Abstract-Protein intake may have some benefits on reducing blood pressure and cardiovascular events, but their effects are still debated. The objective of this study was to test the prognostic value of protein intake assessed by 24-hour urinary urea in a cohort of hypertensive patients with preserved renal function. A total of 1128 hypertensive patients were followed according to tertile of protein intake adjusted for ideal body weight: <0.70, 0.70 to 0.93, and >0.93 g/kg. Baseline characteristics (mean±standard deviation) were age 45.1±13.2 years, systolic/diastolic blood pressure 185±32/107±20 mm Hg, and estimated glomerular filtration rate 82±32 mL/min. After 10 years of follow-up, 289 deaths occurred, 202 of which were of cardiovascular cause. After adjustment for major cardiovascular risk factors, patients in the second and third tertiles of protein intake had a decreased risk of all-cause death (hazard ratio in comparison to patients in the low protein intake tertile. Normal-high protein intake was associated with a better outcome in a subset of the population: younger patients, low salt intake, without aortic atherosclerosis, or previous cardiovascular events (P interaction <0.10 for all). Hypertensive patients having a protein intake >0.7 g/kg ideal body weight, particularly those at low risk, had lower all-cause and cardiovascular mortality rates. Physicians may encourage hypertensive patients to have normal or high protein diet in addition to low salt consumption, moderate alcohol consumption, and regular physical activity. [
Courand et al Protein Intake and Hypertension 1143patients. As some conditions, such as renal function and cardiovascular remodeling, may exert a modifying effect, the interaction with several metabolic or organ damage variables was also tested.
Methods
PatientsThe OLD-HTA Lyon cohort has been described. 11 Briefly, 1152 patients were hospitalized between 1969 and December 1976 in the Cardiology Department at Louis Pradel Hospital (Lyon, France) for a work-up of their hypertension. Twenty-four patients were lost to follow-up and were excluded, leaving a study population of 1128 hypertensive inpatients with a 24-hour urinary collection form. Of these patients, 1092 also had a spot urine collection and 539 completed a food frequency questionnaire.All patients provided oral consent to participate in the study, in accordance with the French regulation prevailing in the 1970s. The study was approved by the Commission Nationale Informatique et Liberté. Under French law, as mentioned in several published technical notes in line with European directives, only the approval of the Commission is required for single-center observational usual-care studies, such as this one. The vital status query was approved by national authorities before data extraction by the Institut National de la Statistique et des Etudes Economiques.
Baseline Work-UpA standardized form was completed for all patients, which collected data on various morphometric characteristics, risk factors for cardiovascular events (s...
