High blood pressure in pregnancy is associated with poor outcomes for both mum and baby, increasing the risk of pregnancy complications including pre-eclampsia, fetal growth restriction and preterm birth. The development of new blood pressure lowering interventions suitable for use in pregnancy is a key research priority. Inorganic nitrate is a compound found in certain types of food, particularly green leafy vegetables and beetroot. Nitrate provides an important source of nitric oxide (NO), a molecule involved in keeping blood vessels healthy and regulating blood pressure. Supplementation with nitrate in the diet, using interventions such as beetroot juice, has been shown to reduce blood pressure and improve blood vessel function. In order for dietary nitrate to have these beneficial effects, it needs to be converted in the body to nitrite, via bacteria that live in the mouth (oral bacteria). Differences in oral bacteria, and how they metabolise nitrate, are thought to influence blood pressure regulation and potentially response to dietary nitrate supplementation. This study aims to understand (1) whether pregnant women with high blood pressure have a different composition of oral bacteria compared to healthy pregnant women and women who are not pregnant, and (2) how differences in oral bacteria affect blood pressure responses to a dose of dietary nitrate (in the form of beetroot juice).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
55
Beetroot juice shot (70mL containing 400mg inorganic nitrate)
Maternal and Fetal Health Research Centre, St Mary's Hospital
Manchester, United Kingdom
Quantity of oral nitrate reducing bacterial species
Assessment of oral bacterial profile using next-generation sequencing (bacterial 16S rRNA sequencing)
Time frame: Baseline
Oral bacterial nitrate reductase activity
Assessment of oral nitrate reductase activity, measured using enzyme assay
Time frame: Baseline
Difference between groups in nitrate/nitrite concentrations before and after dietary nitrate dose
Measurement of plasma and salivary nitrate and nitrite concentrations, using high-performance liquid chromatography (HPLC)
Time frame: Baseline to 2.5 hour post-nitrate dose
Difference between groups in blood pressure response to dietary nitrate dose
Change in blood pressure
Time frame: Baseline to 2.5 hour post-nitrate dose
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