Reduction of cardiovascular risk factors in subjects with type 2 diabetes by Pycnogenol supplementation. Normalization of cardiovascular risk factors in peri-menopausal women with Pycnogenol®. The effect of calcium supplementation on blood pressure in non-pregnant women with previous pre-eclampsia: An exploratory, randomized placebo controlled study. Gestational calcium supplementation and blood pressure in the offspring. PYCNOGENOL in chronic venous insufficiency. Kidney Flow and Function in Hypertension: Protective Effects of Pycnogenol in Hypertensive Participants—A Controlled Study Antidiabetic effect of Pycnogenol French maritime pine bark extract in patients with diabetes type II. Calcium supplementation reduces blood pressure during pregnancy: results of a randomized controlled clinical trial. Does baseline serum total calcium level influence the blood pressure response to calcium supplementation? A double-blind study. The combined effect of calcium channel blocker Lercanidipine and antioxidants on low-grade systemic inflammation parameters in essential hypertension patients. Pycnogenol, French maritime pine bark extract, improves endothelial function of hypertensive patients. Effects of vitamin E on clinic and ambulatory blood pressure in treated hypertensive patients. Collaborative Group of the Primary Prevention Project (PPP)--Hypertension study. Dietary beetroot juice – effects on physical performance in COPD patients: a randomized controlled crossover trial Pycnogenol may alleviate adverse effects in oncologic treatment. Dietary calcium intake and blood pressure in normotensive subjects. Effects of Pycnogenol on endothelial function in patients with stable coronary artery disease: a double-blind, randomized, placebo-controlled, cross-over study. Stability of blood pressure in vegetarians receiving dietary protein supplements. Beetroot supplementation lowers daily systolic blood pressure in older, overweight subjects. Rapid Relief of Signs/Symptoms in Chronic Venous Microangiopathy With Pycnogenol®: A Prospective, Controlled Study Effects of antihypertensive agents on circadian blood pressure in hypertensive patients with previous brain infarction Effects of sodium and potassium supplementation on blood pressure and arterial stiffness: a fully controlled dietary intervention study Inhibition of COX-1 and COX-2 activity by plasma of human volunteers after ingestion of French maritime pine bark extract (Pycnogenol). Effects of Pomegranate Extract Supplementation on Cardiovascular Risk Factors and Physical Function in Hemodialysis Patients.
Patients with type 2 diabetes are at considerable risk of excessive morbidity and mortality from cardiovascular disease ( CVD ) . We investigated the clinical effectiveness of Pycnogenol , a flavonoid-rich dietary supplement , in reducing antihypertensive medication use and CVD risk factors in subjects with type 2 diabetes . Forty-eight individuals were enrolled in a r and omized , double-blind , placebo-controlled trial with parallel-group design . Patients were diagnosed with both type 2 diabetes and mild to moderate hypertension and were undergoing treatment with angiotensin-converting enzyme ( ACE ) inhibitors .  Subjects were r and omly assigned to receive either Pycnogenol pill ( 125 mg daily ) or matched placebo for 12 weeks . According to the values of blood pressure ( BP ) measured at 2-week intervals , the pretrial ACE inhibitor dosage was left unchanged , reduced by 50 % , or brought back to the pretrial dosage until a stable BP was obtained . Fasting plasma glucose , low-density lipoprotein ( LDL ) cholesterol , glycosylated hemoglobin ( HbA1c ) , serum endothelin-1 , and urinary albumin were evaluated monthly . Pycnogenol treatment achieved BP control in 58.3 % of subjects at the end of the 12 weeks with 50 % reduction in individual pretrial dose of ACE-inhibitors ( P < .05 ) . Plasma endothelin-1 decreased by 3.9 pg/mL in Pycnogenol-treated group vs 0.5 pg/mL increase in control group ( P < .001 ) . Mean HbA1c dropped by 0.8 % in Pycnogenol-treated group ( P < .05 ) , whereas it decreased by 0.1 % in control group . Fasting plasma glucose declined by 23.7 mg/dL in Pycnogenol-treated group vs 5.7 mg/dL in control group ( P < .0001 ) . Low-density lipoprotein cholesterol improved significantly in Pycnogenol-treated group , declining by 12.7 mg/dL ( P < .001 ) . A significant decrease in urinary albumin level was observed at week 8 compared with the control group ( P < .05 ) . However , this reduction was not significant at 12th week . After 12 weeks of supplementation , Pycnogenol result ed in improved diabetes control , lowered CVD risk factors , and reduced antihypertensive medicine use vs controls BACKGROUND The aim of the study was the evaluation of the efficacy of Pycnogenol ® in peri-menopausal women in controlling homocysteine and C-reactive protein ( CRP ) levels , borderline cardiovascular risk factors , oxidative stress ( OS ) and symptoms associated to menopausal transition ( MT ) . METHODS Pycnogenol ® , 100mg/day , was used as a supplement for 8 weeks by a group of 35 women . A comparable group of 35 women with identical cardiovascular risk factors was included as the control group . All women were instructed to participate in a best management plan of menopause . RESULTS The two groups were comparable . All women completed the eight weeks study . Only minor deviations from the best management plan were observed . At inclusion , both groups were similar in respect to risk factors . Supplementation with Pycnogenol ® decreased the slightly elevated cholesterol and triglycerides after 8 weeks ( P<0.05 ) . Also the fasting glucose levels were normalized ( P<0.05 ) . The borderline increased blood pressure was reduced to normal values at 8 weeks ( P<0.05 ) . Plasma free radicals dropped significantly by 22 % ( P<0.05 ) . Homocysteine and CRP levels decreased sharply by 43 % and 60 % , respectively ( P<0.05 ) . No significant changes of these risk factors were noted in the control group . Almost all menopausal symptoms , scored by The Menopausal Symptoms Question naire 34 , improved significantly following supplementation with Pycnogenol ® . The supplementation was well tolerated . CONCLUSIONS The supplementation with Pycnogenol ® improved the quality of life of perimenopausal women and normalized a series of cardiovascular risk factors , especially factors connected to cardiovascular events , as homocysteine and CRP BACKGROUND Epidemiological findings suggest that the link between poverty and pre-eclampsia might be dietary calcium deficiency . Calcium supplementation has been associated with a modest reduction in pre-eclampsia , and also in blood pressure ( BP ) . METHODS This exploratory sub- study of the WHO Calcium and Pre-eclampsia ( CAP ) trial aims to determine the effect of 500mg/day elemental calcium on the blood pressure of non-pregnant women with previous pre-eclampsia . Non-pregnant women with at least one subsequent follow-up trial visit at approximately 12 or 24weeks after r and omization were included . RESULTS Of 836 women r and omized by 9 September 2014 , 1st visit data were available in 367 women of whom 217 had previously had severe pre-eclampsia , 2nd visit data were available in 201 women . There was an overall trend to reduced BP in the calcium supplementation group ( 1 - 2.5mmHg ) although differences were small and not statistically significant . In the subgroup with previous severe pre-eclampsia , the mean diastolic BP change in the calcium group ( -2.6mmHg ) was statistically larger than in the placebo group ( + 0.8mmHg ) , ( mean difference -3.4 , 95 % CI -0.4 to -6.4 ; p=0.025 ) . The effect of calcium  on diastolic BP at 12weeks was greater than in those with non-severe pre-eclampsia ( p=0.020 , ANOVA analysis ) . CONCLUSIONS There is an overall trend to reduced BP but only statistically significant in the diastolic BP of women with previous severe pre-eclampsia . This is consistent with our hypothesis that this group is more sensitive to calcium supplementation , however results need to be interpreted with caution BACKGROUND The current study examined the relationship between calcium supplementation  during pregnancy and blood pressure ( BP ) in the mother and offspring at 3 months and at 2 years postpartum . METHODS Nulliparous pregnant women were assigned to either receive 2 g of calcium or placebo daily beginning between weeks 13 to 21 of gestation and continuing until delivery . Blood pressure was measured in children and their mothers at 3 months ( n = 260 ) and ( n = 57 ) at 2 years postpartum . Systolic BP was measured in the infants using a sphygmomanometer with ultrasonic amplification . For the toddlers , three supine BP measurements were taken from the right arm using a Critikon automated sphygmomanometer just after measurement of left ventricular wall thickness . RESULTS Systolic BP in the calcium-supplemented infants was 2.2 mm Hg lower than in the placebo group ( P > .05 ) . At 2 years of age , systolic BP was 4.8 mm Hg lower in the calcium supplemented group ( P < .05 ) , whereas diastolic BP was 3 mm Hg lower ( P > .05 ) . There was no difference in left ventricular mass index between groups , although there was a significant correlation between systolic BP and wall thickness ( P < .05 ) . Maternal BP was positively correlated with circulating 1,25(OH)(2)D3 ( P < .001 ) but did not differ between calcium groups at 3 months postpartum . CONCLUSIONS The data on BP in the children are in agreement with previous studies and argue strongly for additional research into the effects of prenatal calcium supplementation on BP regulation in the offspring The aim of out study was to investigate the efficacy of Pycnogenol - a French maritime pine bark extract - in the treatment of chronic venous insufficiency ( CVI ) . The study consisted of a double-blind phase - in which 20 patients were recruited and r and omly treated with placebo or Pycnogenol ( 100 mg 2 3/day for 2 months ) - and an open phase - in which other 20 patients were treated with Pycnogenol at the same dose schedule . In total , 40 patients were enrolled ; 30 of them were treated with Pycnogenol and 10 with placebo . Pycnogenol significantly improved the legs ' heaviness and subcutaneous edema ; the venous pressure was also significantly reduced by the Pycnogenol treatment , thus adding further clinical evidence to its therapeutic efficacy in patients with CVI .  Pycnogenol was effective , probably by either stabilizing the collagenous subendothelial basal membrane or scavenging the free radicals , or by a combination of these activities . Clinical ly , capillary leakage , perivascular inflammation and subcutaneous edema were all reduced . The safety of use of Pycnogenol is demonstrated by the lack of side effects or changes in blood biochemistry and hematologic parameters .  Pycnogenol can be therefore recommended both for prevention and treatment of CVI and related veno-capillary disturbances This study evaluated the effects of Pycnogenol as an adjunct to angiotensin-converting enzyme (ACE)-inhibitor ramipril treatment of hypertensive patients presenting with early signs of renal function problems . One group of 26 patients was medicated with 10 mg ramipril per day only ; a second group of 29 patients  took Pycnogenol in addition to the ACE inhibitor over a period of 6 months . At trial end , a lowered systolic and diastolic blood pressure was found in both groups , with a significant further reduction of diastolic pressure in the group given Pycnogenol in addition to ramipril . The major aim of this study was the investigation of kidney-protective effects of Pycnogenol . Urinary albumin decreased from 87 ± 23 to 64 ± 16 mg/d with ramipril only . Additional Pycnogenol  lowered albumin significantly better from 91 ± 25 to 39 ± 13 mg/day ( P < .05 ) . In both groups , serum creatinine was lowered ; however , only in the combination treatment group did the effect reached statistical significance . In both groups , CRP levels decreased from 2.1 to 1.8 with ramipril and from 2.2 to 1.1 with the ramipril — Pycnogenol combination ; the latter reached statistical significance . Kidney cortical flow velocity was investigated by Doppler color duplex ultrasonography . Both systolic and diastolic flow velocities increased significantly after 6 months medication with ramipril . The addition of Pycnogenol to the regimen statistically significantly further enhanced kidney cortical flow velocities , by 8 % for diastolic flow and 12 % for systolic flow , relative to values found for the group taking ramipril only . The protective effects of Pycnogenol for initial kidney damage found in this study warrant further research with a larger number of patients and over a longer period of time A double-blind , placebo-controlled , r and omized , multi-center study was performed with 77 diabetes type II patients to investigate anti-diabetic effects of the French maritime pine bark extract , Pynogenol . Supplementation with 100 mg Pycnogenol for 12 weeks , during which a st and ard anti-diabetic treatment was continued , significantly lowered plasma glucose levels as compared to placebo .  HbA1(c ) was also lowered ; however , the difference as compared to placebo was statistically significant only for the first month . In the Pycnogenol-group  endothelin-1 was significantly decreased , while 6-ketoprostagl and in F(1a ) in plasma was elevated compared to placebo . Nitric oxide levels in plasma increased during treatment in both groups , but , differences did not reach statistical significance . Pycnogenol was well-tolerated with ECG , electrolytes , creatinine and blood urea nitrogen remaining unchanged in both groups . Mild and transient unwanted effects were reported for both groups without significant differences . Supplementation of Pycnogenol to conventional diabetes treatment lowers glucose levels and improves endothelial function Fifty-two healthy pregnant women were enrolled in a double-blind , r and omized , controlled clinical trial . After the 26th week of gestation , the women were given either 1.5 g of elemental calcium per day or a placebo . Subjects in the calcium group , after adjustment for race and initial blood pressure ( BP ) , had a term mean systolic and diastolic BP value of 4 - 5 mmHg lower than those in the placebo group ( P less than .05 ) . The incidence of pregnancy-induced hypertension was 11.1 % in the placebo group and 4.0 % in the calcium group , a nonsignificant difference . Combining these values with previous data , we found a dose-effect relationship between calcium intake and BP reduction during the third trimester of pregnancy . Further research should be directed at underst and ing the mechanism of this effect and trying to demonstrate a reduction in pregnancy-induced hypertension with calcium supplementation in a larger population This was a r and omized and double-blind study to examine : ( 1 ) the effect of a 1500 mg/day calcium supplement vs a placebo for 8 wk in 42 adults with high normal or mildly elevated blood pressure ( BP ) and , ( 2 ) the relationship between baseline serum total calcium levels and BP response to calcium supplementation . Following the experimental protocol , mean pressures were lower in the treatment vs placebo group ( 95.7 mmHg and 102.1 mmHg , p = 0.002 ) , but response was not related to initial serum total calcium levels . After 8 wk of calcium supplementation , serum total calcium was greater in the treatment group compared to the placebo group ( p = 0.02 ) . Within the treatment group only , the change in total serum calcium was related to the change in parathyroid hormone ( r = -0.92 , p = 0.0002 ) ; and the change in ionized calcium was related to the change in parathyroid hormone ( r = -0.68 , p = 0.03 ) in the subgroup with low baseline serum total calcium . This study provides further support for the hypotensive effect of supplemental calcium in some people . However , it fails to clarify or exp and upon previous reports that a low serum total calcium level might be predictive of the blood pressure response to increased calcium AIM The influence of oxidative stress ( OS ) and inflammation on up-regulation of blood pressure ( BP ) has been well established . Peripheral polymorphonuclear leukocytes ( PMNLs ) are primed in essential hypertension ( EH ) patients , releasing uncontrolled superoxide anion contributing to OS in these patients . PMNL priming correlates with PMNL intracellular calcium [Ca2+]i . Previous studies have shown that treatment by calcium channel blockers lowers BP , OS and inflammation . In the same time , there are some trials showing down regulation influence of ' ' anti-oxidative ' ' drugs as Vitamin E and C to inflammation and OS . The data of clinical significance of anti-oxidative drugs to BP is controversial . The aim of this paper was to evaluate the benefit of combined treatment by calcium channel blockers ( Lercanidipine ) and antioxidative drugs ( Vitamins C and E ) on BP and on parameters of inflammation and OS . METHODS Sixteen new diagnosed patients with mild to moderate BP were sample d to 2 groups after r and omization by age , sex , and mean arterial pressure ( MAP ) , cholesterol and glucose level . The first group was treated by Lercanidip-ine only , the second group by combination of Lercanidipine and antioxidative drugs both for 6 months . PMNL priming was assessed by the rate of superoxide release from separated , phorbol ester-stimulated PMNLs and by PMNL-CD11b level . Inflammation was reflected by plasma C-reactive protein ( CRP ) and albumin levels , white blood cells ( WBC ) and PMNL counts and by PMNL apoptosis . RESULTS In both groups , BP decreased after 6 months of treatment , and in a more pronounced manner following the combined treatment . In both groups PMNL priming parameters remained unchanged after 6 months of treatment , with transient differences between the two groups during the experimental period . In both groups inflammation parameters remained unchanged after 6 months of treatment , without difference between the two groups , except a pronounced decrease in the percentage of apoptotic PMNLs in the combined treatment group . CONCLUSION Our trial shows a clinical benefit combining calcium channel blockers treatment with antioxidants in BP treatment , although it did not reveal significant influence of complementation of antioxidants to calcium channel blockers on OS and inflammation parameters . Additional clinical and laboratory investigations are needed to clear this issue . Conflicting data are reported on the influence of vitamins E and C on OS and inflammation together with controversy regarding anti-oxidative drugs and their effect on BP A placebo-controlled , double-blind , parallel group study was performed with 58 patients to investigate effects of French maritime pine bark extract , Pycnogenol  , on patients with hypertension . Supplementation of the patients with 100 mg Pycnogenol over a period of 12 weeks helped to reduce the dose of the calcium antagonist nifedipine in a statistically significant manner . The intake of Pycnogenol decreased endothelin-1 concentrations significantly compared to placebo while concentrations of 6-keto prostagl and in F1a in plasma were significantly higher compared to placebo .  Values for nitric oxide ( NO ) in plasma increased in both groups , but the differences were not significant . Angiotensin II concentrations in plasma were lowered in the placebo group to a larger extent than in the Pycnogenol group . Heart rate , electrolytes and blood urea nitrogen were not changed during treatment in both groups of patients . Unwanted effects observed in both groups were of mild and transient nature , such as gastrointestinal problems , vertigo , headache and nausea . Differences in rate of side effects were not statistically significant between the two groups . Study results support a supplementation with Pycnogenol for mildly hypertensive patients A r and omized controlled open trial studied the effect of vitamin E supplementation ( 300 mg/day ) on clinic and 24-h ambulatory blood pressure ( BP ) in 142 treated hypertensive patients . After 12 weeks , clinic BP decreased whether or not patients were r and omized to vitamin E.  Ambulatory BP showed no change in systolic BP and a small decrease in diastolic BP ( -1.6 mm Hg , 95 % confidence intervals from -2.8 to -0.4 mm Hg ) , approaching statistical significance in comparison to the control group ( P = .06 ) . Vitamin E supplementation thus seems to have no clinical ly relevant effect on BP in hypertensive patients already under controlled treatment Background and objective Dietary beetroot juice ( BR ) supplementation has been shown to reduce the oxygen ( O2 ) consumption of st and ardized exercise and reduce resting blood pressure ( BP ) in healthy individuals . However , the physiological response of BR in chronic obstructive pulmonary disease ( COPD ) remains controversial . The objective was to test exercise performance in COPD , supplementing with higher doses of BR for a longer duration compared to previous trials in this patient group . Methods Fifteen COPD patients consumed concentrated BR ( 2 × 70 mL twice daily , each containing 300 mg nitrate ) or placebo ( PL ) ( 2 × 70 mL twice daily , nitrate-negligible ) in a r and omized order for 6 consecutive days . On day 7 , participants consumed either BR or PL 150 min before  testing . BP was measured before completing 6-minute walk test ( 6MWT ) and two trials of submaximal cycling . The protocol was repeated after a minimum washout of 7 days . Results Plasma nitrite concentration was higher in the BR condition compared to PL ( P<0.01 ) . There was no difference between the BR and PL conditions regarding the covered distance during the 6MWT ( mean ± st and ard error of the mean : 515±35 m ( BR ) vs 520±38 m ( PL ) , P=0.46 ) , O2 consumption of submaximal exercise ( trial 1 P=0.31 vs trial 2 P=0.20 ) , physical activity level ( P>0.05 ) , or systolic BP ( P=0.80 ) . However , diastolic BP ( DBP ) was reduced after BR ingestion compared to baseline ( mean difference : 4.6 , 95 % CI : 0.1–9.1 , P<0.05 ) . Conclusion Seven days of BR ingestion increased plasma nitrite concentrations and lowered DBP in COPD patients .  However , BR did not increase functional walking capacity , O2 consumption during submaximal cycling , or physical activity level during the intervention period AIM A large variety of adverse reactions are well known to frequently occur during chemotherapy and radiotherapy in oncology . Specific medications exist to target individual side effects . The aim of this study was to explore in a pilot trial whether supplementation with French maritime pine bark extract Pycnogenol could alleviate side effects and improve patient 's quality of life . METHODS Cancer patients who previously underwent surgery and who were in view of their pathology in relatively good condition , both physically and psychologically , were recruited for this study and divided into two groups . These patients received their first cycle of radiotherapy or chemotherapy , which lasted from 10 days up to 1 month . Then one group of patients received 150 mg Pycnogenol , the control group comparable placebo in a single-blinded fashion . The authors studied the occurrence of side effects and made attempts to judge their severity on a semi-quantitative visual analogue scale over a 2 months period starting after patients completed their first cycle of chemo- or radiotherapy , respectively . RESULTS Twenty five radiotherapy patients receiving Pycnogenol  showed a decreased frequency of essentially all investigated side-effects as compared to 21 patients receiving placebo  , though in many categories the difference was limited . The most apparent improvements of acute side effects related to decreased soreness and ulceration in the mouth and throat as well as less dryness of the mouth and the eyes . A decreased incidence of nausea /vomiting , diarrhoea , edema and weakness was noticed , which was reflected by semi-quantitative evaluation suggesting that severity was only half or even less pronounced than in the control group . Only one case of deep vein thrombosis occurred in the Pycnogenol group whereas 2 cases of superficial vein thromboses and one case of deep vein thrombosis occurred in the control group ( 2.9 % vs 10 % ) . Thirty four chemotherapy patients were supplemented with Pycnogenol and another 30 patients were in the control group . For all patients this was the first chemotherapy treatment period . The Pycnogenol group presented with a lowered incidence of all investigated side effects as compared to the control group , though in many cases to a limited extent . The most prominent improvements were found for nausea , vomiting , diarrhoea and weight loss . Semi-quantitative evaluation showed that here again symptom severity was half or less pronounced than in the control group . Various further symptoms improved such as cognitive impairment and also cardiotoxicity and neutropenia . Effects on anemia could not be investigated as several patients received erythrocyte transfusion . In the Pycnogenol group one case of superficial vein thrombosis was indentified while 3 cases of superficial vein thromboses and one deep vein thrombosis were detected in the control group ( 4 % vs 19 % ) . In both chemotherapy and radiotherapy patients Pycnogenol lowered the requirement for medication to address side effects . This was reflected by less days of hospitalisation the patients required . The authors did not investigate a possible interference with the anti-neoplastic efficacy of chemo- and radiotherapy . This possibility requires attention in future studies with Pycnogenol . From their previous clinical experience the authors suggest that alleviation of side effects described in this study results from Pycnogenol activities related to endothelial protection , and anti-inflammatory anti-edema activities . CONCLUSION The results of this pilot trial warrant further prospect i ve studies with larger number of patients to vali date benefits more specifically with regard to type of malignancy and treatment regimen Epidemiological and prospect i ve studies in man and animals have indicated an inverse relationship between calcium intake and cardiovascular mortality and blood pressure ( BP ) . We have therefore studied the effect of dietary calcium on blood pressure in two groups of women . In a cross-sectional study 103 early postmenopausal women were stratified into three groups according to daily calcium intake calculated from a question naire . Both diastolic and systolic blood pressures were identical in the three groups . We thereafter conducted a prospect i ve placebo-controlled trial on the effect of calcium supplementation .  Twenty-eight healthy women were r and omized to placebo treatment ( n = 14 ) or calcium supplementation 2,000 mg daily ( n = 14 ) for one year . In both groups BP remained at initial levels throughout the study and was identical in the two groups at measurements every three months . We thus conclude that calcium supplementation has no effect on BP in normotensive subjects on a high calcium diet AIMS Extracts from pine tree bark containing a variety of flavonoids have been used in traditional medicine . Pycnogenol is a proprietary bark extract of the French maritime pine tree ( Pinus pinaster ssp . atlantica ) that exerts antioxidative , anti-inflammatory , and anti-platelet effects . However , the effects of Pycnogenol on endothelial dysfunction , a precursor of atherosclerosis and cardiovascular events , remain still elusive . METHODS AND RESULTS Twenty-three patients with coronary artery disease ( CAD ) completed this r and omized , double-blind , placebo-controlled cross-over study . Patients received Pycnogenol ( 200 mg/day ) for 8 weeks followed by placebo or vice versa on top of st and ard cardiovascular therapy . Between the two treatment periods , a 2-week washout period was scheduled . At baseline and after each treatment period , endothelial function , non-invasively assessed by flow-mediated dilatation ( FMD ) of the brachial artery using high-resolution ultrasound , biomarkers of oxidative stress and inflammation , platelet adhesion , and 24 h blood pressure monitoring were evaluated . In CAD  patients , Pycnogenol treatment was associated with an improvement of FMD from 5.3 ± 2.6 to 7.0 ± 3.1 ( P < 0.0001 ) , while no change was observed with placebo ( 5.4 ± 2.4 to 4.7 ± 2.0 ; P = 0.051 ) . This difference between study groups was significant [ estimated treatment effect 2.75 ; 95 % confidence interval ( CI ) : 1.75 , 3.75 , P < 0.0001 ] . 15-F(2t)-Isoprostane , an index of oxidative stress , significantly decreased from 0.71 ± 0.09 to 0.66 ± 0.13 after Pycnogenol treatment , while no change was observed in the placebo group ( mean difference 0.06 pg/mL with an associated 95 % CI ( 0.01 , 0.11 ) , P = 0.012 ] . Inflammation markers , platelet adhesion , and blood pressure did not change after treatment with Pycnogenol or placebo . CONCLUSION This study provides the first evidence that the antioxidant Pycnogenol improves endothelial function in patients with CAD by reducing oxidative stress Vegetarians have relatively low blood pressure ( BP ) levels and consume less protein than do nonvegetarians , and there have been suggestions that certain proteins may raise BP . To determine whether dietary protein supplements raise the BP of vegetarians , 58 g/per day of a 60:40 mixture of soy and wheat proteins and an isocaloric low protein supplement supplying 7 g/day of rice protein were added for 6-week periods to the diet of 18 vegetarians in a 2-group crossover design . Mean daily protein intake during consumption of the low and high protein supplements was 63 and 119 g , respectively . Mean BP was 109/72 mm Hg after the high protein and 108/71 mm Hg after the low protein diet . Consumption of other major nutrients , mean body weight , and sodium and potassium excretion did not change significantly . Thus , protein supplementation of a vegetarian diet that contained a below average but nutritionally adequate amount of protein did not significantly affect BP over 6 weeks Although inorganic nitrate and beetroot juice supplementation are associated with decreased systolic blood pressure ( BP ) , these results have primarily been obtained from short-term trials that focused on healthy young adults . Therefore , we hypothesized that oral supplementation of beetroot juice concentrate would decrease systolic BP in overweight older participants but that the decline in BP would not be sustained after a 1-week interruption of the beetroot juice supplementation . For 3 weeks , 24 participants were r and omized to either the beetroot juice concentrate or blackcurrant juice group , with a 1-week postsupplementation phase ( week 4 ) . Changes in systolic and diastolic BP were assessed during the supplementation and postsupplementation phases . Blood pressure was measured using 3 different methods : ( 1 ) resting clinic BP , ( 2 ) 24-hour ambulatory BP monitoring , and ( 3 ) home monitoring of daily resting BP . The first 2 methods were applied at baseline and after weeks 3 and 4 . Daily measurements were conducted throughout the study , with 21 subjects completing the study ( beetroot/blackcurrant = 10/11 ; male/female = 12/9 ; age = 62.0 ± 1.4 years ; body mass index = 30.1 ± 1.2 kg/m(2 ) ) . After 3 weeks , beetroot juice supplementation was not associated with significant changes in resting clinic BP or 24-hour ABPM .  Conversely , beetroot juice concentrate  reduced daily systolic BP after 3 weeks ( -7.3 ± 5.9 mm Hg , P = .02 ) ; however , the effect was not maintained after the interruption of the supplementation ( week 4 , 2.8 ± 6.1 mm Hg , P = .09 ) . In overweight older subjects , beetroot juice concentrate supplementation was associated with beneficial effects on daily systolic BP , although the effects were not significant when measured by 24-hour ABPM or resting clinic BP The aim of this study was to investigate the clinical efficacy of oral Pycnogenol ® ( Horphag Research Ltd , UK ) in patients with severe chronic venous insufficiency . Patients with severe venous hypertension ( chronic venous insufficiency , ankle swelling ) and history of venous ulcerations were treated with Pycnogenol . Patients received oral Pycnogenol ( 50 mg capsules , 3 times daily for a total of 150 mg daily ) for 8 weeks . A group of 21 patients was included in the treatment group and 18 equivalent patients were observed as controls ( no treatment during the observation period ) . All 21 patients ( age 53 years ; range , 42 - 60 years ; M : F=11:10 ) in the treatment group completed the 8-week study . Also the 18 controls completed the follow-up period . There were no drop-outs . The average ambulatory venous pressure was 59.3 ( SD 7.2 ; range 50 - 68 ) with a refilling time shorter than 10 seconds ( average 7.6 ; SD 3 ) . There were no differences in ambulatory venous pressure or refilling time between the treatment and control patients . The duration of the disease — from the first signs/symptoms — was on average 5.7 years ( SD 2.1 ) . At 4 and 8 weeks , in all Pycnogenol-treated subjects , microcirculatory and clinical evaluations indicated a progressive decrease in skin flux , indicating an improvement in the level of microangiopathy ; a significant decrease in capillary filtration ; a significant improvement in the symptomatic score ; and a reduction in edema . There were no visible effects in controls . In conclusion , this study confirms the fast clinical efficacy of Pycnogenol in patients with chronic venous insufficiency and venous microangiopathy . The study indicates the significant clinical role of Pycnogenol in the management , treatment and control of this common clinical problem . The treatment may be also useful to prevent ulcerations by controlling the level of venous microangiopathy To evaluate the effects of antihypertensive agents on the circadian blood pressure ( BP )  of patients with previous brain infa rct ion , the ambulatory BP was measured non-invasively for 24 h before and after administration of antihypertensive agents . One hundred milligrams of acebutolol twice daily ( n = 15 ) is effective in lowering the BP during the daytime , but has little effect during the night and the morning . Twenty milligrams of slow-release nifedipine twice daily ( n = 14 ) produced a consistent reduction in the BP over the entire 24-h period and effectively blunted the rise in BP in the morning . Captopril ( 12.5 mg ) twice daily ( n = 15 ) produced a mild reduction in BP with little change in the circadian pattern . The slow-release nifedipine group had the greatest decrease in mean systolic and diastolic BP . The heart rate significantly increased after administration of slow-release nifedipine and decreased after administration of acebutolol . To reduce stroke recurrence , we should consider the effects of antihypertensive agents on circadian BP in hypertensive patients with previous brain infa rct ion We performed a r and omised , placebo-controlled , crossover study to examine the effects of sodium and potassium supplementation on  blood pressure ( BP ) and arterial stiffness in untreated (pre)hypertensive individuals . During the study , subjects were on a fully controlled diet that was relatively low in sodium and potassium . After a 1-week run-in period , subjects received capsules with supplemental sodium ( 3 g d−1 , equals 7.6 g d−1 of salt ) , supplemental potassium ( 3 g d−1 ) or placebo , for 4 weeks each , in r and om order . Fasting office BP , 24-h ambulatory BP and measures of arterial stiffness  were assessed at baseline and every 4 weeks . Of 37 r and omized subjects , 36 completed the study . They had a mean pre-treatment BP of 145/81 mm Hg and 69 % had systolic BP ⩾140 mm Hg . Sodium excretion was increased by 98 mmol per 24 h and potassium excretion by 63 mmol per 24 h during active interventions , compared with  placebo .  During sodium supplementation , office BP was significantly increased by 7.5/3.3 mm Hg , 24-h BP by 7.5/2.7 mm Hg and central BP by 8.5/3.6 mm Hg . During potassium supplementation , 24-h BP was significantly reduced by 3.9/1.6 mm Hg and central pulse pressure by 2.9 mm Hg . Pulse wave velocity and augmentation index were not significantly affected by sodium or potassium supplementation . In conclusion , increasing the intake of sodium caused a  substantial increase in BP in subjects with untreated elevated BP . Increased potassium intake , on top of a relatively low-sodium diet , had a beneficial effect on BP . Arterial stiffness did not material ly change during 4-week interventions with sodium or potassium There is evidence from several studies that supplementation with French maritime pine bark extract ( Pycnogenol ) improves inflammatory symptoms in vivo . However , the molecular pharmacological basis for the observed effects has not been fully uncovered yet . Direct inhibitory effects of plant extracts or components upon cyclooxygenase ( COX ) activity have been repeatedly reported , but the question remained whether sufficiently high in vivo concentrations of bioactive compounds could be achieved in humans . The purpose of the present study was to determine a possible inhibition of the enzymatic activity of COX-1 and COX-2 by serum sample s of human volunteers after intake of French maritime pine bark extract .  This methodology considered that the serum sample s would contain any bioavailable active principle . Therefore , we obtained blood sample s before and after 5 days administration of 200 mg  Pycnogenol to five healthy humans . The plasma moderately inhibited both COX-1 and COX-2 activities ex vivo . In a second approach , 10 volunteers received a single dose of 300 mg Pycnogenol . Only 30 min after ingestion of the pine bark extract the serum sample s induced a statistically significant increase in the inhibition of both COX-1 ( P < 0.02 ) and COX-2 ( P < 0.002 ) . This suggests a strikingly rapid bioavailability of bioeffective compounds after oral intake of the extract . Thus , we provide evidence that Pycnogenol exerts effects by inhibition of eicosanoid generating enzymes which is consistent with reported clinical anti-inflammatory and platelet inhibitory effects in vivo . The next challenge is to identify the active principle(s ) that are rapidly bioavailable in human plasma The purpose of this study was to evaluate the effects of oral supplementation with pomegranate extract on cardiovascular risk , physical function , oxidative stress , and inflammation in hemodialysis ( HD ) patients . Thirty-three HD subjects were r and omized to the pomegranate ( POM ) or placebo ( CON ) group . Patients in POM ingested a 1000 mg capsule of a purified pomegranate polyphenol extract 7 days/week for 6 months . Individuals in CON ingested a noncaloric placebo capsule using the same protocol . Measurements were conducted at baseline and repeated 6 months following the start of the intervention . Brachial blood pressure ( BP ) was obtained using an automatic digital BP monitor . Cardiovascular risk was assessed using ultrasound and arterial tonometry . Blood sample s were collected for the measurements of circulating markers of inflammation , oxidative stress , and antioxidant capacity . Muscle strength and physical function were assessed by isokinetic dynamometry , a vali date d shuttle walk test , and a battery of tests to assess functional fitness . Systolic blood pressure and diastolic blood pressure were reduced by 24 ± 13.7 and 10 ± 5.3 mmHg , respectively , in POM ( P < .05 ) . However , the BP differences in POM were no longer significant after controlling for baseline BP . The paraoxonase-1 activity increased by 26.6 % ( P < .05 ) in POM , compared to no significant change in CON . However , pomegranate supplementation had no effect on other markers of cardiovascular disease risk , inflammation and oxidative stress , or measures of physical function and muscle strength . While pomegranate extract supplementation may reduce BP and increase the antioxidant activity in HD patients , it does not improve other markers of cardiovascular risk , physical function , or muscle strength
Therefore , the present meta- analysis does not suggest any significant effect of pycnogenol  on BP
Results of previous clinical trials evaluating the effect of pycnogenol supplementation on  blood pressure ( BP )  are controversial .