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Blood Pressure Lowering Effect of B-vitamins in Adults With a Genetic Pre-disposition to Elevated Blood Pressure.

Not Applicable
Completed
Conditions
Blood Pressure
Interventions
Dietary Supplement: Folic acid
Dietary Supplement: Riboflavin
Dietary Supplement: Placebo
Registration Number
NCT04278378
Lead Sponsor
University of Ulster
Brief Summary

Approximately 12% of the world's population have a have a common C677T polymorphism in the gene encoding the folate metabolising enzyme, methylenetetrahydrofolate reductase (MTHFR). Homozygosity for the polymorphism (TT genotype) causes an increased requirement for the B-vitamins folic acid and riboflavin and more importantly results in an increased risk of developing high blood pressure (BP). Previous work from our Centre has demonstrated significantly higher BP in those with the TT genotype. This work has been conducted in cohorts with premature cardiovascular disease (CVD) and hypertension without overt CVD, but the effect in younger, healthier individuals is unexplored. To date our studies have also focused on BP as the primary outcome, but newer markers of vascular health including central pressure and hemodynamics have emerged as superior prognostic indicators of CVD. The effect of the TT genotype on these measures is an area for investigation and may help us understand the mechanism linking the genotype with BP, which is currently unknown. As adults with the TT genotype have increased requirements for riboflavin and folic acid, and BP in TT adults appears to be riboflavin dependent, the influence of these vitamins on central measures is an area for consideration. Study Design This is an observational study investigating the blood pressure profiles of healthy adults aged 18-65 years, stratified by MTHFR genotype. Apparently healthy adults will be recruited from workplaces and the general community across Northern Ireland and screened for the polymorphism via buccal swab. Those with the TT genotype and a similar number of non-TT (i.e. CC/CT) genotype individuals will be contacted and asked to come to a one-off appointment. Brachial BP will be assessed by an electronic BP monitor, central BP and central haemodynamics (augmentation index, augmentation pressure and pulse wave velocity) will be assessed by SphygmoCor XCEL. In addition, anthropometric measurements, health and lifestyle infromation and a blood sample will be obtained. Data will be statistically analysed using SPSS software to if determine differences between gentoype groups exist.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
2564
Inclusion Criteria
  • MTHFR 677TT genotype, aged at least 18 years old
Exclusion Criteria
  • Taking supplements containing B-vitamins
  • Pregnant or planning to conceive
  • Taking medications interfering with folate metabolism
  • Renal or gastrointestinal disease

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Folic AcidFolic acid0.4 mg folic acid/ day for 24 weeks
RiboflavinRiboflavin1.6 mg riboflavin / day for 24 weeks
Riboflavin + Folic AcidFolic acid1.6mg Riboflavin + 0.4 mg Folic Acid / day for 24 weeks
Riboflavin + Folic AcidRiboflavin1.6mg Riboflavin + 0.4 mg Folic Acid / day for 24 weeks
PlaceboPlacebo-
Primary Outcome Measures
NameTimeMethod
Blood pressureChange from baseline to 24 weeks

Office blood pressure

Secondary Outcome Measures
NameTimeMethod
Red blood cell riboflavinChange from baseline to 24 weeks

Measured using erythrocyte glutathione reductase activity coefficient (EGRAC)

Red blood cell folateChange from baseline to 24 weeks

Measured by microbiological assay

Serum homocysteineChange from baseline to 24 weeks

Measured using an immunoassay

Central blood pressureChange from baseline to 24 weeks

Measured using SphygmoCor device

Pulse wave analysisChange from baseline to 24 weeks

Measured using SphygmoCor device

Pulse wave velocityChange from baseline to 24 weeks

Measured using SphygmoCor device

Plasma vitamin B6Change from baseline to 24 weeks

Measured by High Performance Liquid Chromatography

Trial Locations

Locations (1)

Human Intervention Studies Unit, Ulster University

🇬🇧

Coleraine, Co.Londonderry, United Kingdom

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