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Increased abdominal obesity (waist circumference) and systolic blood pressure (BP) are main risk factors for the metabolic syndrome. Approximately 60% of adults in the United States are prehypertensive or hypertensive. Hypertension has been associated with abnormal endothelial and autonomic function, the two main mechanisms of BP regulation. Endothelial dysfunction, as a result of reduced NO (a vasodilator), and increased sympathetic nervous system activity contribute to arterial stiffness by enhancing the vasomotor tone. Because BP variations are sensed by baroreceptors in the wall of large arteries, increased stiffness of arteries may attenuate the control of BP by the autonomic nervous system leading to hypertension. High production of proinflammatory cytokines and low adiponectin (vascular protective molecule), are considered the underlying mechanisms leading to endothelial dysfunction and arterial stiffness. The recommended intervention for controlling BP in overweight/obese individuals with pre- and stage 1- hypertension is lifestyle modifications and not drug therapy. Among the dietary regimens that are reported to reduce BP is L-arginine, the substrate for endothelial NO production. Recently, oral L-citrulline has been shown to be more effective than L-arginine in improving circulating NO levels because is not affected by enzymatic degradation. Watermelon, the leading US melon crop, is one of the few natural foods rich in L-citrulline which is efficiently transformed to arginine in humans. The investigators long-term goal is to provide feasible and effective dietary ways to reduce cardiovascular risk factors in individuals with high abdominal fat and BP. The overall objective of this study is to bring forth evidence that watermelon supplementation will reduce BP and cardiovascular risk factors such as arterial stiffness, autonomic dysfunction and endothelial dysfunction. The investigators postulate that watermelon supplementation will reduce BP and arterial stiffness by enhancing endothelial function and reducing vascular inflammation. The findings of this study will provide a foundation for disseminating feasible, safe approaches for preventing and combating obesity-related hypertension at its early stage which does not require drug therapy.
The purpose of the study is to examine the effect of 12 weeks of L-citrulline/L-arginine in the form of watermelon supplementation on arterial function and autonomic neural control of the heart rate and blood pressure in older overweight/obese men and women with pre- and stage 1- hypertension. The specific aims of the study are:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Maltodextrin | Placebo Comparator | 6g/day of placebo (maltodextrin) |
|
| Watermelon | Experimental | (6g per day)containing L-citrulline/L-arginine (4/2 g) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Watermelon Extract | Dietary Supplement | 6 weeks of watermelon extract taken in two doses of 3g each per day (6g per day)containing L-citrulline/L-arginine (4/2 g) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Blood Pressure | By measuring brachial and central (aortic and carotid) BP at rest and during physiological stress (head-up tilt test and cold pressor test) | 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Arterial Stiffness | Using pulse wave velocity of the aorta and legs. | 12 weeks |
| Endothelial function | By measuring flow-mediated dilation using vascular ultrasound and circulating levels of vasodilators, vasoconstrictors, and markers of vascular inflammation (adiponectin, leptin, endothelin-1, angiotensin II, prostaglandin F2α, sVCAM-1, sICAM-1, and 8-isoprostane). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Arturo Figueroa, MD, PhD | The Florida State University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cardiovascular Physiology Laboratory | Tallahassee | Florida | 32306 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24572702 | Derived | Figueroa A, Wong A, Kalfon R. Effects of watermelon supplementation on aortic hemodynamic responses to the cold pressor test in obese hypertensive adults. Am J Hypertens. 2014 Jul;27(7):899-906. doi: 10.1093/ajh/hpt295. Epub 2014 Feb 26. |
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| ID | Term |
|---|---|
| D006973 | Hypertension |
| D009765 | Obesity |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D050177 | Overweight |
| D044343 | Overnutrition |
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|
| 12 weeks |
| Autonomic control of BP | By measuring BP variability and BRS at rest and during physiological stress | 12 weeks |
| Autonomic control of heart rate | By measuring heart rate variability at rest and during physiological stress | 12 weeks |
| D009748 |
| Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |