European Journal of Nutrition

, Volume 56, Issue 1, pp 89–97 | Cite as

A Mediterranean diet supplemented with extra virgin olive oil or nuts improves endothelial markers involved in blood pressure control in hypertensive women

  • C. E. Storniolo
  • R. Casillas
  • M. Bulló
  • O. Castañer
  • E. Ros
  • G. T. Sáez
  • E. Toledo
  • R. Estruch
  • V. Ruiz-Gutiérrez
  • M. Fitó
  • M. A. Martínez-González
  • J. Salas-Salvadó
  • M. T. Mitjavila
  • J. J. MorenoEmail author
Original Contribution



Serum nitric oxide (NO) reduction and increased endothelin-1 (ET-1) play a pivotal role in endothelial dysfunction and hypertension. Considering that traditional Mediterranean diet (TMD) reduces blood pressure (BP), the aim of this study was to analyze whether TMD induced changes on endothelial physiology elements such as NO, ET-1 and ET-1 receptors which are involved in BP control.


Non-smoking women with moderate hypertension were submitted for 1 year to interventions promoting adherence to the TMD, one supplemented with extra virgin olive oil (EVOO) and the other with nuts versus a control low-fat diet (30 participants/group). BP, NO, ET-1 and related gene expression as well as oxidative stress biomarkers were measured.


Serum NO and systolic BP (SBP) or diastolic BP (DBP) were negatively associated at baseline, as well as between NO and ET-1. Our findings also showed a DBP reduction with both interventions. A negative correlation was observed between changes in NO metabolites concentration and SBP or DBP after the intervention with TMD + EVOO (p = 0.033 and p = 0.044, respectively). SBP reduction was related to an impairment of serum ET-1 concentrations after the intervention with TMD + nuts (p = 0.008). We also observed changes in eNOS, caveolin 2 and ET-1 receptors gene expression which are related to NO metabolites levels and BP.


The changes in NO and ET-1 as well as ET-1 receptors gene expression explain, at least partially, the effect of EVOO or nuts on lowering BP among hypertensive women.


Endothelin-1 Hypertension Nitric oxide PREDIMED study Oxidative stress 



The authors thank the participants in the PREDIMED study for their continued collaboration. The Fundación Patrimonio Comunal Olivarero, Hojiblanca SA (Málaga, Spain), California Walnut Commission (Sacramento, CA, USA), Borges SA (Reus, Spain) and Morella Nuts SA (Reus, Spain) donated the olive oil, walnuts, almonds and hazelnuts, respectively. We also thank the Scientific and Technical services of the University of Barcelona for malondialdehyde determinations. This study was supported by the Spanish Ministry of Health (FIS PI10/0082, G03/140, RD06/0045), Fondo Europeo de Desarrollo Regional, the Spanish Ministry of Science (BFU2007-61727/BFI) and the Generalitat de Catalunya (2009SGR00438).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • C. E. Storniolo
    • 1
  • R. Casillas
    • 1
  • M. Bulló
    • 2
    • 9
  • O. Castañer
    • 3
    • 9
  • E. Ros
    • 4
    • 9
  • G. T. Sáez
    • 5
    • 9
  • E. Toledo
    • 6
    • 9
  • R. Estruch
    • 7
    • 9
  • V. Ruiz-Gutiérrez
    • 8
    • 9
  • M. Fitó
    • 3
    • 9
  • M. A. Martínez-González
    • 6
    • 9
  • J. Salas-Salvadó
    • 2
    • 9
  • M. T. Mitjavila
    • 1
  • J. J. Moreno
    • 1
    Email author
  1. 1.Department of PhysiologyUniversity of BarcelonaBarcelonaSpain
  2. 2.Human Nutrition Unit, HSPVRovira i Virgili UniversityReusSpain
  3. 3.Cardiovascular Risk and Nutrition Research GroupIMIM-Institut de Recerca Hospital del MarBarcelonaSpain
  4. 4.Endocrinology and Nutrition ServiceHospital ClinicBarcelonaSpain
  5. 5.Department of Biochemistry and Molecular Biology, Clinical Analysis Service-CDB HGUVUniversity of ValenciaValenciaSpain
  6. 6.Department of Preventive Medicine and Public HealthUniversity of NavarraPamplonaSpain
  7. 7.Department of Internal MedicineUniversity of BarcelonaBarcelonaSpain
  8. 8.Instituto de la GrasaConsejo Superior de Investigaciones CientíficasSevilleSpain
  9. 9.Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y NutriciónInstituto de Salud Carlos IIIMadridSpain

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