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Caffeine is an exceedingly popular and consumed pharmacological agent. Although caffeine is primarily consumed from coffee and tea beverages, it is also available in other forms such as sodas, energy drinks, tablets and capsules. Nevertheless, caffeine acutely increases brachial and aortic systolic blood pressure (BP) and arterial stiffness. Arterial stiffness is an independent predictor of cardiovascular disease (CVD) and assessed through pulse wave velocity (PWV). Interestingly, previous studies have proposed that caffeine may increase aortic BP through increases in aortic PWV and augmentation index (AIx), a measurement of wave reflection. Yet, these effects were seen in middle-aged adults with treated hypertension and a wide age range. Therefore, it is imperative to consider that caffeine may cause different effects in young normotensive individuals than in older adults independently of BP levels. Importantly, oral supplementation of the amino-acid, L-citrulline has been shown to enhance the bioavailability of L-arginine levels and nitric oxide (NO) production and, therefore, improve arterial function. L-citrulline supplementation for 7 days given at 6 g/day has shown to increase NO levels while improving PWV. Previous studies by our group also demonstrated that L-citrulline supplementation reduces the BP response to cold exposure; a condition with an increased vasoconstriction. Therefore, the acute effects of caffeine on central and peripheral PWV and BP in healthy young men are yet to be fully evaluated. We hypothesized that acute caffeine intake would increase peripheral and aortic BP and PWV and that L-citrulline supplementation would attenuate the effects induced by acute caffeine ingestion.
The specific aims of this study are:
AIM 1: To examine the effects of the acute ingestion of 200mg caffeine (tablets) on arterial function in young adults. The working hypothesis is that acute caffeine intake would increase brachial, ankle and aortic BP, PWV (aortic and leg), and wave reflection. In order to test this hypothesis, the investigators will perform non-invasive measurements of arterial stiffness (aortic and leg PWV) and pulse wave analysis (aortic BP and AIx) using applanation tonometry of the radial artery 30, 45, and 60 minutes following caffeine ingestion.
AIM 2: To determine the effectiveness of L-citrulline supplementation to attenuate the acute cardiovascular effects of caffeine ingestion. The working hypothesis is that 7 days of L-citrulline supplementation will attenuate the unfavorable arterial responses (increases in BP, PWV, and wave reflection) to acute caffeine ingestion. In order to test this hypothesis, the investigators will perform the same procedures previously specified in AIM 1.
Description of the study:
Sixteen healthy young men 18-40 years of age will be enrolled in this study. Participants with CVD history, resting BP (> 160/100 mmHg), recent history of smoking, or considered competitive athlete will be excluded from the study. All subjects will refrain from food and caffeine for > 8 hours and from exercise for > 24 hours before testing.
Study design:
Following an initial screening, arterial function measurements will be collected. Measurements will be assessed at baseline following 10 minutes of rest in the supine position and then again at 30, 45, and 60 minutes after 200 mg caffeine or placebo ingestion. Participants will receive caffeine or placebo supplementation on two separate visits with a minimum of 48 hours in between sessions. Following the acute phase of the study, subjects will be randomized to consume L-citrulline or placebo for 7 days given at 6 grams/day. Following the same protocol as the acute phase with 200 mg caffeine, measurements will be collected before and after the 7 day supplementation period.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Caffeine | Active Comparator | 200 mg caffeine tablet produced by CVS Pharmacy, USA |
|
| Placebo | Placebo Comparator | Placebo pill produced by NOW FOODS, USA |
|
| L-citrulline | Experimental | L-citrulline capsule (750 mg) provided by NOW FOODS |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Caffeine | Drug | A 200 mg caffeine tablet was given to subject to examine the drugs effect on arterial function. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Aortic Blood Pressure | Aortic blood pressure at rest and 30 minutes after acute ingestion of 200 mg of caffeine before and after 7 days of either 6g/day of Citrulline or 6 g/day of Placebo. | Baseline and Day 7 (Calculated change between rest and 30 minutes post-caffeine ingestion at these time points) |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in Reflected Wave Pressure (P2) | Reflected wave pressure at rest and 30 minutes after ingestion of 200mg of caffeine after 7 days supplementation of 6g/day of either L-Citrulline or Placebo. | Baseline and Day 7 (Calculated change between rest and 30 minutes post-caffeine ingestion at these time points) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Arturo Figueroa, M.D. Ph.D | Florida State University | Principal Investigator |
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Of the 42 individuals screened, 16 individuals completed the intervention in its entirety.
Sixteen young healthy men participated in this study. All subjects were non-smokers, recreationally active, and free of apparent cardiovascular-metabolic diseases based on medical history.
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| ID | Title | Description |
|---|---|---|
| FG000 | Citrulline First, Then Placebo | Each participant received L-Citrulline (6g/day) for a 7 day period. This was followed by a 14 day washout period. Finally, the same participants then received a Placebo (6g/day maltodextrin) for a 7 day period. |
| FG001 | Placebo First, Then L-Citrulline | Each participant received a Placebo (6g/day maltodextrin) for a 7 day period. This was followed by a 14 day washout period. Finally, the same participants then received a L-Citrulline (6g/day) for a 7 day period. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| First Intervention (7 Days) |
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| Washout (14 Days) |
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| Second Intervention (7 Days) |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | L-Citrulline or Placebo | Placebo and L-Citrulline pills produced by NOW FOODS, USA Citrulline or Placebo (both 6g/day) were given for a 7 day supplementation period. This was followed by a 14 day washout period and crossover to the other supplement (L-Citrulline or Placebo) for 7 days. Measurements of arterial function were performed to determine if the supplements had any significant effect on blood pressure control/pressure wave reflection at rest and immediately after ingestion of 200 milligrams of caffeine. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Aortic Blood Pressure | Aortic blood pressure at rest and 30 minutes after acute ingestion of 200 mg of caffeine before and after 7 days of either 6g/day of Citrulline or 6 g/day of Placebo. | Young, apparently healthy individuals, aged 18-40 years old. | Posted | Mean | Standard Deviation | mmHg | Baseline and Day 7 (Calculated change between rest and 30 minutes post-caffeine ingestion at these time points) |
|
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Adverse events were not monitored/assessed because the participants were young and healthy.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Citrulline | Participants received 6g/day of Citrulline for 7 days | 0 |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Arturo Figueroa | Texas Tech University | 8068345587 | arturo.figueroa@ttu.edu |
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| ID | Term |
|---|---|
| D006973 | Hypertension |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D002110 | Caffeine |
| D002956 | Citrulline |
| ID | Term |
|---|---|
| D014970 | Xanthines |
| D000470 | Alkaloids |
| D006571 | Heterocyclic Compounds |
| D011688 | Purinones |
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| Placebo | Drug | A 750 mg placebo capsule (maltodextrin) was given to subjects to examine the effect of the drug on arterial function. |
|
|
| L-citrulline | Dietary Supplement | L-citrulline was used to examine the effect of the supplement on arterial function. |
|
|
| Changes in Femoral-ankle Pulse Wave Velocity After 7 Days of Either L-Citrulline or Placebo (6g/Day) |
Femoral-ankle pulse wave velocity at rest and 30 minutes after ingestion of 200mg of caffeine after 7 days supplementation of 6g/day of either L-Citrulline or Placebo. |
| Baseline and Day 7 (Calculated change between rest and 30 minutes post-caffeine ingestion at these time points) |
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| NOT COMPLETED |
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| Participants |
|
| Age, Continuous | ages of 18 to 40 years | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race and Ethnicity Not Collected | Race and Ethnicity were not collected from any participant. | Count of Participants | Participants |
|
| Units | Counts |
|---|---|
| Participants |
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|
|
| Secondary | Changes in Reflected Wave Pressure (P2) | Reflected wave pressure at rest and 30 minutes after ingestion of 200mg of caffeine after 7 days supplementation of 6g/day of either L-Citrulline or Placebo. | Young, apparently healthy adults, aged 18-40 years. | Posted | Mean | Standard Deviation | mmHg | Baseline and Day 7 (Calculated change between rest and 30 minutes post-caffeine ingestion at these time points) |
|
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|
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| Secondary | Changes in Femoral-ankle Pulse Wave Velocity After 7 Days of Either L-Citrulline or Placebo (6g/Day) | Femoral-ankle pulse wave velocity at rest and 30 minutes after ingestion of 200mg of caffeine after 7 days supplementation of 6g/day of either L-Citrulline or Placebo. | young, apparently healthy adults, aged 18-40 years | Posted | Mean | Standard Deviation | m/s | Baseline and Day 7 (Calculated change between rest and 30 minutes post-caffeine ingestion at these time points) |
|
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|
| 0 |
| 0 |
| 0 |
| 0 |
| 0 |
| EG001 | Placebo | Participants received 6g/day of Placebo (Maltodextrin) for 7 days | 0 | 0 | 0 | 0 | 0 | 0 |
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| D011687 |
| Purines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D000599 | Amino Acids, Diamino |
| D000596 | Amino Acids |
| D000602 | Amino Acids, Peptides, and Proteins |