THE EFFECT OF INTERMITTENT FASTING ON NIGHTTIME BLOOD PRESSURE LEVELS

Abstract

Objective: Hypertension, a preventable disease with a high prevalence, is frequently seen in obesity patients with cardiovascular risk factors. Our study aimed to investigate the effect of an intermittent fasting regimen on nighttime blood pressure levels. Materials and Methods: Patients who applied to Karabuk University Faculty of Medicine Training and Research Hospital Cardiology and Family Medicine Polyclinic between January and March 2021 and were followed up for 24 hours on an outpatient basis were included in this self-controlled interventional study. Patients underwent a second 24-hour Holter blood pressure follow-up after one month of diet and the results were compared. Results: The study was conducted with 30 subjects who adhered to a one-month intermittent fasting regimen. 63.3% of the patients were male and the mean age was 54.60 ± 9.71 years. One month later, 13 patients whose nighttime blood pressure improved were assigned to Group 1 and 17 patients to Group 2. There was no important variance between the groups in terms of gender, age, height, waist circumference and BMI (p=0.609, p=0.105 and p=0.087, in order of). Mean VA and BSA were considerably lower in Group 2 (p=0.027 and p=0.045, in order of). HT duration was longer in Group 1 (p=0.001). There was no important variance between the groups in terms of smoking, alcohol use, average daily sleep time, salt intake awareness and exercise habits. The rate of snacking habits in Group 2 was statistically considerably higher (p=0.033). Conclusion: Intermittent fasting may be beneficial in preventing nocturnal hypertension.

Keywords

• Hypertension
• Intermittent Fasting Regimen
• Nighttime Blood Pressure.

References

1. WHO World Health Organization [Internet]. https://www.who.int/health-topics/hypertension/#tab=tab_1’. 2021. (Accessed: 30 Kasım 2021).
2. Mills KT, Stefanescu A, He J. The Global Epidemiology of Hypertension. Nat Rev Nephrol. 2020;16(4):223- 37 (doi: 10.1038/s41581-019-0244-2).
3. T.E.M.D Association. Hypertension and Treatment Guide. 2019. p. 82
4. WHO World Health Organization [Internet]. https://www.who.int/news-room/fact-sheets/detail/the-top10-causes-of-death’. (Accessed: 30 Kasım 2021).
5. TÜSEB-TÜHKE Turkish Institute of Public Health and Chronic Diseases (2021). World Hypertension Day May 17, 2021.
6. Dong TA, Sandesara PB, Dhindsa DS, Mehta A, Arneson LC, Dollar AL, Pam R, Taub MD, Sperling LS. Intermittent fasting: a heart healthy dietary pattern? The American Journal of Medicine. 2020;133(8): 901-07.
7. Patterson RE, Sears DD. Metabolic effects of intermittent fasting. Annual Review of Nutrition. 2017;37:371-93.
8. de Toledo FW, Grundler F, Bergouignan A, Drinda S, Michalsen A. Safety, health improvement and well-being during a 4 to 21-day fasting period in an observational study including 1422 subjects. PloS one. 2019;14(1), e0209353.

9. Erdem Y, Özkan G, Ulusoy Ş, Arıcı M, Derici Ü, Şengül Ş, Sındel Ş, Ertürk Ş, The effect of intermittent fasting on blood pressure variability in patients with newly diagnosed hypertension or prehypertension. Journal of the American Society of Hypertension. 2018;12(1):42-49.
10. Li C, Sadraie B, Steckhan N, Kessler C, Stange R, Jeitler M, Michalsen A. Effects of a one-week fasting therapy in patients with type-2 diabetes mellitus and metabolic syndrome–A randomized controlled explorative study. Experimental and Clinical Endocrinology & Diabetes. 2017; 125(09): 618-624.
11. Stote KS, Baer DJ, Spears K, Paul DR, Harris GK, Rumpler WV, Strycula P, Najjar SS, Ferrucci L, Ingram DK, Longo DL, Mattson MP. A controlled trial of reduced meal frequency without caloric restriction in healthy, normal-weight, middle-aged adults. The American journal of clinical nutrition. 2007; 85(4): p. 981-88.
12. Hall JE, do Carmo JM, da Silva AA, Wang, Hall ME. Obesity-induced hypertension. Interaction Of Neurohumoral and Renal Mechanisms. 2015;116(6): 991-1006.
13. Wan R, Ahmet I, Brown M, Cheng A, Kamimur N, Talan M, Mattson MP. Cardioprotective effect of intermittent fasting is associated with an elevation of adiponectin levels in rats. The Journal of Nutritional Biochemistry. 2010; 21(5): 413-417.
14. Heilbronn LK, Smith SR, Martin CK, Anton SD, Ravussin E. Alternate-day fasting in nonobese subjects: effects on body weight, body composition, and energy metabolism. The American Journal of Clinical Nutrition, 2005; 81(1): 69-73.
15. Byrne NM, Sainsbury A, King NA, Hills AP, Wood RE. Intermittent energy restriction improves weight loss efficiency in obese men: the MATADOR study. International Journal of Obesity. 2018; 42(2):129-38.
16. Eshghinia S, Mohammadzadeh F. The effects of modified alternate-day fasting diet on weight loss and CAD risk factors in overweight and obese women. Journal of Diabetes & Metabolic Disorders. 2013;12(1), 1-4.
17. Kolanowski J, Bodson A, Desmecht P, Bemelmans S, Stein F, Crabbe J. On the relationship between ketonuria and natriuresis during fasting and upon refeeding in obese patients. European Journal of Clinical Investigation. 1978; 8(5): 277-82.
18. Yang B, Slonimsky JD, Birren SJ. A rapid switch in sympathetic neurotransmitter release properties mediated by the p75 receptor. Nature Neuroscience. 2002;5(6): 539-45.
19. Sutton EF, Beyl R, Early KS, Cefalu WT, Ravussin E, Peterson CM. Early time-restricted feeding improves insulin sensitivity, blood pressure, and oxidative stress even without weight loss in men with prediabetes. Cell Metabolism. 2018; 27(6): 1212-1221.
20. Nematy M, Alinezhad-Namaghi M, Rashed MM, Mozhdehifard M, Sajjadi SS., Akhlaghi S, Sabery M, Mohajery SAR, Shalaey N, Norouzy A. (2012). Effects of Ramadan fasting on cardiovascular risk factors: a prospective observational study. Nutrition Journal. 2012;11(1): 1-7.