on October 21, 2002
Published online before print October 21, 2002, doi: 10.1161/01.HYP.0000039961.13718.00
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Submitted on March 29, 2002
From the Regional Centre for Endocrinology and Diabetes,
Royal Victoria Hospital (B.A.M., D.R.M.), Belfast, Northern Ireland;
and the Department of Medicine (I.S.Y.) and the Department of
Anaesthesia and Intensive Care Medicine (H.F.), Queen's University
Belfast, Northern Ireland. * To whom correspondence should be addressed. E-mail: brian{at}mullan99.fsnet.co.uk.
Abstract—Experimental
evidence suggests that acute parenteral administration of high-dose
ascorbic acid has beneficial vascular effects in type 2 diabetes. We
studied the hemodynamic effects of chronic oral
supplementation in this condition. Thirty patients, 45 to 70 years of
age, with type 2 diabetes, were randomly assigned in a double-blind
manner to receive 500 mg ascorbic acid daily by mouth or placebo.
Patients were studied at baseline and after 4 weeks of assigned
treatment. The central aortic augmentation index (AgIx) and the time to
wave reflection (Tr) were derived from radial artery pulse wave
analysis data. AgIx and Tr were used as measures of systemic
arterial stiffness and aortic stiffness, respectively.
Ascorbic acid decreased brachial systolic blood pressure from
142.1±12.6 (SD) to 132.3±12.1 mm Hg (difference [95% CI] 9.9
[4.7, 15.0]; P<0.01),
brachial diastolic pressure from 83.9±4.8 to
79.5±6.0 mm Hg (4.4 [1.8, 7.0];
P<0.01), and AgIx from
26.8±5.5% to 22.5±6.8% (4.3 [1.5, 7.1];
P<0.01). Tr increased from
137.1±12.6 to 143.4±9.2 ms (-6.3 [-10.1, -2.5];
P<0.01). Placebo had no
hemodynamic effects, and this difference between
treatments was significant
(P<0.01 for blood pressure and
Tr, P=0.03 for AgIx). We have
therefore shown that after 1 month, oral ascorbic acid lowered
arterial blood pressure and improved arterial
stiffness in patients with type 2 diabetes. As strict control of blood
pressure reduces cardiovascular risk in diabetes,
ascorbic acid supplementation may potentially be a useful and
inexpensive adjunctive therapy. Larger and longer studies now need to
be performed.
Revised on April 25, 2002
Ascorbic Acid Reduces Blood Pressure and
Arterial Stiffness in Type 2 Diabetes
Brian A. Mullan*;
Key words: blood pressure • antioxidants • arteries • vitamins • diabetes mellitus
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