugonda, K., 2009. Pomegranate juice: A heart-healthy fruit juice. Nutrition Reviews,
67: 49-56.
- Castilla, P., Davalos, A., Teruel, J.L., Cerrato, F., Fernández-Lucas, M., Merino, J.L., Sánchez-Martín, C.C., Ortuño, J. and Lasunción, M.A., 2008. Comparative effects of dietary supplementation with red grape juice and vitamin E on production of superoxide by circulating neutrophil NADPH oxidase in hemodialysis patients. AmericanJournalof Clinical Nutrition , 87(4): 1053-1061.
- Charakida, M., Masi, S., Lüscher, T.F., Kastelein, J.J. and Deanfield, J.E., 2010. Assessment of atherosclerosis: the role of flow mediated dilatation. European Heart Journal, 31(23): 2854-2861.
- Chidambara Murthy, K.N., Jayaprakasha, G.K. and Singh, R.P, 2002. Studies on antioxidant activity of pomegranate (Punica granatum) peel extract using in vivo models. Journal of Agricultural and Food Chemistry, 50(17): 4791-4795.
- Close, D.C. and Beadle, C.L., 2003. The ecophysiology of foliar anthocyanin. The Botanical Review; 69(2): 149-161.
- Davies, M.J., Judd, J.T., Baer, D.J., Clevidence, B.A., Paul, D.R., Edwards, A.J., Wiseman, S.A., Muesing, R.A. and Chen, S.C., 2003. Black tea consumption reduces total and LDL cholesterol in mildly hypercholesterolemic adults. Journal of Nutrition, 133(10): 3298-3302.
- Dohadwala, M.M. and Vita, J.A., 2009. Grapes and cardiovascular disease. Journal of Nutrition, 139: 1788-1793.
- Dohadwala, M.M., Holbrook, M., Hamburg, N.M., Shenouda, S.M., Chung, W.B., Titas, M., Kluge, M.A., Wang, N., Palmisano, J., Milbury, P.E., Blumberg, J.B. and Vita, J.A., 2011. Effects of cranberry juice consumption on vascular function in patients with coronary artery disease. American Journal of Clinical Nutrition, 93(5): 934-940.
- Erdman Jr, J.W., Balentine, D., Arab, L., Beecher, G., Dwyer, J.T., Folts, J., Harnly, J., Hollman, P., Keen, C.L., Mazza, G., Messina, M., Scalbert, A., Vita, J., Williamson, G. and Burrowes, J., 2007. Flavonoids and heart health: proceedings of the ILSI north America flavonoids workshop. Journal of Nutrition, 137(4): 718S-737S.
- Esmaillzadeh, E., Tahbaz, A., Gaieni, F., Ailavi-Majd, H. and Azadbakht, L., 2006. Cholesterol-lowering effect of concentrated pomegranate juice consumption in type II diabetic patients with hyperlipidemia. International Journal for Vitamin and Nutrition Research, 76(3): 147-151.
- Freedman, J.E., Parker, C., Li, L., Perlman, J.A., Frei, B., Ivanov, V., Deak, L.R., Iafrati, M.D. and Folts, J.D., 2001. Select flavonoids and whole juice from purple grapes inhibit platelet function and enhance nitric oxide release. Circulation, 103(23): 2792-2798.
- Gaziano, T.A., Bitton, A., Anand, S., Abrahams-Gessel, S. and Murphy, A., 2010. Growing epidemic of coronary heart disease in low-and middle-income countries. Current Problems in Cardiology, 35(2): 72-115.
- Giordano, L., Coletta, W., Tamburrelli, C., D’Imperio, M., Crescente, M., Silvestri, C., Rapisarda, P., Recupero, G.R., De Curtis, A., Iacoviello, L., de Gaetano, G., Rotilio, D., Cerletti, C. and Donati, M.B., 2012. Four-week ingestion of blood orange juice results in measurable anthocyanin urinary levels but does not affect cellular markers related to cardiovascular risk: a randomized cross-over study in healthy volunteers. European Journal of Nutrition, 51(5): 541-548.
- Grassi, D., Lippi, C., Necozione, S., Desideri, G. and Ferri, C., 2005. Short-term administration of dark chocolate is followed by a significant increase in insulin sensitivity and a decrease in blood pressure in healthy persons. AmericanJournalof Clinical Nutrition, 81(3): 611-614.
- Hara, Y., 1992. Effect of tea polyphenols on cardiovascular disease. PreventiveMedicine Journal, 21(3): 333.
- Heller, R., Unbehaun, A., Schellenberg, B., Mayer, B., Werner-Felmayer, G. and Werner, E.R., 2001.
L-ascorbic acid potentiates endothelial nitric oxide synthesis via a chemical stabilization of tetrahydrobiopterin. The Journal of Biological Chemistry, 276: 40-47.
- Hooper, L., Kroon, P.A., Rimm, E.B., Cohn, J.S., Harvey, I., Le Cornu, K.A., Ryder, J.J., Hall, W.L. and Cassidy, A., 2008. Flavonoids, flavonoid-rich foods, and cardiovascular risk: a meta-analysis of randomized controlled trials. AmericanJournalof Clinical Nutrition, 88: 38-50.
- Kaur, G., Jabbar, Z., Athar, M. and Alam, M.S., 2006. Punica granatum (pomegranate) flower extract possesses potent antioxidant activity and abrogates Fe-NTA induced hepatotoxicity in mice. Food and Chemical Toxicology, 44(7): 984-993.
- Landmesser, U. and Drexler, H., 2005. The clinical significance of endothelial dysfunction. Current Opinion in Cardiology, 20(6): 547-551.
- Mertens-Talcott, S.U., Jilma-Stohlawetz, P., Rios, J., Hingorani, L. and Derendorf, H., 2006. Absorption, metabolism, and antioxidant effects of pomegranate (Punica granatum L.) polyphenols after ingestion of a standardized extract in healthy human volunteers. Journal of Agricultural and Food Chemistry, 54(23): 8956-8961.
- Morand, C., Dubray, C, Milenkovic, D., Lioger, D., Martin, J.F., Scalbert, A. and Mazur, A., 2011. Hesperidin contributes to the vascular protective effects of orange juice: a randomized crossover study in healthy volunteers. American Journal of Clinical Nutrition, 93: 73-80.
- Pérez-Vicente, A., Gil-Izquierdo, A. and García-Viguera, C., 2002. In vitro gastrointestinal digestion study of pomegranate juice phenolic compounds, anthocyanins, and vitamin C. Journal of Agricultural and Food Chemistry, 50(8): 2308-2312.
- Plantinga, Y., Ghiadoni, L., Magagna, A., Giannarelli, C., Franzoni, F., Taddei, S. and Salvetti, A., 2007. Supplementation with vitamins C and E improves arterial stiffness and endothelial function in essential hypertensive patients. American Journal of Hypertension, 20: 392-397.
- Pyke, K.E. and Tschakovsky, M.E., 2005. The relationship between shear stress and flow-mediated dilatation: implications for the assessment of endothelial function. The Journal of Physiology, 568: 357-369.
- Rosenblat, M., Hayek, T. and Aviram, M., 2006. Anti-oxidative effects of pomegranate juice (PJ) consumption by diabetic patients on serum and on macrophages. Atherosclerosis, 187: 363-371.
- Shimbo, D., Grahame-Clarke, C., Miyake, Y., Rodriguez, C., Sciacca, R., Di Tullio, M., Boden-Albala, B., Sacco, R. and Homma, S., 2007. The association between endothelial dysfunction and cardiovascular outcomes in a population based multi-ethnic cohort. Atherosclerosis, 192: 197-203.
- Sies, H., Schewe, T., Heiss, C. and Kelm, M., 2005. Cocoa polyphenols and inflammatory mediators. AmericanJournalof Clinical Nutrition, 81: 304S-312S.
- Stowe, C.B., 2011. The effects of pomegranate juice consumption on blood pressure and cardiovascular health. Complementary Therapies in Clinical Practice, 17: 113-115.
- Tabit, C.E., Chung, W.B., Hamburg, N.M. and Vita, J.A., 2010. Endothelial dysfunction in diabetes mellitus: molecular mechanisms and clinical implications. Reviews in Endocrine and Metabolic Disorders, 11:61-74.
- Taubert, D., Roesen, R., Lehmann, C., Jung, N. and Schomig, E., 2007. Effects of low habitual cocoa intake on blood pressure and bioactive nitric oxide: a randomized controlled trial. Journal of the American Medical Association, 298: 49-60
- W.H.O., 1998. Prevention and management of the global epidemic of obesity. Report of the WHO Consultation on Obesity. WHO: Geneva.
- Widlansky, M.E., Gokce, N., Keaney Jr, J.F. and Vita, J.A., 2003. The clinical implications of endothelial dysfunction. Journal of the American College of Cardiology, 42: 1149-1160.
- Williams, J.S., Brown, S.M. and Conlin, P.R., 2009. Blood-pressure measurement. New England Journal of Medicine, 360(5): e6.
- Witte, D.R., van der Graaf, Y., Grobbee, D.E. and Bots, M.L., 2005. Measurement of flow-mediated dilatation of the brachial artery is affected by local elastic vessel wall properties in high-risk patients. Atherosclerosis, 182(2): 323-330.
- Yeboah, J., Crouse, J.R., Hsu, F.C., Burke, G.L. and Herrington, D.M., 2007. Brachial flow-mediated dilation predicts incident cardiovascular events in older adults: the cardiovascular health study. Circulation, 115: 2390-2397.