Effect of pomegranate extract on blood pressure and anthropometry in adults: a double-blind placebo-controlled randomised clinical trial

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CVD currently affects more than 7 million individuals in the UK and is responsible for 26 % of total deaths⁽¹⁾. High blood pressure is the greatest contributor to CVD worldwide and one of the most common CVD risk factors⁽²⁾. Obesity remains a global epidemic and is an independent risk factor for CVD. It is also associated with increased blood pressure, morbidity and mortality risks, and decreased life expectancy⁽³⁾. The benefits of lowering blood pressure and reducing obesity for the prevention of CVD are well established. Studies have reported that a reduction in systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) by 5 mmHg is clinically significant as it decreased cardiovascular risk by 20 %⁽⁴⁾, the risk of stroke by 20 %⁽⁵⁾and mortality risk by 7 %⁽⁶⁾. Moreover, a modest weight loss (5-10 %) can significantly decrease risk factors for diabetes and CVD^(7,8). Therefore, attenuating obesity and blood pressure could have a potential effect on reducing CVD risk in the population.

In addition to diet and exercise, the study of complementary approaches for the prevention and management of CVD is now emerging. Bioactive components, particularly polyphenols, have been studied for their potential beneficial effects on health. Pomegranate has a high antioxidant capacity due its considerable polyphenol content, particularly tannins, anthocyanins and ellagic acid derivatives⁽⁹⁾. Pomegranate has been reported to reduce inflammation⁽¹⁰⁾, lipid peroxidation, oxidative stress⁽¹¹⁾and insulin resistance⁽¹²⁾. Some studies have shown that pomegranate juice reduces blood pressure in hypertensive⁽¹³⁾and normotensive populations^(14,15). However, another study showed that 3 months of pomegranate juice supplementation did not significantly affect blood pressure in patients with CHD⁽¹⁶⁾. In addition, Mathew et al.⁽¹⁷⁾showed that pomegranate extract (PE) suppressed the postprandial increase in SBP following a high-fat meal⁽¹⁷⁾. A randomised controlled parallel trial including twenty-nine participants also illustrated that 4 weeks of daily PE...