H ypertension (HTN) contributes to approximately half of all cardiovascular diseases.1 In 2000, the worldwide prevalence of HTN was estimated to be 26%, affecting ≈1 billion people. It is expected that 29% of the world population will be experiencing HTN in 2025, mainly because of the expected increase in hypertensive people in economically developing regions.
2American and European guidelines emphasize the importance of weight control, regular physical activity, moderate alcohol intake, and reduced sodium intake for the prevention of HTN and cardiovascular diseases. 3,4 A diet low in saturated and total fat and rich in fruit, vegetables, and low-fat dairy products substantially lowered blood pressure (BP) in the Dietary Approaches to Stop Hypertension (DASH) Trial. 5 Dairy products contain protein, minerals (eg, calcium, potassium, magnesium, and phosphorus), and vitamins (eg, folate and vitamin D, if fortified) that may individually or in combination reduce BP. [6][7][8] A recent meta-analysis of 5 prospective cohort studies showed significant inverse associations of total dairy, low-fat dairy, and fluid dairy foods with BP. 9 However, large variation in the types of dairy intake and serving sizes exists among populations, which has not yet been fully explored. Therefore, we conducted a dose-response meta-analysis of 9 populationbased cohort studies in which we examined total dairy, low-fat dairy, high-fat dairy, and different types of dairy products in relation to incidence of HTN.
Methods
Study SelectionA systematic literature search was conducted for articles on dairy consumption and BP or HTN, which were published until July 2011, using the databases of PubMed (www.ncbi.nlm.nih.gov/pubmed), Embase (www.embase.com), and Scopus (www.scopus.com). Titles and abstracts were screened to select prospective studies on dairy intake and HTN or BP changes over time. We identified a total of 1709 unique articles, from which we excluded animal studies, in vitro studies, comments, letters, editorials, ecological studies, and randomized controlled trials. Studies in children, adolescents and pregnant women, patients, and hypertensive populations were also excluded. Additional articles were found by checking bibliographies of cohort studies and reviews.Abstract-Observational and clinical studies suggest that dairy intake, particularly low-fat dairy, could have a beneficial effect on blood pressure. We performed a dose-response meta-analysis of prospective cohort studies on dairy intake and risk of hypertension in the general population. A systematic literature search for eligible studies was conducted until July 2011, using literature databases and hand search. Study-specific dose-response associations were computed according to the generalized least squares for trend estimation method, and linear and piecewise regression models were created. Random-effects models were performed with summarized dose-response data. We included 9 studies with a sample size of 57 256, a total of 15 367 incident hypertension cases, and a...