ESPN 50th Annual Meeting

ESPN 2017


 
Lowering of dietary fructose load may lead to an improvement of arterial stiffness in hypertensive and prehypertensive children.
MAŁGORZATA STAŃCZYK 1 DARIA TOMCZYK 1 MONIKA GRZELAK 1 JUSTYNA TOPOLSKA-KUSIAK 2 PIOTR RACZYŃSKI 3 MARCIN TKACZYK 1

1- Department of Pediatrics, Immunology and Nephrology, Polish Mother’s Memorial Hospital Research Institute, Lodz , Poland
2- Department of Cardiology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
3- Department of Imaging Diagnostics, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
 
Introduction:

Non-farmacological treatments of hypertension include lowering the salt load in the diet, consuming more fruits and vegetables, and less saturated fats. Recent research has shown that consuming sweet beverages could elevate blood pressure. It may be postulated that fructose might increase BP by influencing the uric acid genaration pathway. The aim of this study was to assess the influence of decreasing dietary fructose on arterial stiffness.

Material and methods:

This study was a prospective clinical analysis of the influence of decreasing the daily fructose load. 41 individuals aged 12-18 with elevated blood pressure (70% with hypertension, 30% with pre-hypertension) participated in this study. A  questionnaire was used to assess the day-to-day diet. Blood pressure measurements and applanation tonometry were performed to assess arterial stiffness. A dietitian instucted participants to lower their fructose intake by 10 %. After 6 weeks of a low-fructose diet, the same measurements were repeated. Patient adherence was validated by assessing the urine uric acid-to-creatine ratio (uUA/Cr). The study was sponsored by the Polish Mother’s Memorial Hospital—Research Institute—Young Researcher Grant no 2014/V/8-MN

Results:

After 6 weeks of a low-fructose diet, no changes in casual systolic and diastolic blood pressure were recorded. However, a significant decrease in pulse wave velocity was observed (6 m/s vs 5,6 m/s, p=0,004). Aortic systolic blood pressure was also lower (103 vs 100 mmHg, p=0,02), with no changes in diastolic blood pressure. Augmentation index adjusted for heart rate tended to be lower after decreasing diatary fructose (5,0 vs 2,0, p=0,07). There was a significant fall in the uUA/Cr after applying the diet (0,4 vs 0,07 mg/mg, p<0,001) which confirmed the participants adherence to the protocol.

Conclusions:

Decreasing dietary fructose may improve arterial stiffness without affecting blood pressure. Our data suggests that a low-fructose diet could be a beneficial component of a non-pharmacological treatment in children with hypertension.