Abstract
Diet plays a crucial role in maintaining healthy blood pressure. Functional foods are increasingly popular among health-conscious consumers to reduce cardiovascular risk factors and improve vascular health. In particular, dietary polyphenols represent an extraordinary inventory of structurally different compounds that may represent promising candidate chemical entities to prevent or delay the onset of hypertension. In recent years, it has been recognized that prehypertension may be a predictor of clinical hypertension and consequently of cardiovascular risk. Moreover, prehypertension status is associated with increased levels of several inflammatory markers and it is also characterized by structural changes, including endothelial dysfunction and arteriolar hypertrophy. Despite the low bioavailability of polyphenols and the lack of clinical data from nutritional intervention studies, the antihypertensive role of polyphenols to control blood pressure and reduce inflammation and endothelial dysfunction has been subject of recent debate. The purpose of this article is to discuss the potential benefits of dietary polyphenols as a promising and effective nutritional strategy for the management of prehypertension.
Similar content being viewed by others
References
Rothwell PM. Does blood pressure variability modulate cardiovascular risk? Curr Hypertens Rep. 2011;13:177–86.
Webb AJ, Fischer U, Mehta Z, Rothwell PM. Effects of antihypertensive-drug class on interindividual variation in blood pressure and risk of stroke: a systematic review and meta-analysis. Lancet. 2010;375:906–15.
Muntner P, Shimbo D, Tonelli M, Reynolds K, Arnett DK, Oparil S. The relationship between visit-to-visit variability in systolic blood pressure and all-cause mortality in the general population: findings from NHANES III, 1988 to 1994. Hypertension. 2011;57:160–6.
Parati G, Ochoa JE, Bilo G. Blood pressure variability, cardiovascular risk, and risk for renal disease progression. Curr Hypertens Rep. 2012;14:421–31.
Parati G, Ochoa JE, Lombardi C, Bilo G. Assessment and management of blood-pressure variability. Nat Rev Cardiol. 2013;10:143–55.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ, Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42:1206–52.
Vasan RS, Larson MG, Leip EP, Kannel WB, Levy D. Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham heart study: a cohort study. Lancet. 2001;358:1682–6.
Greenlund KJ, Croft JB, Mensah GA. Prevalence of heart disease and stroke risk factors in persons with prehypertension in the United States, 1999–2000. Arch Intern Med. 2004;164:2113–8.
Qureshi AI, Suri MF, Kirmani JF, Divani AA, Mohammad Y. Is prehypertension a risk factor for cardiovascular diseases? Stroke. 2005;36:1859–63.
Liszka HA, Mainous AG 3rd, King DE, Everett CJ, Egan BM. Prehypertension and cardiovascular morbidity. Ann Fam Med. 2005;3:294–9.
Fernandez C, Sander GE, Giles TD. Prehypertension: defining the transitional phenotype. Curr Hypertens Rep. 2016;18:2.
Davis JT, Rao F, Naqshbandi D, Fung MM, Zhang K, Schork AJ, Nievergelt CM, Ziegler MG, O’Connor DT. Autonomic and hemodynamic origins of pre-hypertension: central role of heredity. J Am Coll Cardiol. 2012;59:2206–16.
Nandeesha H, Bobby Z, Selvaraj N, Rajappa M. Pre-hypertension: is it an inflammatory state? Clin Chim Acta. 2015;451:338–42.
Pitsavos C, Chrysohoou C, Panagiotakos DB, Lentzas Y, Stefanadis C. Abdominal obesity and inflammation predicts hypertension among prehypertensive men and women: the ATTICA Study. Heart Vessels. 2008;23:96–103.
Wang G, Wang A, Tong W, Liu Y, Zhang Y. Association of elevated inflammatory and endothelial biomarkers with prehypertension among Mongolians in China. Hypertens Res. 2011;34:516–20.
Van Guilder GP. It is time to contend with the endothelial consequences of prehypertension. J Hum Hypertens. 2015;29:457–8.
Celik T, Yuksel UC, Fici F, Celik M, Yaman H, Kilic S, Iyisoy A, Dell’oro R, Grassi G, Yokusoglu M, Mancia G. Vascular inflammation and aortic stiffness relate to early left ventricular diastolic dysfunction in prehypertension. Blood Press. 2013;22:94–100.
Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM, American Heart Association. Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension. 2006;47:296–308.
Izzo R, de Simone G, Giudice R, Chinali M, Trimarco V, De Luca N, Trimarco B. Effects of nutraceuticals on prevalence of metabolic syndrome and on calculated Framingham Risk Score in individuals with dyslipidemia. J Hypertens. 2010;28:1482–7.
Trimarco V, Izzo R, Stabile E, Rozza F, Santoro M, Manzi MV, Serino F, Schiattarella GG, Esposito G, Trimarco B. Effects of a new combination of nutraceuticals with Morus alba on lipid profile, insulin sensitivity and endotelial function in dyslipidemic subjects. A cross-over, randomized, double-blind trial. High Blood Press Cardiovasc Prev. 2015;22:149–54.
Rozza F, de Simone G, Izzo R, De Luca N, Trimarco B. Nutraceuticals for treatment of high blood pressure values in patients with metabolic syndrome. High Blood Press Cardiovasc Prev. 2009;16:177–82.
Li B, Li F, Wang L, Zhang D. Fruit and vegetables consumption and risk of hypertension: a meta-analysis. J Clin Hypertens (Greenwich). 2016. doi:10.1111/jch.12777.
Davinelli S, Sapere N, Visentin M, Zella D, Scapagnini G. Enhancement of mitochondrial biogenesis with polyphenols: combined effects of resveratrol and equol in human endothelial cells. Immun Ageing. 2013;10:28.
Huang WY, Davidge ST, Wu J. Bioactive natural constituents from food sources-potential use in hypertension prevention and treatment. Crit Rev Food Sci Nutr. 2013;53:615–30.
Habauzit V, Morand C. Evidence for a protective effect of polyphenols-containing foods on cardiovascular health: an update for clinicians. Ther Adv Chronic Dis. 2012;3:87–106.
Huang Y, Wang S, Cai X, Mai W, Hu Y, Tang H, Xu D. Prehypertension and incidence of cardiovascular disease: a meta-analysis. BMC Med. 2013;11:177.
Julius S, Nesbitt SD, Egan BM, Weber MA, Michelson EL, Kaciroti N, Black HR, Grimm RH Jr, Messerli FH, Oparil S, Schork MA, Trial of Preventing Hypertension (TROPHY) Study Investigators. Feasibility of treating prehypertension with an angiotensin-receptor blocker. N Engl J Med. 2006;354:1685–97.
Siti HN, Kamisah Y, Kamsiah J. The role of oxidative stress, antioxidants and vascular inflammation in cardiovascular disease (a review). Vascul Pharmacol. 2015;71:40–56.
Scoditti E, Calabriso N, Massaro M, Pellegrino M, Storelli C, Martines G, De Caterina R, Carluccio MA. Mediterranean diet polyphenols reduce inflammatory angiogenesis through MMP-9 and COX-2 inhibition in human vascular endothelial cells: a potentially protective mechanism in atherosclerotic vascular disease and cancer. Arch Biochem Biophys. 2012;527:81–9.
Mukai Y, Sato S. Polyphenol-containing azuki bean (Vigna angularis) seed coats attenuate vascular oxidative stress and inflammation in spontaneously hypertensive rats. J Nutr Biochem. 2011;22:16–21.
Loke WM, Proudfoot JM, Hodgson JM, McKinley AJ, Hime N, Magat M, Stocker R, Croft KD. Specific dietary polyphenols attenuate atherosclerosis in apolipoprotein E-knockout mice by alleviating inflammation and endothelial dysfunction. Arterioscler Thromb Vasc Biol. 2010;30:749–57.
Jimenez R, Lopez-Sepulveda R, Romero M, Toral M, Cogolludo A, Perez-Vizcaino F, Duarte J. Quercetin and its metabolites inhibit the membrane NADPH oxidase activity in vascular smooth muscle cells from normotensive and spontaneously hypertensive rats. Food Funct. 2015;6:409–14.
Ruijters EJ, Weseler AR, Kicken C, Haenen GR, Bast A. The flavanol (−)-epicatechin and its metabolites protect against oxidative stress in primary endothelial cells via a direct antioxidant effect. Eur J Pharmacol. 2013;715:147–53.
Cruz MN, Agewall S, Schenck-Gustafsson K, Kublickiene K. Acute dilatation to phytoestrogens and estrogen receptor subtypes expression in small arteries from women with coronary heart disease. Atherosclerosis. 2008;196:49–58.
Natsume M, Baba S. Suppressive effects of cacao polyphenols on the development of atherosclerosis in apolipoprotein E-deficient mice. Subcell Biochem. 2014;77:189–98.
da Costa CA, de Oliveira PR, de Bem GF, de Cavalho LC, Ognibene DT, da Silva AF, Dos Santos Valença S, Pires KM, da Cunha Sousa PJ, de Moura RS, Resende AC. Euterpe oleracea Mart.-derived polyphenols prevent endothelial dysfunction and vascular structural changes in renovascular hypertensive rats: role of oxidative stress. Naunyn Schmiedebergs Arch Pharmacol. 2012;385:1199–209.
Martin S, Andriambeloson E, Takeda K, Andriantsitohaina R. Red wine polyphenols increase calcium in bovine aortic endothelial cells: a basis to elucidate signalling pathways leading to nitric oxide production. Br J Pharmacol. 2002;135:1579–87.
Ma X, He D, Ru X, Chen Y, Cai Y, Bruce IC, Xia Q, Yao X, Jin J. Apigenin, a plant-derived flavone, activates transient receptor potential vanilloid 4 cation channel. Br J Pharmacol. 2012;166:349–58.
Ndiaye M, Chataigneau M, Lobysheva I, Chataigneau T, Schini-Kerth VB. Red wine polyphenol-induced, endothelium-dependent NO-mediated relaxation is due to the redox-sensitive PI3-kinase/Akt-dependent phosphorylation of endothelial NO-synthase in the isolated porcine coronary artery. FASEB J. 2005;19:455–7.
Anter E, Thomas SR, Schulz E, Shapira OM, Vita JA, Keaney JF Jr. Activation of endothelial nitric-oxide synthase by the p38 MAPK in response to black tea polyphenols. J Biol Chem. 2004;279:46637–43.
Ndiaye M, Chataigneau T, Andriantsitohaina R, Stoclet JC, Schini-Kerth VB. Red wine polyphenols cause endothelium-dependent EDHF-mediated relaxations in porcine coronary arteries via a redox-sensitive mechanism. Biochem Biophys Res Commun. 2003;310:371–7.
Nishida S, Satoh H. Role of gap junction involved with endothelium-derived hyperpolarizing factor for the quercetin-induced vasodilatation in rat mesenteric artery. Life Sci. 2013;92:752–6.
Xu YC, Leung SW, Leung GP, Man RY. Kaempferol enhances endothelium-dependent relaxation in the porcine coronary artery through activation of large-conductance Ca(2+)-activated K(+) channels. Br J Pharmacol. 2015;172:3003–14.
Stoclet JC, Chataigneau T, Ndiaye M, Oak MH, El Bedoui J, Chataigneau M, Schini-Kerth VB. Vascular protection by dietary polyphenols. Eur J Pharmacol. 2004;500:299–313.
Park E, Edirisinghe I, Choy YY, Waterhouse A, Burton-Freeman B. Effects of grape seed extract beverage on blood pressure and metabolic indices in individuals with pre-hypertension: a randomised, double-blinded, two-arm, parallel, placebo-controlled trial. Br J Nutr. 2016;115:226–38.
Vaisman N, Niv E. Daily consumption of red grape cell powder in a dietary dose improves cardiovascular parameters: a double blind, placebo-controlled, randomized study. Int J Food Sci Nutr. 2015;66(3):342–9.
Hassellund SS, Flaa A, Kjeldsen SE, Seljeflot I, Karlsen A, Erlund I, Rostrup M. Effects of anthocyanins on cardiovascular risk factors and inflammation in pre-hypertensive men: a double-blind randomized placebo-controlled crossover study. J Hum Hypertens. 2013;27:100–6.
Taubert D, Roesen R, Lehmann C, Jung N, Schömig E. Effects of low habitual cocoa intake on blood pressure and bioactive nitric oxide: a randomized controlled trial. JAMA. 2007;298:49–60.
Moreno-Luna R, Muñoz-Hernandez R, Miranda ML, Costa AF, Jimenez-Jimenez L, Vallejo-Vaz AJ, Muriana FJ, Villar J, Stiefel P. Olive oil polyphenols decrease blood pressure and improve endothelial function in young women with mild hypertension. Am J Hypertens. 2012;25:1299–304.
McKay DL, Chen CY, Saltzman E, Blumberg JB. Hibiscus sabdariffa L. tea (tisane) lowers blood pressure in prehypertensive and mildly hypertensive adults. J Nutr. 2010;140:298–303.
Botden IP, Draijer R, Westerhof BE, Rutten JH, Langendonk JG, Sijbrands EJ, Danser AH, Zock PL, van den Meiracker AH. Red wine polyphenols do not lower peripheral or central blood pressure in high normal blood pressure and hypertension. Am J Hypertens. 2012;25:718–23.
Ras RT, Zock PL, Zebregs YE, Johnston NR, Webb DJ, Draijer R. Effect of polyphenol-rich grape seed extract on ambulatory blood pressure in subjects with pre- and stage I hypertension. Br J Nutr. 2013;110:2234–41.
Ried K, Frank OR, Stocks NP. Dark chocolate or tomato extract for prehypertension: a randomised controlled trial. BMC Complement Altern Med. 2009;8(9):22.
Accardi G, Aiello A, Gambino CM, Virruso C, Caruso C, Candore G. Mediterranean nutraceutical foods: strategy to improve vascular ageing. Mech Ageing Dev. 2016;S0047–6374(16):30011–2.
Siow RC, Mann GE. Dietary isoflavones and vascular protection: activation of cellular antioxidant defenses by SERMs or hormesis? Mol Asp Med. 2010;31(6):468–77.
Scapagnini G, Davinelli S, Kaneko T, Koverech G, Koverech A, Calabrese EJ, Calabrese V. Dose response biology of resveratrol in obesity. J Cell Commun Signal. 2014;8:385–91.
Vasto S, Buscemi S, Barera A, Di Carlo M, Accardi G, Caruso C. Mediterranean diet and healthy ageing: a Sicilian perspective. Gerontology. 2014;60:508–18.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None.
Research involving human participants and/or animals
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent
For this type of study formal consent is not required.
Rights and permissions
About this article
Cite this article
Davinelli, S., Scapagnini, G. Polyphenols: a Promising Nutritional Approach to Prevent or Reduce the Progression of Prehypertension. High Blood Press Cardiovasc Prev 23, 197–202 (2016). https://doi.org/10.1007/s40292-016-0149-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40292-016-0149-0