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Abstract

Cardiovascular disease (CVD) is the leading cause of death worldwide; thus, understanding novel interventions (e.g., diet) to reduce CVD is critical. Ambulatory blood pressure (BP) monitoring allows assessment under real-world conditions and may be superior to in-office BP for CVD risk prediction. BP variability is also emerging as an independent CVD risk factor. Spicy pepper consumption and its constituent, capsaicin, reduce CVD risk, but the controlled effect on BP in humans is unknown. PURPOSE: This study examined the effects of an acute dietary capsaicin intervention on 24-hour ambulatory BP, pulse pressure (PP), and BP variability, with attention to sex-specific responses. METHODS: In a double-blind, randomized, placebo-controlled design, 70 healthy adults, 36 females (26 ± 13 years), 34 males (25 ± 13 years) were assigned to either a placebo (PLA; n=34; two 500 mg fiber capsules) or capsaicin (CAP; n=36; two 440 mg capsules), after which 24-hour ambulatory oscillometric BP was recorded using standard protocol. Systolic and diastolic BP, PP, BP dipping, and BP variability were assessed as standard deviation (SD). RESULTS: Total systolic BP variability showed a sex effect (M > F) and a trend for condition (p = .04), with CAP < PLA, driven by females. Daytime systolic BP variability was lower in CAP compared to PLA (p = .05). Pulse pressure variability was higher in males than females (M > F, p = .05) and lower in CAP compared to PLA for both total (p = .00) and daytime (p = .02) measures. Pulse pressure measures also showed sex and sex-by-condition interaction effects. Post-hoc tests revealed pulse pressure variability was higher in males than females (p = .03) and lower in the CAP condition compared to placebo (CAP: females 10.2 ± 3.8, males 12.7 ± 3.7; PLA: females 13.2 ± 3.4, males 15.2 ± 4.3; p = .01). A significant sex × condition interaction revealed lower PP variability in CAP females compared to PLA males (p = .00). CONCLUSIONS: Capsaicin may reduce ambulatory blood pressure variability, with some sex-related differences. Reductions in BP variability may reflect improved vascular or autonomic regulation rather than changes in BP dipping, suggesting dietary capsaicin may influence cardiovascular risk through effects on blood pressure variability. Funding: American Heart Association (24AIREA1247045).

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