Effect of Beetroot Juice on Coronary Blood Flow and Walking Performance in PAD

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-12-31

Study Completion Date

2024-12-31

Brief Summary

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In this study the investigators will test the hypothesis that short-term consumption of inorganic nitrate (supplied in concentrated beetroot juice) enhances coronary blood flow responses, large artery hemodynamics, and leg oxygenation/exercise tolerance in patients with peripheral arterial disease (PAD). Understanding and improving blood flow regulation in the heart and skeletal muscles of patients with PAD is important because exercise triggers symptoms of leg pain and substantially raises blood pressure and myocardial demand in these patients.

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Detailed Description

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Peripheral arterial disease (PAD) is a strong predictor of cardiovascular mortality and negatively affects functional capacity and quality of life for as many as 14 million patients in the U.S. alone. One open-label study showed that acute consumption of beetroot juice improved 6 min walk performance, reduced blood pressure, and enhanced leg muscle oxygenation in PAD patients. However, no studies have rigorously confirmed these findings in a double-blind manner, nor have the effects of this supplement been investigated (acutely or short-term) in the coronary circulation of PAD patients.

In addition to studying its effects on graded treadmill walking performance and consequent large artery vasodilation, the present study will examine the effects of short-term beetroot juice consumption (twice/day) on both coronary and leg vasodilator (graded calf flexion) and vasoconstrictor (isometric handgrip, voluntary apnea) responses in patients with PAD. Participants will randomly consume either nitrate-rich or nitrate-depleted beetroot juice with a 7 to 14 day wash-out period between. Effects of beetroot juice consumption on plasma nitrate, nitrite and methemoglobin will also be assessed.

Conditions

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Peripheral Arterial Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Beetroot juice (Beet-It Organic Shot)

Subjects will consume 70 ml of beetroot juice (Beet-It Organic Shot) twice per day (morning, afternoon) for 5 to 7 days to assess the short term effects of this nitrate supplement on graded treadmill walking responses (day 4) and vasodilator/vasoconstrictor responses in the coronary and lower leg circulations (day 5 or 6 or 7). On both study visits, subjects will consume their morning dose 1 hour 45 min before experiments begin.

Group Type ACTIVE_COMPARATOR

Beetroot juice

Intervention Type DRUG

This beverage contains 0.3 g of inorganic nitrate per 70 ml container, and is bottled and supplied by James White Drinks (UK).

Beetroot juice placebo (Beet-It Organic Placebo)

Subjects will consume 70 ml of beetroot juice placebo (Beet-It Organic Placebo) twice per day (morning, afternoon) for 5 to 7 days to assess the short term effects of this nitrate supplement on graded treadmill walking responses (day 4) and vasodilator/vasoconstrictor responses in the coronary and lower leg circulations (day 5 or 6 or 7). On both study visits, subjects will consume their morning dose 1 hour 45 min before experiments begin.

Group Type PLACEBO_COMPARATOR

Beetroot juice placebo

Intervention Type DRUG

This beverage is identical in look and taste to the Beet-It organic shot, but has the nitrate removed. It is also bottled and supplied by James White Drinks (UK).

Interventions

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Beetroot juice

This beverage contains 0.3 g of inorganic nitrate per 70 ml container, and is bottled and supplied by James White Drinks (UK).

Intervention Type DRUG

Beetroot juice placebo

This beverage is identical in look and taste to the Beet-It organic shot, but has the nitrate removed. It is also bottled and supplied by James White Drinks (UK).

Intervention Type DRUG

Other Intervention Names

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Beet-It Organic Shot Beet-It organic placebo

Eligibility Criteria

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Inclusion Criteria

1. Patients with peripheral arterial disease (PAD)
2. Capable of giving informed consent
3. Men and women age 21- 85 years
4. Diagnosed with PAD (i.e., ankle-brachial index below 0.9)
5. Fontaine stage II or less - no pain while resting
6. Satisfactory history and physical exam

Exclusion Criteria

1. Children
2. Pregnant or nursing women
3. Patients taking nitroglycerine or nitrate preparations
4. Patients taking phosphodiesterase inhibitors such as sildenafil or tadalafil
5. Patients taking proton pump inhibitors
6. Ejection fraction \< 40%
7. Uncontrolled hypertension
8. Uncontrolled diabetes
9. Myocardial infarction within past 6 months or unstable angina
10. Severe lung disease (i.e., on supplemental oxygen or frequently use rescue inhalers)
11. Abnormality in hemoglobin or hematocrit or methemoglobin
12. Impaired renal function
13. Impaired liver function
14. History or diagnosis of Barrett's esophagus
15. Known allergy to beetroot juice or lemon juice
16. Inability to walk on a treadmill at a moderate pace (2.0 miles/hour)

Minimum Eligible Age

21 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No