Evidence mapPaperPMID 41220152Full record

ArticleJournal of the American Heart Association2025

Prevention and Reversal of Hypertension-Induced Coronary Microvascular Dysfunction by a Plant-Based Diet.

Rami S Najjar, Nedumangalam Hekmatyar, Yanling Wang, Vu Ngo, Hannah L Lail, Juan P Tejada, Jessica P Danh, Desiree Wanders, Rafaela G Feresin, Puja K Mehta and 1 more

Abstract read
In one paragraph

Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Rami S NajjarCenter for Inflammation, Immunity and Infection, Institute for Biomedical Sciences Georgia State University Atlanta GA USA.ORCID 0000-0001-5348-3008
Nedumangalam HekmatyarAdvanced Translational Imaging Facility Georgia State University Atlanta GA USA.
Yanling WangCenter for Inflammation, Immunity and Infection, Institute for Biomedical Sciences Georgia State University Atlanta GA USA.ORCID 0000-0002-1172-1917
Vu NgoCenter for Inflammation, Immunity and Infection, Institute for Biomedical Sciences Georgia State University Atlanta GA USA.ORCID 0000-0002-9820-0443
Hannah L LailDepartment of Nutrition Georgia State University Atlanta GA USA.
Juan P TejadaCenter for Inflammation, Immunity and Infection, Institute for Biomedical Sciences Georgia State University Atlanta GA USA.
Jessica P DanhDepartment of Nutrition Georgia State University Atlanta GA USA.ORCID 0000-0001-7739-0287
Desiree WandersDepartment of Nutrition Georgia State University Atlanta GA USA.
Rafaela G FeresinDepartment of Nutrition Georgia State University Atlanta GA USA.ORCID 0000-0003-0649-2774
Puja K MehtaEmory Clinical Cardiovascular Research Institute, Division of Cardiology Emory University School of Medicine Atlanta GA USA.ORCID 0000-0002-5678-812X
Andrew T GewirtzCenter for Inflammation, Immunity and Infection, Institute for Biomedical Sciences Georgia State University Atlanta GA USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCoronary microvascular dysfunction (CMD) is associated with adverse cardiovascular outcomes. CMD is driven by endothelial and vascular smooth muscle cell (VSMC) dysfunction. We aimed to test whether CMD could be mitigated by a plant-based diet (PBD) in an animal model of hypertension.

methodsWe compared 28- and 40-week-old female normotensive Wistar-Kyoto and spontaneously hypertensive rats (SHRs), maintained, from age 4 weeks, on a control refined diet or a PBD, composed of 28% fruits, vegetables, nuts, and legumes. A subset of control SHRs was switched to the PBD at 28 weeks. CMD was assessed by coronary flow reserve via echocardiogram. Cardiac microvascular endothelial function was assessed via cardiac magnetic resonance imaging. Endothelial and VSMC function were assessed in the left ventricle or in isolated VSMCs. The role of gut microbiota was probed via 16S sequencing and antibiotics. Cardiac inflammation, oxidative stress, and fibrosis were also explored.

resultsSHRs exhibited endothelial dysfunction and likely VSMC dysfunction. A PBD did not ameliorate their hypertension but, nonetheless, prevented and reversed CMD. The PBD's mitigation of CMD was associated with improved endothelial nitric oxide synthase function and nitric oxide-mediated VSMC signaling, as well as reductions in left ventricular oxidative stress, inflammatory signaling, and fibrosis. A PBD altered the gut microbiota, although antibiotic studies failed to establish its importance in ameliorating CMD.

conclusionsA PBD prevented CMD development and reversed established CMD in SHRs. Such benefits of PBD, which occurred without alleviating hypertension, were possibly due to improved endothelial function and likely improved VSMC function. These results support clinical trials to test PBDs in human CMD.

Indexed as

Coronary Artery DiseaseCoronary CirculationCoronary VesselsDiet, VegetarianHypertensionMicrovesselsAnimalsDiet, Plant-BasedDisease Models, AnimalEndothelium, VascularFemaleGastrointestinal MicrobiomeMicrocirculationMuscle, Smooth, VascularNitric Oxide Synthase Type IIIOxidative StressNitric Oxide Synthase Type IIIendothelial functionhypertensionmicrovascular dysfunctionMRInutritionplant‐based diet

Identifiers

PMID41220152
PMCPMC12887229

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.