The BEET-BP Trial - Investigating the Effect of Dietary Nitrates on Hypertension in Pregnancy

NCT ID: NCT04604535

Last Updated: 2020-10-30

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

320 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-10-22

Study Completion Date

2022-12-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This is a randomised placebo controlled trial investigating the effects of dietary nitrate supplementation on hypertension in pregnancy

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Reduced nitrate and nitrite concentrations have been found in women with preeclampsia (PE) and studies have shown increased concentrations of an endogenously generated Nitric Oxide Synthase inhibitor, amongst women with PE.

Nitrate and nitrite are required to produce Nitric Oxide (NO). NO is released from the endothelial lining of blood vessels, and acts to relax smooth muscle within the vasculature, acting as a potent vasodilator. Reduced NO concentrations are hence thought to contribute towards the systemic vascular constriction seen in PE.

Hypertensive diseases in pregnancy are an important cause of morbidity and mortality in both maternal, fetal and neonatal health. Treatment options are limited in pregnancy and hence alternative methods to improve blood pressure control should be sought.

In this randomised placebo controlled double blinded trial we aim to assess the effect of dietary nitrate supplementation on the hypertensive diseases of pregnancy and the subsequent maternal, fetal-neonatal outcomes. The safety and acceptability of dietary nitrate supplementation will also be confirmed in this study.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Hypertension in Pregnancy Pre-Eclampsia Gestational Hypertension Pregnancy Induced Hypertension

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Concentrated beetroot juice

70mL of concentrated beetroot juice with 400mg nitrate

Group Type ACTIVE_COMPARATOR

Concentrated beetroot juice

Intervention Type DIETARY_SUPPLEMENT

70mL concentrated beetroot juice (400mg nitrate)

Placebo

70mL of concentrated beetroot juice with \<0.01mmol/L nitrate

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DIETARY_SUPPLEMENT

70mL concentrated nitrate deplete beetroot juice (\<0.01mmol/L nitrate)

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Concentrated beetroot juice

70mL concentrated beetroot juice (400mg nitrate)

Intervention Type DIETARY_SUPPLEMENT

Placebo

70mL concentrated nitrate deplete beetroot juice (\<0.01mmol/L nitrate)

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Aged ≥18
* Able to give written informed consent
* Singleton pregnancies, between 24+0 to 36+6 weeks gestation with new onset gestational hypertension (defined by ISSHP2018 as new onset BP \>140/90 and no evidence of proteinuria, biochemical or haematological abnormalities or fetal growth restriction) Or
* Singleton pregnancies, between 24+0 - 36+6 weeks gestation, with chronic hypertension (defined by ISSHP2018 as BP ≥140/90 predating the pregnancy or recognised at \<20 week's gestation) Or
* Singleton pregnancies, between 24+0 - 36+6 weeks gestation, with preeclampsia (defined by ISSHP2018 as Gestational hypertension accompanied by ≥ 1 of the following new onset conditions at or after 20 weeks' gestation:
* Proteinuria (24h urine collection\>300mg/day, Protein-creatinine ratio\>30 mg/mmol)
* Other markers of maternal organ dysfunction, including:
* Acute Kidney Injury (AKI) (creatinine ≥90μmol/L; 1mg/dL)
* Liver involvement (elevated transaminases e.g. alanine transaminase (ALT) or aspartate aminotransferase (AST) \>40IU/L) with or without right upper quadrant or epigastric abdominal pain
* Neurological complications e.g. eclampsia, altered mental status, blindness, stroke, clonus, severe headaches and persistent visual scotomata
* Haematological complications (thrombocytopenia - platelet count \<150 000/μL, disseminated intravascular coagulation, haemolysis
* Uteroplacental dysfunction (fetal growth restriction, abnormal umbilical artery doppler wave form analysis, or stillbirth)

Exclusion Criteria

* Unable to tolerate taste of beetroot juice concentrate during taste test
* Multiple pregnancy
* History of acute or chronic liver conditions (aside from preeclampsia)
* Fetal aneuploidies or major fetal anomalies
* Unwillingness to comply with all study-related procedures e.g. Women who have used mouthwash or tongue scraping in last 7 days and are not able/unwilling unable to stop this for the duration of the study
* Women on treatment for gingivitis
* Women with persistent hyperemesis or ptyalism
* On Proton-pump-inhibitors/antacids other treatment for gastritis/peptic ulcer/gastric ulcers
* Those with long term antibiotic use e.g. prophylaxis of urinary tract infections (UTIs) or those who are likely to need repeated courses of antibiotics e.g. history of recurrent UTI
* Women with known allergy/intolerance to beetroot or lemon
* Type 1 and Type 2 diabetics
* Moderate iron deficiency anaemia with haemoglobin \<100g/dL and/or ferritin \<15μg/L
* Any blood disorder or significant illness that may affect platelet function and coagulation. However, patients taking low-dose aspirin (150mg) for preeclampsia prophylaxis who are at increased risk of developing preeclampsia will be included in the study.
* History of alcohol or recreational drug abuse use within the past 6 months
* Systemic autoimmune disease e.g. Rheumatoid Arthritis, antiphospholipid syndrome connective tissue disease e.g. Systemic Lupus Erythematous or other conditions known to be associated with chronic inflammation such as inflammatory bowel disease - Chron's disease/Ulcerative Colitis
* Women not intending to deliver at the recruiting site
* Participating in another intervention study that influences the outcomes of this study
* Those with serious mental illness or learning difficulties and unable to give written informed consent
* Those who are detained as a prisoner or detained in any secured unit, including those held under the Mental Health Act
* Those not fluent in local language, and absence of appropriate interpreter despite use of services such as Language Line
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Fetal Medicine Foundation

OTHER

Sponsor Role collaborator

Barts and the London School of Medicine and Dentistry

OTHER

Sponsor Role collaborator

King's College Hospital NHS Trust

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Nick Kametas

Role: STUDY_CHAIR

Fetal Medicine Research Institute, King's College Hospital London

Kypros Nicolaides

Role: STUDY_CHAIR

Fetal Medicine Research Institute, King's College Hospital London

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

King's College Hospital

London, , United Kingdom

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

United Kingdom

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Katherine Lau

Role: CONTACT

Phone: 07738247830

Email: [email protected]

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Katherine Lau, MBBS/BSc

Role: primary

Nick Kametas

Role: backup

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

263871

Identifier Type: -

Identifier Source: org_study_id