Blood Pressure in Treated Hypertensive Individuals With the MTHFR 677TT Genotype Is Responsive to Intervention With Riboflavin: Findings of a Targeted Randomized Trial

Hypertension
Q1
Jun 2013
Citations:81
Influential Citations:6
Interventional (Human) Studies
81
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Methods
Randomized, double-blind, placebo-controlled trial in hypertensive adults with MTHFR 677TT genotype without overt cardiovascular disease. N=91 (46 riboflavin, 45 placebo) identified from the TUDA aging cohort; mean age ~69 years; predominantly male; most on antihypertensive therapy; participants stratified by baseline systolic BP and randomized to riboflavin or placebo for 16 weeks.
Intervention
Riboflavin 1.6 mg/day for 16 weeks; oral supplementation.
Results
Systolic BP decreased by 5.6 ± 2.6 mm Hg with riboflavin versus placebo (P=0.033); diastolic BP change not significant (P=0.291). EGRac improved with riboflavin (P<0.001). Post-intervention attainment of goal BP (≤140/90 mm Hg) was 57% in the riboflavin group vs 30% in placebo (P=0.052). Conclusion: In treated hypertensives with MTHFR 677TT, riboflavin supplementation lowers BP and improves BP control, supporting a genotype-guided personalized approach; larger trials are needed to confirm effects on cardiovascular endpoints.
Limitations
Small genotype-specific sample (n=91); short duration (16 weeks); generalizability limited to MTHFR 677TT without overt CVD and may not extend to other genotypes or to those with cardiovascular disease; outcome significance for goal BP is borderline (P=0.052); no hard cardiovascular endpoints assessed; potential interaction with multiple antihypertensive medications.

Abstract

&NA; Intervention with riboflavin was recently shown to produce genotype-specific lowering of blood pressure (BP) in patients with premature cardiovascular disease homozygous for the 677C→T polymorphism (TT genotype) in the gene encoding the enzyme m...