Artery Research (May 2020)
Rationale and Design of a Randomized Controlled Trial to Evaluate the Effects of Probiotics during Energy Restriction on Blood Pressure, Body Composition, Metabolic Profile and Vascular Function in Obese Hypertensive Individuals
Abstract
Introduction: Hypertension often clusters with other cardiovascular risk factors such as obesity, dyslipidemia and glucose intolerance. Weight loss can decrease Blood Pressure (BP) and improve cardiometabolic abnormalities. There is evidence that hypertension and obesity are associated with alterations in gut microbiome. Recent studies evaluating the effects of probiotics on BP, body weight, metabolic profile, inflammatory biomarkers, endothelial function and arterial stiffness found inconsistent results, probably due to the wide heterogeneity in trials design. To date, it is not known if probiotics can potentiate the effects of energy restriction in individuals with increased risk of metabolic, inflammatory and vascular abnormalities such as individuals presenting hypertension and obesity. Objective: To evaluate the effects of probiotics during energy restriction on BP, body adiposity (total, central and visceral), insulin resistance, lipid profile, microvascular reactivity and arterial stiffness in obese hypertensive subjects. Methods: This 12-week randomized, double-blind, controlled clinical trial with obese hypertensive adults, instructed to follow an energy-reduced diet (−800 Kcal/day) will be conducted at State University of Rio de Janeiro, Brazil. Probiotics and control groups will take one capsule/day containing nine freeze-dried probiotic strains and cellulose, respectively. At baseline and at the end of the study, participants will undergo nutritional, laboratory, BP and vascular evaluation. Nutritional assessment will include bioelectrical impedance analysis and dual energy X-ray absorptiometry. Laboratory parameters will include glucose, insulin, lipid profile, C-reactive protein, adiponectin, tumor necrosis factor alpha, interleukin-6 and lipopolysaccharide. Post-occlusive microvascular reactivity will be evaluated by laser speckle contrast imaging and oscillometric pulse wave analysis by Mobil-O-Graph.
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