A prospective study of nutritional factors and hypertension among US women.

Abstract

The relation of various nutritional factors with hypertension was examined prospectively among 58,218 predominantly white US female registered nurses, aged 34-59 years. In 1980, all women completed an independently validated dietary questionnaire. During 4 years of follow-up, 3,275 women reported a diagnosis of hypertension; the validity of the self-report was shown in a subsample. Age, relative weight, and alcohol consumption were the strongest predictors for the development of hypertension. Dietary calcium and magnesium had independent and significant inverse associations with hypertension. For women with a calcium intake of at least 800 mg/day, the relative risk of hypertension was 0.78 (95% confidence interval, 0.69-0.88) when compared with an intake of less than 400 mg/day. The relative risk for magnesium intake of 300 mg/day or more compared with an intake of less than 200 mg/day was 0.77 (95% confidence interval, 0.67-0.88). For women with high intakes of both calcium and magnesium compared with those having low intakes of both, the relative risk of hypertension was 0.65 (95% confidence interval, 0.53-0.80). No independent associations with hypertension were observed for intakes of potassium, fiber, and saturated and polyunsaturated fatty acids. These prospective findings add to the growing evidence to support the need for randomized trials to determine whether there is a protective role of dietary calcium and magnesium in the regulation of blood pressure. (Circulation 1989;80:1320-1327 T he search for nonpharmacologic approaches to prevent and control hypertension has led to interest in the effects of diet. For several decades, research has mainly focused on potentially adverse effects of excess sodium intake.' Dietary potassium has been inversely related to blood pressure in some,2-4 but not all156 cross-sectional studies, and supplementation has yielded conflicting results in clinical trials.7'8 Among other dietary constituents of protective effects, calcium,3'4'6 fiber,9 and polyunsaturated fatty acids'0 have been suggested. Positive associations have been observed between alcohol intake and blood pressure." The relation of dietary magnesium with blood pressure has received much less attention.With few exceptions,12"13 epidemiologic studies of diet and blood pressure have been cross-sectional2-6'9'14 rather than prospective. Although most studies excluded subjects on a prescribed diet, these studies still might have included hypertensive subjects who changed their diet after the diagnosis. Furthermore, most studies used a 24-hour recall to measure diet,3-5.9,14 which is generally a poor reflection of the usual intake of an individual. 15 In 1980, information on dietary intake over the preceding year was collected from a large cohort of US women. In the present study, we examine nutrient intake in relation to the development of hypertension during 4 years of follow-up. In addition to providing a very large study population, the potential for dietary change secondary to the diagnosis of high blood pres...

Sex‐Specific Associations Between Alcohol Consumption and Incidence of Hypertension: A Systematic Review and Meta‐Analysis of Cohort Studies

“…In women, there was no observed risk increase for consumption of 1 or 2 drinks/day in comparison with abstainers, and an increased risk beyond this level with a pooled RR=1.42 (95% CI, 1.22–1.66; I 2 =88%) for consumption of 3 or more drinks per day (Figure 3 and Figure S3). Because we included 2 studies from the Nurses’ Health Study42, 45 with different follow‐up periods of the same participants, we ran a sensitivity analysis including only 1 42. The results compared to Figure 3 were almost identical (1–2 drinks/day: pooled RR=0.95; 95% CI, 0.88–1.03).…”

“…Nine reports were from the United States,22, 23, 24, 42, 43, 44, 45, 46, 47 4 from Japan,48, 49, 50, 51 2 from China,52, 53 and 1 each from Germany,54 South Korea,55 Finland,56 Turkey,57 and Thailand58 (Table). Several reports from the Nurses’ Health Study42, 44, 45, 46 were included, but any 1 case of incident hypertension was included only once in any particular analysis. Overall, data from 361 254 participants (125 907 men and 235 347 women) and 90 160 incident cases of hypertension (32 426 men and 57 734 women) were analyzed.…”

Association between leisure time physical activity and 10-year body mass change among working-aged men and women

“…1±5 Overweight and obesity are well known independent risk factors for increased mortality, 6±8 and for several chronic disorders such as musculoskeletal 9,10 and cardiovascular diseases, 11±14 hypertension, 15,16 and diabetes. 17±20 Although there appears to be a graded association between body mass and the disease risk, a clinically signi®cant risk for some of these states is associated with a body mass index (BMI) value of approximately 26 or more and with a body mass gain of at least 5 kg during a 10 y or longer follow-up period.…”

Lack of effect on blood pressure by low fat diets with different fatty acid compositions

“…20 In the prospective Nurses' Health Study, dietary fatty acids showed no association with the 4-year incidence of hypertension. 21 An increase in linoleic acid intake has been shown to reduce BP both in combination with reduced fat intake [22][23][24][25] and with unchanged fat intake. [26][27][28][29] In contrast to these findings, several studies have failed to show an effect on BP by increased intake of linoleic acid.…”