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Effect of Flavonoids on Oxidative Stress and Inflammation in Adults at Risk of Cardiovascular Disease: A Systematic Review.

ABSTRACT: Oxidative stress (OS) and inflammatory processes initiate the first stage of cardiovascular disease (CVD). Flavonoid consumption has been related to significantly improved flow-mediated dilation and blood pressure. Antioxidant and anti-inflammatory mechanisms are thought to be involved. The effect of flavonoids on markers of oxidative stress and inflammation, in at risk individuals is yet to be reviewed. Systematic literature searches were conducted in MEDLINE, Cochrane Library, CINAHL and SCOPUS databases. Randomised controlled trials in a Western country providing a food-based flavonoid intervention to participants with one or two modifiable risk factors for CVD measuring a marker of OS and/or inflammation, were included. Reference lists were hand-searched. The Cochrane Collaboration Risk of Bias Tool was used to assess study quality. The search strategy retrieved 1248 articles. Nineteen articles meeting the inclusion criteria were reviewed. Eight studies were considered at low risk of bias. Cocoa flavonoids provided to Type 2 diabetics and olive oil flavonoids to mildly-hypertensive women reduced OS and inflammation. Other food sources had weaker effects. No consistent effect on OS and inflammation across patients with varied CVD risk factors was observed. Study heterogeneity posed a challenge for inter-study comparisons. Rigorously designed studies will assist in determining the effectiveness of flavonoid interventions for reducing OS and inflammation in patients at risk of CVD.

SUBMITTER: Suen J

PROVIDER: S-EPMC5041070 | biostudies-other | 2016 Sep

REPOSITORIES: biostudies-other

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Effect of Flavonoids on Oxidative Stress and Inflammation in Adults at Risk of Cardiovascular Disease: A Systematic Review.

Suen Jenni J Thomas Jolene J Kranz Amelia A Vun Simon S Miller Michelle M

Healthcare (Basel, Switzerland) 20160914 3

Oxidative stress (OS) and inflammatory processes initiate the first stage of cardiovascular disease (CVD). Flavonoid consumption has been related to significantly improved flow-mediated dilation and blood pressure. Antioxidant and anti-inflammatory mechanisms are thought to be involved. The effect of flavonoids on markers of oxidative stress and inflammation, in at risk individuals is yet to be reviewed. Systematic literature searches were conducted in MEDLINE, Cochrane Library, CINAHL and SCOPU ...[more]

PMID: 27649255

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Project description:To identify, critically appraise and summarise existing systematic reviews on the impact of global cardiovascular risk assessment in the primary prevention of cardiovascular disease (CVD) in adults.Systematic review of systematic reviews published between January 2005 and October 2016 in The Cochrane Library, EMBASE, MEDLINE or CINAHL databases, and post hoc analysis of primary trials.Systematic reviews of interventions involving global cardiovascular risk assessment relative to no formal risk assessment in adults with no history of CVD. The primary outcomes of interest were CVD-related morbidity and mortality and all-cause mortality; secondary outcomes were systolic blood pressure (SBP), cholesterol and smoking.We identified six systematic reviews of variable but generally of low quality (mean Assessing the Methodological Quality of Systematic Reviews 4.2/11, range 0/11 to 7/11). No studies identified by the systematic reviews reported CVD-related morbidity or mortality or all-cause mortality. Meta-analysis of reported randomised controlled trials (RCTs) showed small reductions in SBP (mean difference (MD) -2.22?mm?Hg (95% CI -3.49 to -0.95); I2=66%; n=9; GRADE: very low), total cholesterol (MD -0.11?mmol/L (95% CI -0.20 to -0.02); I2=72%; n=5; GRADE: very low), low-density lipoprotein cholesterol (MD -0.15?mmol/L (95% CI -0.26 to -0.05), I2=47%; n=4; GRADE: very low) and smoking cessation (RR 1.62 (95% CI 1.08 to 2.43); I2=17%; n=7; GRADE: low). The median follow-up time of reported RCTs was 12?months (range 2-36?months).The quality of existing systematic reviews was generally poor and there is currently no evidence reported in these reviews that the prospective use of global cardiovascular risk assessment translates to reductions in CVD morbidity or mortality. There are reductions in SBP, cholesterol and smoking but they may not be clinically significant given their small effect size and short duration. Resources need to be directed to conduct high-quality systematic reviews focusing on hard patient outcomes, and likely further primary RCTs.CRD42015019821.

Project description:A physical exercise program is one of the commonly used methods for improving an individual's antioxidative capacity. However, an inappropriate physical exercise program would induce extra oxidative stress (OS), and the relationship between the details of a physical exercise protocol and the severity of intracellular OS is still unclear. A systematic review and meta-analysis of randomized controlled trials were conducted by searching PubMed, Medline, and Web of Science with the eligibility criteria: (1) participants over 18 years old; (2) physical exercise interventions; (3) 8-hydroxydeoxyguanosine, F2-isoprostanes, and protein carbonyls (PCs) as outcome measures; (4) published in English and peer-reviewed. 12 studies were included, and the data of 8 in them were pooled together. The agreement between authors reached a kappa value of 0.73. The results of the meta-analysis showed that: (1) the level of OS did not depend on the absolute intensity of physical exercise but on both the intensity and the volume of exercise; (2) high-intensity aerobic exercise (HIAE) and a combined protocol of HIAE and resistance training had the highest potential to induce large OS in unhealthy people; (3) the OS induced by moderate-to-high intensity aerobic exercise was significantly larger than that induced by ordinary life activities in healthy adults; (4) high-intensity interval training and moderate-intensity aerobic exercise had the lowest and sub-lowest probabilities to induce high intracellular OS for unhealthy adults. activities induce OS in various tissues in the human body, and the severity of OS depends on many factors of physical exercises as well as the health condition of an individual. A high-intensity and high-volume physical exercise program has the largest possibility of inducing severe OS, while a moderate-intensity aerobic exercise program and a high-intensity interval training program with a relatively low volume might be beneficial to the redox balance for unhealthy individuals. In conclusion, continuous aerobic exercise under moderate-intensity or high-intensity interval training could be recommended to enhance the body's capacity for maintaining redox balance, especially for unhealthy individuals. The PROSPERO Registration Number is CRD42022349687.

Project description:BackgroundPeer support by persons affected with diabetes improves peer supporter's diabetes self-management skills. Peer support interventions by individuals who have diabetes or are affected by diabetes have been shown to improve glycemic control; however, its effects on other cardiovascular disease risk factors in adults with diabetes are unknown. We aimed to estimate the effect of peer support interventions on cardiovascular disease risk factors other than glycemic control in adults with diabetes.MethodsWe conducted a systematic review and meta-analysis of randomized controlled trials comparing peer support interventions to a control condition in adults affected by diabetes that measured any cardiovascular disease risk factors [Body Mass Index, smoking, diet, physical activity, cholesterol level, glucose control and blood pressure]. Quality was assessed by Cochrane's risk of bias tool. We calculated standardized mean difference effect sizes using random effects models.ResultsWe retrieved 438 citations from multiple databases including OVID MEDLINE, Cochrane database and Scopus, and author searches. Of 233 abstracts reviewed, 16 articles met inclusion criteria. A random effects model in a total of 3243 participants showed a positive effect of peer support interventions on systolic BP with a pooled effect size of 2.07 mmHg (CI 0.35 mmHg to 3.79 mmHg, p = 0.02); baseline pooled systolic blood pressure was 137 mmHg. There was a non-significant effect of peer support interventions on diastolic blood pressure, cholesterol, body mass index, diet and physical activity. Cardiovascular disease risk factors other than glycemic control outcomes were secondary outcomes in most studies and baseline values were normal or mildly elevated. Only one study reported smoking outcomes.ConclusionsWe found a small (2 mmHg) positive effect of peer support interventions on systolic blood pressure in adults with diabetes whose baseline blood pressure was on average minimally elevated. Additional studies need to be conducted to further understand the effect of peer support interventions on high-risk cardiovascular disease risk factors in adults with diabetes.

Project description:The objective of the study was to evaluate oxidative stress (OS) status in subjects with different cardiovascular risk factors. With this in mind, we have studied three models of high cardiovascular risk: hypertension (HT) with and without metabolic syndrome, familial hypercholesterolemia (FH) and familial combined hyperlipidemia (FCH) with and without insulin resistance. Oxidative stress markers (oxidized/reduced glutathione ratio, 8-oxo-deoxyguanosine and malondialdehide) together with the activity of antioxidant enzyme triad (superoxide dismutase, catalase, glutathione peroxidase) and activation of both pro-oxidant enzyme (NAPDH oxidase components) and AGTR1 genes, as well as antioxidant enzyme genes (CuZn-SOD, CAT, GPX1, GSR, GSS and TXN) were measured in mononuclear cells of controls (n = 20) and patients (n = 90) by assessing mRNA levels. Activity of some of these antioxidant enzymes was also tested. An increase in OS and pro-oxidant gene mRNA values was observed in patients compared to controls. The hypertensive group showed not only the highest OS values, but also the highest pro-oxidant activation compared to those observed in the other groups. In addition, in HT a significantly reduced antioxidant activity and mRNA induction of antioxidant genes were found when compared to controls and the other groups. In FH and FCH, the activation of pro-oxidant enzymes was also higher and antioxidant ones lower than in the control group, although it did not reach the values obtained in hypertensives. The thioredoxin system was more activated in patients as compared to controls, and the highest levels were in hypertensives. The increased oxidative status in the presence of cardiovascular risk factors is a consequence of both the activation of pro-oxidant mechanisms and the reduction of the antioxidant ones. The altered response of the main cytoplasmic antioxidant systems largely contributes to OS despite the apparent attempt of the thioredoxin system to control it.

Dataset Information

Effect of Flavonoids on Oxidative Stress and Inflammation in Adults at Risk of Cardiovascular Disease: A Systematic Review.

Publications

Effect of Flavonoids on Oxidative Stress and Inflammation in Adults at Risk of Cardiovascular Disease: A Systematic Review.

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