Acute citrulline oral supplementation induces greater post-exercise hypotension response in hypertensive than normotensive individuals
Palavras-chave:
Blood pressure, Citrulline, Dietary supplements, Exercise, HypertensionResumo
Objective
To investigate whether acute citrulline supplementation might infl uence post-exercise hypotension in normotensive and hypertensive individuals.
Methods
Following a randomized double-blind design, twenty normotensive (28±7 years, 74±17kg, 1.7±0.09m) and 20 hypertensive individuals (55±12 years, 76±15kg, 1.59±0.09m) were randomly assigned to one of the four experimental groups (Normotensive-Placebo; Normotensive-Citrulline; Hypertensive-Placebo; HypertensiveCitrulline). The placebo groups ingested 6g of corn starch and the citrulline groups ingested 6g of citrulline dissolved in water. The participants performed 40 minutes of walking/running on a treadmill at 60-70% heart rate reserve. Blood pressure was measured immediately after a 60-min exercise session using an oscillometric device and 24-h ambulatory monitoring.
Results
The post-exercise hypotension was more pronounced in hypertensives and the Hypertensive-Citrulline group showed a consistent systolic blood pressure reduction during the laboratorial phase, which can be seen by looking at the mean of 60 minutes (-15.01mmHg vs -3.14mmHg [P=0.005]; -4.16mmHg [P=0.009]; -6.30mmHg [P=0.033] in comparison with the Normotensive-Placebo, Normotensive-Citrulline, and Hypertensive-Placebo groups, respectively). During ambulatory blood pressure monitoring, the Hypertensive-Citrulline group showed a significant reduction in systolic blood pressure (-21.05mmHg) in the awake period compared with the Normotensive-Citrulline group (-3.17mmHg [P=0.010]).
Conclusion
Acute citrulline oral supplementation can induce greater post-exercise hypotension response in hypertensive than normotensive individuals.
Referências
Kenney MJ, Seals DR. Postexercise hypotension: Key features, mechanisms, and clinical significance. Hypertension. 1993;22(5):653-64.
Moraes MR, Bacurau RF, Ramalho JD, Reis FC, Casarini DE, Chagas JR, et al. Increase in kinins on post-exercise hypotension in normotensive and hypertensive volunteers. Biol Chem. 2007;388(5):533-40.
Hecksteden A, Grutters T, Meyer T. Association between postexercise hypotension and long-term training-induced blood pressure reduction: A pilot study. Clin J Sport Med. 2013;23(1):58-63.
Liu S, Goodman J, Nolan R, Lacombe S, Thomas SG. Blood pressure responses to acute and chronic exercise are related in prehypertension. Med Sci Sports Exerc. 2012;44(9):1644-52.
Luttrell MJ, Halliwill JR. Recovery from exercise: Vulnerable state, window of opportunity, or crystal ball? Front Physiol. 2015;6:204.
Lloyd-Jones D, Adams R, Carnethon M, De Simone G, Ferguson TB, Flegal K, et al. Heart disease and stroke statistics-2009 update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119(3):e21-181.
Floras JS, Wesche J. Haemodynamic contributions to post-exercise hypotension in young adults with hypertension and rapid resting heart rates. J Hum Hypertens. 1992;6(4):265-9.
Rondon MUB, Alves MJ, Braga AM, Teixeira OT, Barretto AC, Krieger EM, et al. Postexercise blood pressure reduction in elderly hypertensive patients. J Am Coll Cardiol. 2002;39(4):676-82.
Coats AJ, Conway J, Isea JE, Pannarale G, Sleight P, Somers VK. Systemic and forearm vascular resistance changes after upright bicycle exercise in man. J Physiol. 1989;413:289-98.
Isea JE, Piepoli M, Adamopoulos S, Pannarale G, Sleight P, Coats AJ. Time course of haemodynamic changes after maximal exercise. Eur J Clin Invest. 1994;24(12):824-9.
Archer SL, Huang JM, Hampl V, Nelson DP, Shultz PJ, Weir EK. Nitric oxide and cGMP cause vasorelaxation by activation of a charybdotoxinsensitive K channel by cGMP-dependent protein kinase. Proc Natl Acad Sci USA. 1994;91(16):7583-7.
Tanaka Y, Tang G, Takizawa K, Otsuka K, Eghbali M, Song M, et al. Kv channels contribute to nitric oxide- and atrial natriuretic peptide-induced relaxation of a rat conduit artery. J Pharmacol Exp Ther. 2006;317(1):341-54.
Breuillard C, Cynober L, Moinard C. Citrulline and nitrogen homeostasis: An overview. Amino Acids. 2015;47(4):685-91.
Alsop P, Hauton D. Oral nitrate and citrulline decrease blood pressure and increase vascular conductance in young adults: A potential therapy for heart failure. Eur J Appl Physiol. 2016;116(9):1651-61.
Gordon CC, Chumlea WC, Roche AF. Stature, recumbent length, and weight. In Lohman TG, Roche AF, Martorell R, editors. Champaign: Human Kinetics Books; 1988. p.3-8
Coleman A, Freeman P, Steel S, Shennan A. Validation of the Omron MX3 Plus oscillometric blood pressure monitoring device according to the European Society of Hypertension international protocol. Blood Press Monit. 2005;10(3):165-8.
Pickering TG, Hall JE, Appel LJ, Falkner BE, Graves J, Hill MN, et al. Recommendations for blood pressure measurement in humans and experimental animals: Blood pressure measurement in humans: A statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Hypertension. 2005;45(1):142-61.
Casonatto J, Tinucci T, Dourado AC, Polito M. Cardiovascular and autonomic responses after exercise sessions with different intensities and durations. Clinics. 2011;66(3):453-8.
Bendahan D, Mattei JP, Ghattas B, ConfortGouny S, Le Guern ME, Cozzone PJ. Citrulline/malate promotes aerobic energy production in human exercising muscle. Brit J Sports Med. 2002;36(4):282-9.
Sureda A, Cordova A, Ferrer MD, Tauler P, Perez G, Tur JA, et al. Effects of L-citrulline oral supplementation on polymorphonuclear neutrophils oxidative burst and nitric oxide production after exercise. Free Radic Res. 2009;43(9):828-35.
Schwedhelm E, Maas R, Freese R, Jung D, Lukacs Z, Jambrecina A, et al. Pharmacokinetic and pharmacodynamic properties of oral L-citrulline and L-arginine: Impact on nitric oxide metabolism. Brit J Clin Pharmacol. 2008;65(1):51-9.
Mori M. Regulation of nitric oxide synthesis and apoptosis by arginase and arginine recycling. J Nutr. 2007;137(6Suppl.2):1616S-20S.
Figueroa A, Wong A, Jaime SJ, Gonzales JU. Influence of L-citrulline and watermelon supplementation on vascular function and exercise performance. Curr Opin Clin Nutr Metab Care. 2017;20(1):92-8.
Wong A, Alvarez-Alvarado S, Jaime SJ, Kinsey AW, Spicer MT, Madzima TA, et al. Combined whole-body vibration training and l-citrulline supplementation improves pressure wave reflection in obese postmenopausal women. Appl Physiol Nutr Metab. 2016;41(3):292-7.
Hagberg JM, Montain SJ, Martin WH. Blood pressure and hemodynamic responses after exercise in older hypertensives. J Appl Physiol. 1987;63(1):270-6.
Casonatto J, Polito MD. Hipotensão pós-exercício aeróbio: uma revisão sistemática. Rev Bras Med Esporte. 2009;15(2):151-7.
Carpio-Rivera E, Moncada-Jimenez J, Salazar-Rojas W, Solera-Herrera A. Acute effects of exercise on blood pressure: A meta-analytic investigation. Arq Bras Cardiol. 2016;106(5):422-33.
Li Q, Youn JY, Cai H. Mechanisms and consequences of endothelial nitric oxide synthase dysfunction in hypertension. J Hypertens. 2015;33(6):1128-36.
Joannides R, Haefeli WE, Linder L, Richard V, Bakkali EH, Thuillez C, et al. Nitric oxide is responsible for flowdependent dilatation of human peripheral conduit arteries in vivo. Circulation. 1995;91(5):1314-9.
Ochiai M, Hayashi T, Morita M, Ina K, Maeda M, Watanabe F, et al. Short-term effects of L-citrulline supplementation on arterial stiffness in middleaged men. Inter J Cardiol. 2012;155(2):257-61.
Wijnands KA, Vink H, Briede JJ, van Faassen EE, Lamers WH, Buurman WA, et al. Citrulline a more suitable substrate than arginine to restore NO production and the microcirculation during endotoxemia. Plos One. 2012;7(5):e37439.
El-Hattab AW, Hsu JW, Emrick LT, Wong LJ, Craigen WJ, Jahoor F, et al. Restoration of impaired nitric oxide production in MELAS syndrome with citrulline and arginine supplementation. Mol Gen Metab. 2012;105(4):607-14.
Luiking YC, Poeze M, Ramsay G, Deutz NE. Reduced citrulline production in sepsis is related to diminished de novo arginine and nitric oxide production. Am J Clin Nutr. 2009;89(1):142-52.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Junior JL, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42(6):1206-52.
Wax B, Kavazis AN, Luckett W. Effects of supplemental citrulline-malate ingestion on blood lactate, cardiovascular dynamics, and resistance exercise performance in trained males. J Diet Suppl. 2016;13(3):269-82.
Kelley GA, Kelley KS. Progressive resistance exercise and resting blood pressure: A meta-analysis of randomized controlled trials. Hypertension. 2000;35(3):838-43.
Cornelissen VA, Smart NA. Exercise training for blood pressure: A systematic review and metaanalysis. J Am Heart Assoc. 2013;2(1):e004473.
Anunciação PG, Casonatto J, Polito M. Blood pressure responses and heart rate variability after resistance exercise with different intensities and same workload. Int Sport J. 2011;12(2):53-67.
Casonatto J, Goessler KF, Cornelissen VA, Cardoso JR, Polito MD. The blood pressure-lowering effect of a single bout of resistance exercise: A systematic review and meta-analysis of randomised controlled trials. Eur J Prev Cardiol. 2016;23(16):1700-14.
Moraes MR, Bacurau RF, Simoes HG, Campbell CS, Pudo MA, Wasinski F, et al. Effect of 12 weeks of resistance exercise on post-exercise hypotension in stage 1 hypertensive individuals. J Hum Hypertens. 2012;26(9):533-9.
Mota MR, Oliveira RJ, Dutra MT, Pardono E, Terra DF, Lima RM, et al. Acute and chronic effects of resistive exercise on blood pressure in hypertensive elderly women. J Strength Cond Res. 2013;27(12):3475-80.
Sullivan GM, Feinn R. Using effect size or why the p value is not enough. J of Grad Med Educ. 2012;4(3):279-82.
Lakens D. Calculating and reporting effect sizes to facilitate cumulative science: A practical primer for t-tests and ANOVAs. Front Psychol. 2013;4:863.
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