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Item #8
Ascorbic
Acid Reduces Blood Pressure and Arterial Stiffness in Type 2 Diabetes
Oral
ascorbic acid lowered arterial blood pressure and improved
arterial stiffness in patients with type 2 diabetes
Experimental
evidence suggests that acute parenteral administration of
high-dose ascorbic acid has beneficial vascular effects in type
2 diabetes.
We
studied the hemodynamic effects of chronic oral
supplementation in this condition. Thirty patients, 45 to
70 years of age, with type 2 diabetes, were randomly assigned in
a double-blind manner to receive 500 mg ascorbic acid daily by
mouth or placebo.
Patients
were studied at baseline and after 4 weeks of assigned
treatment. The central aortic augmentation index (AgIx) and
the time to wave reflection (Tr) were derived from radial
artery pulse wave analysis data. AgIx and Tr were used as
measures of systemic arterial stiffness and aortic stiffness, respectively.
Ascorbic acid decreased brachial systolic blood pressure
from 142.1±12.6 (SD) to 132.3±12.1 mm Hg (difference [95%
CI] 9.9 [4.7, 15.0]; P<0.01), brachial diastolic
pressure from 83.9±4.8 to 79.5±6.0 mm Hg (4.4 [1.8, 7.0];
P<0.01), and AgIx from 26.8±5.5% to 22.5±6.8%
(4.3 [1.5, 7.1]; P<0.01). Tr increased from 137.1±12.6
to 143.4±9.2 ms (-6.3 [-10.1, -2.5]; P<0.01).
Placebo had no hemodynamic effects, and this difference
between treatments was significant (P<0.01 for blood
pressure and Tr, P=0.03 for AgIx).
We
have therefore shown that after 1 month, oral ascorbic acid
lowered arterial blood pressure and improved arterial
stiffness in patients with type 2 diabetes. As strict
control of blood pressure reduces cardiovascular risk in
diabetes, ascorbic acid supplementation may potentially be
a useful and inexpensive adjunctive therapy. Larger and longer studies
now need to be performed.
Hypertension.
2002;40:804.
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