Skip to main content Accessibility help
×
×
Home

Contents:

Information:

  • Access

Figures:

Actions:

      • Send article to Kindle

        To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

        Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

        Find out more about the Kindle Personal Document Service.

        A randomised controlled trial to investigate ambulatory blood pressure response to riboflavin supplementation in adults with the MTHFR 677TT genotype
        Available formats
        ×

        Send article to Dropbox

        To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

        A randomised controlled trial to investigate ambulatory blood pressure response to riboflavin supplementation in adults with the MTHFR 677TT genotype
        Available formats
        ×

        Send article to Google Drive

        To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

        A randomised controlled trial to investigate ambulatory blood pressure response to riboflavin supplementation in adults with the MTHFR 677TT genotype
        Available formats
        ×
Export citation

Hypertension is the leading cause of preventable premature death, estimated to affect over 1 billion adults worldwide. Meta-analyses of epidemiological studies suggest that the C677 T polymorphism in the gene MTHFR encoding the folate metabolising enzyme methylenetetrahydrofolate reductase (MTHFR) is associated with an increased risk of hypertension by 24–87%(1). Supplementation with riboflavin (a cofactor for MTHFR) can modify this phenotype as demonstrated in a series of randomised controlled trials conducted at this centre(1). Compared with clinic blood pressure measured at one time-point only, ambulatory blood pressure monitoring (ABPM) measures BP over a 24hr period and provides a more reliable assessment of an individual's BP(2). The aim of this study was to utilise ABPM to investigate the effect of riboflavin supplementation on BP in adults with the MTHFR 677TT genotype.

Adults 18–65yrs recruited across Northern Ireland to the RIBOGENE study (NCT02463513) were screened for the MTHFR TT genotype and those who were eligible and willing to participate (n = 81), were stratified by baseline systolic BP and randomised to receive either riboflavin treatment (10 mg/day) or placebo for 16 weeks. Biomarker status of riboflavin was measured using the erythrocyte glutathione reductase activation coefficient (EGRac) assay and BP was measured by both clinic BP and ABPM, in accordance with NICE guidelines(3).

BP response to riboflavin was found to be strongly dependent on baseline BP. Participants with a baseline systolic BP of less than 125 mmHg showed no response to riboflavin supplementation (data not shown). In participants with a baseline systolic BP ≥125 mmHg, riboflavin supplementation resulted in a significant BP lowering of daytime systolic BP by 3·8 mmHg compared to 0·2 mmHg in the placebo group (see Table).

Response to intervention analysed by repeated measures ANCOVA, adjusting for sex. Higher EGRac values are indicative of lower riboflavin status. mean of participant daytime/awake hrs which was personalised for each participant.

This is the first study to use ABPM to show that riboflavin supplementation, targeted at adults with the MTHFR 677TT genotype, results in significant lowering of mean day and night BP. It is also the first demonstration of this genotype specific effect of riboflavin on BP in non-hypertensive and younger adults. Given the frequency of this genotype worldwide (approximately 10%, but as high as 30% in some populations) and the global burden of blood pressure-related disease, these findings could offer a personalised approach for BP management in these at risk sub-populations.

This work was funded by DSM Nutritional Products, Ltd. The support of the Wellcome Trust- Wolfston Northern Ireland Clinical Research Facility is acknowledged.

1.McNulty, et al. (2017) Molecular Aspects of Medicine 53, 29.
2.McMahon, et al. (2016) Nutrients 8, 720. doi:10.3390/nu8110720
3.National Institute for Health and Care Excellence (2011) Hypertension in adults: diagnosis and management nice.org.uk/guidance/cg127.