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Published in: Trials 1/2020

Open Access 01-12-2020 | Hypertension | Study protocol

Effect of barberry (Berberis vulgaris) consumption on blood pressure, plasma lipids, and inflammation in patients with hypertension and other cardiovascular risk factors: study protocol for a randomized clinical trial

Authors: Hadi Emamat, Ali Zahedmehr, Sanaz Asadian, Hadith Tangestani, Javad Nasrollahzadeh

Published in: Trials | Issue 1/2020

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Abstract

Background

Cardiovascular diseases (CVDs) remain the leading causes of morbidity and mortality in the world. Hypertension is an important and prevalent cardiovascular risk factor. The present study will be conducted to investigate the effect of barberry as a cardio-protective fruit on the blood pressure in patients with hypertension and other CVD risk factors. Furthermore, plasma concentrations of lipids and inflammatory biomarkers will be evaluated.

Methods/design

This is an 8-week, prospective, single-blinded, parallel assigned, randomized controlled clinical trial (RCT) in which eligible men and women with hypertension and other cardiovascular risk factors will be randomized to either placebo powder (PP; containing 9 g maltodextrin, 1 g citric acid, 1 g milled sucrose and edible red color (n = 37)) or barberry powder (BP; containing 10 g milled dried barberry and 1 g of milled sucrose (n = 37)) groups. At baseline and after 8 weeks of intervention, plasma lipids and inflammatory markers, 24-h urinary nitrite/nitrate and sodium excretion, and 24-h ambulatory blood pressure monitoring (ABPM) will be measured. Anthropometric measures and dietary assessment will be performed as well. Data analysis will be done using SPSS version-21 software.

Discussion

The interest in natural and functional food products has increased globally. This RCT will add to the growing literature for the potential antihypertensive, lipid-lowering, and anti-inflammatory effects of barberry in humans.

Trial registration

ClinicalTrials.gov (NCT number) NCT04084847. Registered on 10 December 2019.
Appendix
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Literature
1.
go back to reference Tarride JE, Lim M, DesMeules M, Luo W, Burke N, O'Reilly D, Bowen J, Goeree R. A review of the cost of cardiovascular disease. Can J Cardiol. 2009;25:e195–202.CrossRef Tarride JE, Lim M, DesMeules M, Luo W, Burke N, O'Reilly D, Bowen J, Goeree R. A review of the cost of cardiovascular disease. Can J Cardiol. 2009;25:e195–202.CrossRef
2.
go back to reference Ahmadi A, Soori H, Mehrabi Y, Etemad K, Khaledifar A. Epidemiological pattern of myocardial infarction and modelling risk factors relevant to in-hospital mortality: the first results from the Iranian Myocardial Infarction Registry. Kardiol Pol. 2015;73:451–7.CrossRef Ahmadi A, Soori H, Mehrabi Y, Etemad K, Khaledifar A. Epidemiological pattern of myocardial infarction and modelling risk factors relevant to in-hospital mortality: the first results from the Iranian Myocardial Infarction Registry. Kardiol Pol. 2015;73:451–7.CrossRef
3.
go back to reference Sadeghi M, Haghdoost AA, Bahrampour A, Dehghani M. Modeling the burden of cardiovascular diseases in Iran from 2005 to 2025: the impact of demographic changes. Iran J Public Health. 2017;46:506–16.PubMedPubMedCentral Sadeghi M, Haghdoost AA, Bahrampour A, Dehghani M. Modeling the burden of cardiovascular diseases in Iran from 2005 to 2025: the impact of demographic changes. Iran J Public Health. 2017;46:506–16.PubMedPubMedCentral
4.
go back to reference Carretero OA, Oparil S. Essential hypertension. Part I: definition and etiology. Circulation. 2000;101:329–35.CrossRef Carretero OA, Oparil S. Essential hypertension. Part I: definition and etiology. Circulation. 2000;101:329–35.CrossRef
5.
go back to reference World Health Organization. World health statistics 2012: WHO; 2012. p. 176.. World Health Organization. World health statistics 2012: WHO; 2012. p. 176..
6.
go back to reference Hermann M, Flammer A, Lüscher TF. Nitric oxide in hypertension. J Clin Hypertension. 2006;8:17–29.CrossRef Hermann M, Flammer A, Lüscher TF. Nitric oxide in hypertension. J Clin Hypertension. 2006;8:17–29.CrossRef
7.
go back to reference O'Donnell CJ, Elosua R. Cardiovascular risk factors. Insights from Framingham Heart Study. Rev Esp Cardiol. 2008;61:299–310.CrossRef O'Donnell CJ, Elosua R. Cardiovascular risk factors. Insights from Framingham Heart Study. Rev Esp Cardiol. 2008;61:299–310.CrossRef
8.
go back to reference Zakynthinos E, Pappa N. Inflammatory biomarkers in coronary artery disease. J Cardiol. 2009;53:317–33.CrossRef Zakynthinos E, Pappa N. Inflammatory biomarkers in coronary artery disease. J Cardiol. 2009;53:317–33.CrossRef
9.
go back to reference Zhan J, Liu YJ, Cai LB, Xu FR, Xie T, He QQ. Fruit and vegetable consumption and risk of cardiovascular disease: a meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr. 2017;57:1650–63.CrossRef Zhan J, Liu YJ, Cai LB, Xu FR, Xie T, He QQ. Fruit and vegetable consumption and risk of cardiovascular disease: a meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr. 2017;57:1650–63.CrossRef
10.
go back to reference Cassidy A, Bertoia M, Chiuve S, Flint A, Forman J, Rimm EB. Habitual intake of anthocyanins and flavanones and risk of cardiovascular disease in men. Am J Clin Nutr. 2016;104:587–94.CrossRef Cassidy A, Bertoia M, Chiuve S, Flint A, Forman J, Rimm EB. Habitual intake of anthocyanins and flavanones and risk of cardiovascular disease in men. Am J Clin Nutr. 2016;104:587–94.CrossRef
11.
go back to reference Cassidy A, Mukamal KJ, Liu L, Franz M, Eliassen AH, Rimm EB. High anthocyanin intake is associated with a reduced risk of myocardial infarction in young and middle-aged women. Circulation. 2013;127:188–96.CrossRef Cassidy A, Mukamal KJ, Liu L, Franz M, Eliassen AH, Rimm EB. High anthocyanin intake is associated with a reduced risk of myocardial infarction in young and middle-aged women. Circulation. 2013;127:188–96.CrossRef
12.
go back to reference Maatta-Riihinen KR, Kamal-Eldin A, Mattila PH, Gonzalez-Paramas AM, Torronen AR. Distribution and contents of phenolic compounds in eighteen Scandinavian berry species. J Agric Food Chem. 2004;52:4477–86.CrossRef Maatta-Riihinen KR, Kamal-Eldin A, Mattila PH, Gonzalez-Paramas AM, Torronen AR. Distribution and contents of phenolic compounds in eighteen Scandinavian berry species. J Agric Food Chem. 2004;52:4477–86.CrossRef
13.
go back to reference Reis JF, Monteiro VVS, de Souza Gomes R, do Carmo MM, da Costa GV, Ribera PC, Monteiro MC. Action mechanism and cardiovascular effect of anthocyanins: a systematic review of animal and human studies. J Transl Med. 2016;14:315.CrossRef Reis JF, Monteiro VVS, de Souza Gomes R, do Carmo MM, da Costa GV, Ribera PC, Monteiro MC. Action mechanism and cardiovascular effect of anthocyanins: a systematic review of animal and human studies. J Transl Med. 2016;14:315.CrossRef
14.
go back to reference Huang H, Chen G, Liao D, Zhu Y, Xue X. Effects of berries consumption on cardiovascular risk factors: a meta-analysis with trial sequential analysis of randomized controlled trials. Sci Rep. 2016;6:23625.CrossRef Huang H, Chen G, Liao D, Zhu Y, Xue X. Effects of berries consumption on cardiovascular risk factors: a meta-analysis with trial sequential analysis of randomized controlled trials. Sci Rep. 2016;6:23625.CrossRef
15.
go back to reference Tjelle TE, Holtung L, Bohn SK, Aaby K, Thoresen M, Wiik SA, Paur I, Karlsen AS, Retterstol K, Iversen PO, Blomhoff R. Polyphenol-rich juices reduce blood pressure measures in a randomised controlled trial in high normal and hypertensive volunteers. Br J Nutr. 2015;114:1054–63.CrossRef Tjelle TE, Holtung L, Bohn SK, Aaby K, Thoresen M, Wiik SA, Paur I, Karlsen AS, Retterstol K, Iversen PO, Blomhoff R. Polyphenol-rich juices reduce blood pressure measures in a randomised controlled trial in high normal and hypertensive volunteers. Br J Nutr. 2015;114:1054–63.CrossRef
16.
go back to reference Loo BM, Erlund I, Koli R, Puukka P, Hellstrom J, Wahala K, Mattila P, Jula A. Consumption of chokeberry (Aronia mitschurinii) products modestly lowered blood pressure and reduced low-grade inflammation in patients with mildly elevated blood pressure. Nutr Res. 2016;36:1222–30.CrossRef Loo BM, Erlund I, Koli R, Puukka P, Hellstrom J, Wahala K, Mattila P, Jula A. Consumption of chokeberry (Aronia mitschurinii) products modestly lowered blood pressure and reduced low-grade inflammation in patients with mildly elevated blood pressure. Nutr Res. 2016;36:1222–30.CrossRef
17.
go back to reference Erlund I, Koli R, Alfthan G, Marniemi J, Puukka P, Mustonen P, Mattila P, Jula A. Favorable effects of berry consumption on platelet function, blood pressure, and HDL cholesterol. Am J Clin Nutr. 2008;87:323–31.CrossRef Erlund I, Koli R, Alfthan G, Marniemi J, Puukka P, Mustonen P, Mattila P, Jula A. Favorable effects of berry consumption on platelet function, blood pressure, and HDL cholesterol. Am J Clin Nutr. 2008;87:323–31.CrossRef
18.
go back to reference Skoczynska A, Jedrychowska I, Poreba R, Affelska-Jercha A, Turczyn B, Wojakowska A, Andrzejak R. Influence of chokeberry juice on arterial blood pressure and lipid parameters in men with mild hypercholesterolemia. Pharmacol Rep. 2007;59:177–82. Skoczynska A, Jedrychowska I, Poreba R, Affelska-Jercha A, Turczyn B, Wojakowska A, Andrzejak R. Influence of chokeberry juice on arterial blood pressure and lipid parameters in men with mild hypercholesterolemia. Pharmacol Rep. 2007;59:177–82.
19.
go back to reference Cicero AF, Ertek S. Berberine: metabolic and cardiovascular effects in preclinical and clinical trials. Nutr Diet Suppl. 2009;1:1–10.CrossRef Cicero AF, Ertek S. Berberine: metabolic and cardiovascular effects in preclinical and clinical trials. Nutr Diet Suppl. 2009;1:1–10.CrossRef
20.
go back to reference Kalmarzi RN, Naleini SN, Ashtary-Larky D, Peluso I. Anti-inflammatory and immunomodulatory effects of barberry (Berberis vulgaris) and its main compounds. Oxid Med Cell Longev. 2019;2019:6183965. Kalmarzi RN, Naleini SN, Ashtary-Larky D, Peluso I. Anti-inflammatory and immunomodulatory effects of barberry (Berberis vulgaris) and its main compounds. Oxid Med Cell Longev. 2019;2019:6183965.
21.
go back to reference Lazavi F, Mirmiran P, Sohrab G, Nikpayam O, Angoorani P, Hedayati M. The barberry juice effects on metabolic factors and oxidative stress in patients with type 2 diabetes: a randomized clinical trial. Complement Ther Clin Pract. 2018;31:170–4.CrossRef Lazavi F, Mirmiran P, Sohrab G, Nikpayam O, Angoorani P, Hedayati M. The barberry juice effects on metabolic factors and oxidative stress in patients with type 2 diabetes: a randomized clinical trial. Complement Ther Clin Pract. 2018;31:170–4.CrossRef
22.
go back to reference Shidfar F, Ebrahimi SS, Hosseini S, Heydari I, Shidfar S, Hajhassani G. The effects of Berberis vulgaris fruit extract on serum lipoproteins, apoB, apoA-I, homocysteine, glycemic control and total antioxidant capacity in type 2 diabetic patients. Iran J Pharm Res. 2012;11:643–52.PubMedPubMedCentral Shidfar F, Ebrahimi SS, Hosseini S, Heydari I, Shidfar S, Hajhassani G. The effects of Berberis vulgaris fruit extract on serum lipoproteins, apoB, apoA-I, homocysteine, glycemic control and total antioxidant capacity in type 2 diabetic patients. Iran J Pharm Res. 2012;11:643–52.PubMedPubMedCentral
23.
go back to reference Hadi A, Arab A, Ghaedi E, Rafie N, Miraghajani M, Kafeshani M. Barberry (Berberis vulgaris L.) is a safe approach for management of lipid parameters: a systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2019;43:117–24.CrossRef Hadi A, Arab A, Ghaedi E, Rafie N, Miraghajani M, Kafeshani M. Barberry (Berberis vulgaris L.) is a safe approach for management of lipid parameters: a systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2019;43:117–24.CrossRef
24.
go back to reference Chan A-W, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, Hróbjartsson A, Mann H, Dickersin K, Berlin JA, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158:200–7.CrossRef Chan A-W, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, Hróbjartsson A, Mann H, Dickersin K, Berlin JA, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158:200–7.CrossRef
25.
go back to reference Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–91.CrossRef Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–91.CrossRef
26.
go back to reference Goff David C, Lloyd-Jones Donald M, Bennett G, Coady S, D’Agostino Ralph B, Gibbons R, Greenland P, Lackland Daniel T, Levy D, O’Donnell Christopher J, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk. Circulation. 2014, 129:S49–73. Goff David C, Lloyd-Jones Donald M, Bennett G, Coady S, D’Agostino Ralph B, Gibbons R, Greenland P, Lackland Daniel T, Levy D, O’Donnell Christopher J, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk. Circulation. 2014, 129:S49–73.
27.
go back to reference Sarraf M, Beig Babaei A, Naji-Tabasi S. Investigating functional properties of barberry species: an overview. J Sci Food Agric. 2019;99:5255–69.CrossRef Sarraf M, Beig Babaei A, Naji-Tabasi S. Investigating functional properties of barberry species: an overview. J Sci Food Agric. 2019;99:5255–69.CrossRef
28.
go back to reference Hemmati M, Zohoori E, Mehrpour O, Karamian M, Asghari S, Zarban A, Nasouti R. Anti-atherogenic potential of jujube, saffron and barberry: anti-diabetic and antioxidant actions. EXCLI J. 2015;14:908–15.PubMedPubMedCentral Hemmati M, Zohoori E, Mehrpour O, Karamian M, Asghari S, Zarban A, Nasouti R. Anti-atherogenic potential of jujube, saffron and barberry: anti-diabetic and antioxidant actions. EXCLI J. 2015;14:908–15.PubMedPubMedCentral
29.
go back to reference Fatehi-Hassanabad Z, Jafarzadeh M, Tarhini A, Fatehi M. The antihypertensive and vasodilator effects of aqueous extract from Berberis vulgaris fruit on hypertensive rats. Phytother Res. 2005;19:222–5.CrossRef Fatehi-Hassanabad Z, Jafarzadeh M, Tarhini A, Fatehi M. The antihypertensive and vasodilator effects of aqueous extract from Berberis vulgaris fruit on hypertensive rats. Phytother Res. 2005;19:222–5.CrossRef
30.
go back to reference Changizi Ashtiyani S, Zarei A, Taheri S, Rezaei A, Golshan M, Ghafarzadegan R. A comparative study of hypolipidemic activities of the extracts of Melissa officinalis and Berberis vulgaris in rats. jmpir. 2013;3:38–47. Changizi Ashtiyani S, Zarei A, Taheri S, Rezaei A, Golshan M, Ghafarzadegan R. A comparative study of hypolipidemic activities of the extracts of Melissa officinalis and Berberis vulgaris in rats. jmpir. 2013;3:38–47.
31.
go back to reference Mohammadi A, Sahebkar A, Kermani T, Zhilaee M, Tavallaie S, Ghayour Mobarhan M. Barberry administration and pro-oxidant-antioxidant balance in patients with metabolic syndrome. Iran Red Crescent Med J. 2014;16:e16786.CrossRef Mohammadi A, Sahebkar A, Kermani T, Zhilaee M, Tavallaie S, Ghayour Mobarhan M. Barberry administration and pro-oxidant-antioxidant balance in patients with metabolic syndrome. Iran Red Crescent Med J. 2014;16:e16786.CrossRef
32.
go back to reference Iloon Kashkooli R, Najafi SS, Sharif F, Hamedi A, Hoseini Asl MK, Najafi Kalyani M, Birjandi M. The effect of berberis vulgaris extract on transaminase activities in non-alcoholic fatty liver disease. Hepat Mon. 2015;15:e25067.CrossRef Iloon Kashkooli R, Najafi SS, Sharif F, Hamedi A, Hoseini Asl MK, Najafi Kalyani M, Birjandi M. The effect of berberis vulgaris extract on transaminase activities in non-alcoholic fatty liver disease. Hepat Mon. 2015;15:e25067.CrossRef
33.
go back to reference Spencer JPE, Abd El Mohsen MM, Minihane A-M, Mathers JC. Biomarkers of the intake of dietary polyphenols: strengths, limitations and application in nutrition research. Br J Nutr. 2007;99:12–22.CrossRef Spencer JPE, Abd El Mohsen MM, Minihane A-M, Mathers JC. Biomarkers of the intake of dietary polyphenols: strengths, limitations and application in nutrition research. Br J Nutr. 2007;99:12–22.CrossRef
Metadata
Title
Effect of barberry (Berberis vulgaris) consumption on blood pressure, plasma lipids, and inflammation in patients with hypertension and other cardiovascular risk factors: study protocol for a randomized clinical trial
Authors
Hadi Emamat
Ali Zahedmehr
Sanaz Asadian
Hadith Tangestani
Javad Nasrollahzadeh
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Trials / Issue 1/2020
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-020-04918-7

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