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Title: Riboflavin, MTHFR genotype and blood pressure : implications for personalised nutrition
Author: McAuley, Emma
ISNI:       0000 0004 6057 4751
Awarding Body: Ulster University
Current Institution: Ulster University
Date of Award: 2016
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Hypertension is the most common risk factor for cardiovascular morbidity and mortality affecting approximately 1 billion people worldwide. Recently evidence has called for a more rigorous approach to lower blood pressure (BP) to levels below the current threshold. Thus, there is a clear need to identify new strategies for the prevention and treatment of hypertension including targeted, non-pharmacological approaches to reduce BP. A common polymorphism (C677T) in the folate metabolising enzyme methylenetetrahydrofolate reductase (MTHFR) has been associated with hypertension. Furthermore, in three randomised controlled trials previously conducted at this centre riboflavin (required as a cofactor for MTHFR) has been shown to effectively lower BP in cardiovascular disease (CVD) and hypertensive patients homozygous for the MTHFR C677T polymorphism (TT genotype) in premature CVD and hypertensive patients. No previous study has however considered the BP lowering effect of riboflavin at a higher dose than previously used (1.6mg/d), or indeed considered how this novel option might translate to patient care. Finally the role of this polymorphism in the development of hypertension over time has not been previously considered. The aim of this thesis therefore was to investigate the role of the MTHFR C677T polymorphism and its interaction with riboflavin, in determining BP in generally healthy adults, and to consider the implications of this gene-nutrient interaction for a personalised nutrition approach to managing hypertension. The findings from a 10-year follow up study provide evidence that adults with the TT genotype had a higher systolic BP than those with the CC/CT genotypes at any given age from 40-65 years. Furthermore, individuals with the TT genotype had a BP in the hypertensive category at a younger age, an effect that appears to be significantly influenced by riboflavin, with the highest BP in adults with the TT genotype in combination with low riboflavin status (ft =0.155, P <0.034). In a randomised controlled trial, that investigated the BP lowering of riboflavin, preliminary findings suggest that the BP response to riboflavin may be strongest in younger adults (<55 years) and in females, but this requires further investigation and no firm conclusions can be made until this trial reaches completion (mid 2016). The GPs and genetically at-risk adults investigated reported a positive attitude towards the novel role of riboflavin in the prevention and treatment of hypertension. In conclusion, the MTHFR 677TT genotype is an important determinant of BP, furthermore in these genetically at risk individuals riboflavin offers a novel preventive and a treatment option for hypertension.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available