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Pycnogenol May Help Kidney Function in Hypertension

Abstracted by Marcia J. Egles,MD,  March 28, 2010  from Kidney Flow and Function in Hypertension: Protective Effects of Pycnogenol in Hypertensive Participants—A Controlled Study by Maria Rosaria Cesarone, MD et al in Journal of Cardiovascular Pharmacology and Theurapeutics, originally published online Jan 22, 2010.

KEY WORDS: hypertension, kidney, Pycnogenol

A recent preliminary clinical study from Italy (1) reported several benefits to the addition of Pycnogenol to a standard medical treatment of hypertensive ( high blood pressure) patients with deteriorating kidney function.  Pycnogenol is the trade name of a flavonoid-rich extract of French maritime pine tree bark.

Several other medical studies have suggested a value of Pycnogenol in reducing abnormally high blood pressure (2,3) .  Pycnogenol  may act by dilating blood vessels and improving the flow of blood in several areas of the body such as the kidneys(3).  The benefits of Pycnogenol reported in this latest study include indications of healthier kidney function in addition to improvements in blood pressure.

The effects of pycnogenol,when added to a standard anti-hypertensive treatment with ramipril, were evaluated in this randomized, controlled, six- month study.  All fifty-five male and female participants had ongoing cardiovascular disease with past histories of heart attacks or stroke, but none were diabetic requiring diabetes medications.   All of the subjects had evidence of early kidney disease at the start of the study. Only persons with limited abdominal fat (body mass index less than 26) were suitable for the study because of the constraints of the ultrasound technology used to measure kidney blood flow.

All of the subjects received 10mg per day of the antihypertensive drug ramipril. (Ramipril belongs to a commonly used class of drugs known as ACE-inhibitors.)  Half of the subjects received Pycnogenol  50 milligrams three times a day for a total daily dose of 150 milligrams in addition to the ramipril.  By means of clinical blood pressure measurements, by laboratory blood tests of kidney function, and by ultrasound-aided kidney blood flow measurements, the effects of Pycnogenol were evaluated.

Compared to the measurements done at the start of the study, both groups responded with therapeutically appropriate reductions in blood pressure.  A further significant reduction was seen in the diastolic (bottom number of a blood pressure reading) of the group given Pycnogenol in addition to ramipril.

The major aim of the study was to investigate the kidney- protective effects of Pycnogenol.   Major tests of kidney function include serum creatinine and urinary albumin. Both groups achieved improvements in these parmeters, but the effects were more pronounced in the pycnogenol/ramipril group.  In the ramipril group, the average serum creatinine at baseline was 1.6 milligrams per deciliter.  After six months of ramipril treatment, the serum creatine was lowered to1.3 milligrams per deciliter.  In the pycnogenol/ramipril group a baseline serum creatinine of 1.54 improved to 1.1 milligrams per deciliter after six months.  Urinary albumin in the ramipril group decreased from an average of 87 milligrams per day to 64 milligrams per day.   In the pycnogenol /ramipril group the urinary albumin dropped from 91 milligrams per day at baseline to 39 milligrams per day. (P value was less than 0.05 for all data reported.)   For the kidney flow velocities obtained by ultrasound, the addition of Pycnogenol to ramipril enhanced  flow by approximately 10 per cent.

The recommendation of the researchers is for further investigation of the kidney protective effects of Pycnogenol using a larger number of hypertensive patients for a longer time period.  In the meantime they expressed that Pycnogenol may be considered a safe adjunct to the standard management of hypertension.

REFERENCES:

1. Cesarone,MR.   Kidney Flow and Function in Hypertension: Protective Effects of Pycnogenol in Hypertensive Participants—A Controlled Study.Journal of Cardiovascular Pharmacology and Theurapeutics, originally published online Jan 22, 2010
2. Hosseini S, Lee J, Sepulveda RT, Fagan T, Rohdewald P, Watson RR. A randomized, double blind, placebo controlled, prospective, 16 week crossover study to determine the role of
Pycnogenol1in modifying blood pressure in mildly hypertensive patients. Nutr Res. 2001;21(9):67-76.
3. Liu X, Wei J, Tan F, Zhou S, Wu¨rthwein G, Rohdewald P.Pycnogenol, French maritime pine bark extract, improves endothelial function of hypertensive patients. Life Sci. 2004; 2;74(7):855-862.
4. Zibadi S, Rohdewald PJ, Park D, Watson RR. Reduction of cardiovascular risk factors in subjects with type 2 diabetes by Pycnogenol supplementation. Nutr Res. 2008;28(5):315-320.