Influence of Vitamin C on Baroreflex Sensitivity in Chronic Heart Failure

Piccirillo, Gianfranco; Nocco, Marialuce; Moisè, Antonio; Lionetti, Marco; Naso, Camilla; Carlo, Silvia Di; Marigliano, Vincenzo

doi:10.1161/01.hyp.0000073581.74107.22

Cited by 47 publications

(41 citation statements)

References 53 publications

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“…These data suggest a direct suppressive action of reactive oxygen species on carotid baroreceptors. Moreover, acute intravenous infusion of ascorbic acid increases cardiovagal BRS in patients with congestive heart failure (27,28). Importantly, administration of antioxidants in these previous investigations, as well as in the present study, had no effect on baroreflex function in healthy young controls (22,27), suggesting that ascorbic acid administration in the absence of oxidative stress has no influence on cardiovagal BRS.…”

Section: Discussionsupporting

confidence: 49%

“…Depressed cardiovagal responsiveness has been linked to impaired BP regulation with aging (32) and an increased incidence of sudden cardiac death in patients with coronary artery disease (19,20). Thus the identification of mechanisms underlying depressed cardiovagal BRS has important clinical implications.Many cardiovascular disease states are associated with baroreflex impairment (4, 10), with oxidative stress playing a possible mechanistic role (22,27,28). Aging, which is a primary risk factor for cardiovascular disease development (21), is associated with a reduction in cardiovagal BRS (9, 13, 25) and increased levels of oxidative stress (15,17,18,40).…”

mentioning

confidence: 99%

“…Many cardiovascular disease states are associated with baroreflex impairment (4, 10), with oxidative stress playing a possible mechanistic role (22,27,28). Aging, which is a primary risk factor for cardiovascular disease development (21), is associated with a reduction in cardiovagal BRS (9, 13, 25) and increased levels of oxidative stress (15,17,18,40).…”

mentioning

confidence: 99%

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Ascorbic acid increases cardiovagal baroreflex sensitivity in healthy older men

Monahan

Eskurza²,

Seals³

2004

American Journal of Physiology-Heart and Circulatory Physiology

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Monahan, Kevin D., Iratxe Eskurza, and Douglas R. Seals. Ascorbic acid increases cardiovagal baroreflex sensitivity in healthy older men. Am J Physiol Heart Circ Physiol 286: H2113-H2117, 2004. First published February 12, 2004 10.1152/ajpheart.01054. 2003.-Cardiovagal baroreflex sensitivity (BRS) declines with advancing age in healthy men. We tested the hypothesis that oxidative stress contributes mechanistically to this age-associated reduction. Eight young (23 Ϯ 1 yrs, means Ϯ SE) and seven older (63 Ϯ 3) healthy men were studied. Cardiovagal BRS was assessed using the modified Oxford technique (bolus infusion of 50 -100 g sodium nitroprusside, followed 60 s later by a 100-to 150-g bolus of phenylephrine hydrochloride) in triplicate at baseline and during acute intravenous ascorbic acid infusion. At baseline, cardiovagal BRS (slope of the linear portion of the R-R interval-systolic blood pressure relation during pharmacological changes in arterial blood pressure) was 56% lower (P Ͻ 0.01) in older (8.3 Ϯ 1.6 ms/mmHg) compared with young (19.0 Ϯ 3.1 ms/mmHg) men. Ascorbic acid infusion increased plasma concentrations similarly in young (62 Ϯ 9 vs. 1,249 Ϯ 72 mol/l for baseline and during ascorbic acid; P Ͻ 0.05) and older men (62 Ϯ 4 vs. 1,022 Ϯ 55 mol/l; P Ͻ 0.05) without affecting baseline blood pressure, heart rate, carotid artery compliance, or the magnitude of change in systolic blood pressure in response to bolus sodium nitroprusside and phenylephrine hydrochloride infusion. Ascorbic acid (vitamin C) infusion increased cardiovagal BRS in older (⌬58 Ϯ 16%; P Ͻ 0.01), but not younger (⌬ Ϫ 4 Ϯ 4%) men. These data provide experimental support for the concept that oxidative stress contributes mechanistically to age-associated reductions in cardiovagal BRS in healthy men.baroreceptors; blood pressure; antioxidants THE SLOPE RELATING CONSECUTIVE cardiac periods (R-R intervals) and systolic blood pressures (SBP) during acute changes in arterial BP has become a widely accepted method of quantifying cardiovagal baroreflex sensitivity (BRS) in humans (2, 3, 33). Depressed cardiovagal responsiveness has been linked to impaired BP regulation with aging (32) and an increased incidence of sudden cardiac death in patients with coronary artery disease (19,20). Thus the identification of mechanisms underlying depressed cardiovagal BRS has important clinical implications.Many cardiovascular disease states are associated with baroreflex impairment (4, 10), with oxidative stress playing a possible mechanistic role (22,27,28). Aging, which is a primary risk factor for cardiovascular disease development (21), is associated with a reduction in cardiovagal BRS (9, 13, 25) and increased levels of oxidative stress (15,17,18,40). However, it is unknown whether these events are mechanistically linked. Increased levels of oxidative stress with age could impair baroreflex function through a direct suppressive influence on baroreceptors (22). In addition, because nitric oxide appears to be an important modulator of baroreflex function...

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Section: Discussionsupporting

confidence: 49%

mentioning

confidence: 99%

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Ascorbic acid increases cardiovagal baroreflex sensitivity in healthy older men

Monahan

Eskurza²,

Seals³

2004

American Journal of Physiology-Heart and Circulatory Physiology

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“…However, we also showed that ascorbic acid could significantly attenuate the increase in blood pressure during hyperglycemia. Because ascorbic acid does not have hypotensive properties in healthy, disease-free individuals (7,32,34,51,52), it is therefore evident that ascorbic acid is not masking hyperglycemia-induced hemodynamic changes but is instead preventing the changes.…”

Section: Discussionmentioning

confidence: 99%

Protective effects of ascorbic acid on arterial hemodynamics during acute hyperglycemia

Mullan¹,

Ennis²,

Fee³

et al. 2004

American Journal of Physiology-Heart and Circulatory Physiology

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Mortality increases when acute coronary syndromes are complicated by stress-induced hyperglycemia. Early pulse wave reflection can augment central aortic systolic blood pressure and increase left ventricular strain. Altered pulse wave reflection may contribute to the increase in cardiac risk during acute hyperglycemia. Chronic ascorbic acid (AA) supplementation has recently been shown to reduce pulse wave reflection in diabetes. We investigated the in vivo effects of acute hyperglycemia, with and without AA pretreatment, on pulse wave reflection and arterial hemodynamics. Healthy male volunteers were studied. Peripheral blood pressure (BP) was measured at the brachial artery, and the SphygmoCor pulse wave analysis system was used to derive central BP, the aortic augmentation index (AIx; measure of systemic arterial stiffness), and the time to pulse wave refection ( Tr; measure of aortic distensibility) from noninvasively obtained radial artery pulse pressure (PP) waveforms. Hemodynamics were recorded at baseline and then every 30 min during a 120-min systemic hyperglycemic clamp (14 mmol/l). The subjects, studied on two separate occasions, were randomized in a double-blind, crossover manner to placebo or 2 g intravenous AA before the initiation of hyperglycemia. During hyperglycemia, AIx increased and Tr decreased. Hyperglycemia did not change peripheral PP but did magnify central aortic PP and diminished the normal physiological amplification of PP from the aorta to the periphery. Pulse wave reflection, as assessed from peripheral pulse wave analysis, is enhanced during acute hyperglycemia. Pretreatment with AA prevented the hyperglycemia-induced hemodynamic changes. By protecting hemodynamics during acute hyperglycemia, AA may have therapeutic use.

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“…we can conclude from our findings that oxidative stress has probably caused changes in blood flow and forearm vascular conductance in obese children, since the muscle vasodilator response was restored after supplementation with vitamin C 23,24 .…”

Section: Post-interventionmentioning

confidence: 51%