TY - JOUR
T1 - Prebiotic intervention with HAMSAB in untreated essential hypertensive patients assessed in a phase II randomized trial
AU - Jama, Hamdi A.
AU - Rhys-Jones, Dakota
AU - Nakai, Michael
AU - Yao, Chu K.
AU - Climie, Rachel E.
AU - Sata, Yusuke
AU - Anderson, Dovile
AU - Creek, Darren J.
AU - Head, Geoffrey A.
AU - Kaye, David M.
AU - Mackay, Charles R.
AU - Muir, Jane
AU - Marques, Francine Z.
N1 - Funding Information:
We would like to acknowledge the Monash Proteomics and Metabolomics Facility for SCFA measurement and the Monash Bioinformatics Platform for access to M3 servers. We also would like to acknowledge M. Schlaich and J. Sesa-Ashton for their help with recruitment and T. Veitch for help developing the recipes used in the trial. This work was supported by a National Heart Foundation Vanguard grant (102182), a National Health & Medical Research Council (NHMRC) of Australia project grant (GNT1159721) and NHMRC fellowships to D.M.K., G.A.H., J.M. and R.E.C. F.Z.M. is supported by a Senior Medical Research Fellowship from the Sylvia and Charles Viertel Charitable Foundation Fellowship and by National Heart Foundation Future Leader Fellowships (101185 and 105663). The Baker Heart & Diabetes Institute is supported, in part, by the Victorian Government’s Operational Infrastructure Support Program.
Funding Information:
We would like to acknowledge the Monash Proteomics and Metabolomics Facility for SCFA measurement and the Monash Bioinformatics Platform for access to M3 servers. We also would like to acknowledge M. Schlaich and J. Sesa-Ashton for their help with recruitment and T. Veitch for help developing the recipes used in the trial. This work was supported by a National Heart Foundation Vanguard grant (102182), a National Health & Medical Research Council (NHMRC) of Australia project grant (GNT1159721) and NHMRC fellowships to D.M.K., G.A.H., J.M. and R.E.C. F.Z.M. is supported by a Senior Medical Research Fellowship from the Sylvia and Charles Viertel Charitable Foundation Fellowship and by National Heart Foundation Future Leader Fellowships (101185 and 105663). The Baker Heart & Diabetes Institute is supported, in part, by the Victorian Government’s Operational Infrastructure Support Program.
Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2023/1/9
Y1 - 2023/1/9
N2 - Fibers remain undigested until they reach the colon, where some are fermented by gut microbiota, producing metabolites called short-chain fatty acids (SCFAs), such as acetate and butyrate 1. SCFAs lower blood pressure in experimental models 2–5, but their translational potential is unknown. Here we present the results of a phase II, randomized, placebo-controlled, double-blind cross-over trial (Australian New Zealand Clinical Trials Registry ACTRN12619000916145) using prebiotic acetylated and butyrylated high-amylose maize starch (HAMSAB) supplementation 6. Twenty treatment-naive participants with hypertension were randomized to 40 g per day of HAMSAB or placebo, completing each arm for 3 weeks, with a 3-week washout period between them. The primary endpoint was a reduction in ambulatory systolic blood pressure. Secondary endpoints included changes to circulating cytokines, immune markers and gut microbiome modulation. Patients receiving the HAMSAB treatment showed a clinically relevant reduction in 24-hour systolic blood pressure independent of age, sex and body mass index without any adverse effects. HAMSAB increased levels of acetate and butyrate, shifted the microbial ecosystem and expanded the prevalence of SCFA producers. In summary, a prebiotic intervention with HAMSAB could represent a promising option to deliver SCFAs and lower blood pressure in patients with essential hypertension.
AB - Fibers remain undigested until they reach the colon, where some are fermented by gut microbiota, producing metabolites called short-chain fatty acids (SCFAs), such as acetate and butyrate 1. SCFAs lower blood pressure in experimental models 2–5, but their translational potential is unknown. Here we present the results of a phase II, randomized, placebo-controlled, double-blind cross-over trial (Australian New Zealand Clinical Trials Registry ACTRN12619000916145) using prebiotic acetylated and butyrylated high-amylose maize starch (HAMSAB) supplementation 6. Twenty treatment-naive participants with hypertension were randomized to 40 g per day of HAMSAB or placebo, completing each arm for 3 weeks, with a 3-week washout period between them. The primary endpoint was a reduction in ambulatory systolic blood pressure. Secondary endpoints included changes to circulating cytokines, immune markers and gut microbiome modulation. Patients receiving the HAMSAB treatment showed a clinically relevant reduction in 24-hour systolic blood pressure independent of age, sex and body mass index without any adverse effects. HAMSAB increased levels of acetate and butyrate, shifted the microbial ecosystem and expanded the prevalence of SCFA producers. In summary, a prebiotic intervention with HAMSAB could represent a promising option to deliver SCFAs and lower blood pressure in patients with essential hypertension.
UR - http://www.scopus.com/inward/record.url?scp=85146061423&partnerID=8YFLogxK
U2 - 10.1038/s44161-022-00197-4
DO - 10.1038/s44161-022-00197-4
M3 - Article
AN - SCOPUS:85146061423
SN - 2731-0590
VL - 2
SP - 35
EP - 43
JO - Nature Cardiovascular Research
JF - Nature Cardiovascular Research
IS - 1
ER -