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Tse YH, Tuet CY, Lau KK, Tse HF. Dietary modification for prevention and control of high blood pressure. Postgrad Med J 2023; 99:1058-1067. [PMID: 37286197 DOI: 10.1093/postmj/qgad021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/16/2023] [Accepted: 01/31/2023] [Indexed: 06/09/2023]
Abstract
Hypertension (HT) remains the leading cause of cardiovascular and premature death around the world. Diet is one of the important factors that contributes to the development of HT. We review the current evidence of how different dietary factors may influence blood pressure (BP) and consequent development of HT. There is evidence that BP is positively associated with higher consumption of sodium, alcohol, animal-based protein such as red meat, low-quality carbohydrates such as sugar-sweetened beverages, and saturated fatty acids. On the contrary, other dietary constituents have BP-lowering effects. These include potassium, calcium, magnesium, yogurt, eggs, plant-based proteins such as soy and legumes, mono- and polyunsaturated fatty acids, and high-quality carbohydrates such as whole grain and fruits. Dietary fibre is unrelated to BP lowering, possibly due to the different mechanisms of various types of fibre. The effects of caffeine, hibiscus tea, pomegranate, and sesame on BP are also unclear as evidence is hard to assess due to the varying concentrations and different types of drinks used in studies. Implementing dietary changes such as the Dietary Approaches to Stop Hypertension (DASH diet) or adopting a Mediterranean diet has been shown to reduce and control BP. Although the effect of diet on BP control has been established, the optimal amount of each dietary component and consequent ability to devise a personalized diet for HT prevention and BP control for different populations still require further investigation.
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Affiliation(s)
- Yiu-Hei Tse
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Choi-Yee Tuet
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Kui-Kai Lau
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China
| | - Hung-Fat Tse
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Center for Translational Stem Cell Biology, Hong Kong, China
- Cardiac and Vascular Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, China
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Kwon YJ, Lee HS, Park G, Lee JW. Association between dietary sodium, potassium, and the sodium-to-potassium ratio and mortality: A 10-year analysis. Front Nutr 2022; 9:1053585. [PMID: 36438773 PMCID: PMC9691953 DOI: 10.3389/fnut.2022.1053585] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 10/25/2022] [Indexed: 10/05/2023] Open
Abstract
There is inconclusive evidence of the association between dietary sodium, potassium, and the sodium-to-potassium ratio and all-cause and cardiovascular disease mortality. To investigate the association between dietary sodium, potassium, and the sodium-to-potassium ratio and all-cause and cardiovascular disease mortality risks. Data from 143,050 adult participants were analyzed from prospective 10-year community-based cohort analysis. Dietary sodium, potassium, and the sodium-to-potassium ratio at baseline were assessed by a food frequency questionnaire. In Cox proportional hazards regression models, the association between dietary sodium, potassium, and their ratio and all-cause and cardiovascular disease mortality was estimated using hazard ratios and 95% confidence intervals, and their predictive ability as mortality predictors was evaluated using Harrell's c-index. During the mean (range) 10.1 (0.2-15.9) years of follow-up, 5,436 participants died, of whom 985 died of cardiovascular causes. After adjustment for age, sex, body mass index, alcohol intake, smoking, regular exercise, total calorie intake, dyslipidemia, hypertension, diabetes, chronic kidney diseases (CKDs), and potassium or sodium intake, respectively, sodium intake was unassociated with all-cause mortality whereas potassium intake was significantly associated inversely with all-cause (Quintile-5 vs. Quintile-1, hazard ratio, 95% confidence interval, 1.09, 0.97-1.22, and 0.79, 0.69-0.91, respectively). The sodium-to-potassium ratio was not significantly associated with all-cause mortality in the adjusted model, and similar trends were observed for cardiovascular disease mortality.
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Affiliation(s)
- Yu-Jin Kwon
- Department of Family Medicine, Yonsei University College of Medicine, Yongin Severance Hospital, Seoul, Gyeonggi, South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, South Korea
| | - Goeun Park
- Biomedical Statistics Center, Samsung Medical Center, Research Institute for Future Medicine, Seoul, South Korea
| | - Ji-Won Lee
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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Wang DD, Li Y, Bhupathiraju SN, Rosner BA, Sun Q, Giovannucci EL, Rimm EB, Manson JE, Willett WC, Stampfer MJ, Hu FB. Fruit and Vegetable Intake and Mortality: Results From 2 Prospective Cohort Studies of US Men and Women and a Meta-Analysis of 26 Cohort Studies. Circulation 2021; 143:1642-1654. [PMID: 33641343 DOI: 10.1161/circulationaha.120.048996] [Citation(s) in RCA: 157] [Impact Index Per Article: 52.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The optimal intake levels of fruit and vegetables for maintaining long-term health are uncertain. METHODS We followed 66 719 women from the Nurses' Health Study (1984-2014) and 42 016 men from the Health Professionals Follow-up Study (1986-2014) who were free from cardiovascular disease (CVD), cancer, and diabetes at baseline. Diet was assessed using a validated semiquantitative food frequency questionnaire at baseline and updated every 2 to 4 years. We also conducted a dose-response meta-analysis, including results from our 2 cohorts and 24 other prospective cohort studies. RESULTS We documented 33 898 deaths during the follow-up. After adjustment for known and suspected confounding variables and risk factors, we observed nonlinear inverse associations of fruit and vegetable intake with total mortality and cause-specific mortality attributable to cancer, CVD, and respiratory disease (all Pnonlinear<0.001). Intake of ≈5 servings per day of fruit and vegetables, or 2 servings of fruit and 3 servings of vegetables, was associated with the lowest mortality, and above that level, higher intake was not associated with additional risk reduction. In comparison with the reference level (2 servings/d), daily intake of 5 servings of fruit and vegetables was associated with hazard ratios (95% CI) of 0.87 (0.85-0.90) for total mortality, 0.88 (0.83-0.94) for CVD mortality, 0.90 (0.86-0.95) for cancer mortality, and 0.65 (0.59-0.72) for respiratory disease mortality. The dose-response meta-analysis that included 145 015 deaths accrued in 1 892 885 participants yielded similar results (summary risk ratio of mortality for 5 servings/d=0.87 [95% CI, 0.85-0.88]; Pnonlinear<0.001). Higher intakes of most subgroups of fruits and vegetables were associated with lower mortality, with the exception of starchy vegetables such as peas and corn. Intakes of fruit juices and potatoes were not associated with total and cause-specific mortality. CONCLUSIONS Higher intakes of fruit and vegetables were associated with lower mortality; the risk reduction plateaued at ≈5 servings of fruit and vegetables per day. These findings support current dietary recommendations to increase intake of fruits and vegetables, but not fruit juices and potatoes.
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Affiliation(s)
- Dong D Wang
- Channing Division for Network Medicine (D.D.W., S.N.B., B.A.R., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Nutrition (D.D.W., Y.L., S.N.B., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Harvard T. H. Chan School of Public Health, Boston, MA
| | - Yanping Li
- Department of Nutrition (D.D.W., Y.L., S.N.B., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Harvard T. H. Chan School of Public Health, Boston, MA
| | - Shilpa N Bhupathiraju
- Channing Division for Network Medicine (D.D.W., S.N.B., B.A.R., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Nutrition (D.D.W., Y.L., S.N.B., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Harvard T. H. Chan School of Public Health, Boston, MA
| | - Bernard A Rosner
- Channing Division for Network Medicine (D.D.W., S.N.B., B.A.R., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Biostatistics (B.A.R.), Harvard T. H. Chan School of Public Health, Boston, MA
| | - Qi Sun
- Channing Division for Network Medicine (D.D.W., S.N.B., B.A.R., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Nutrition (D.D.W., Y.L., S.N.B., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Harvard T. H. Chan School of Public Health, Boston, MA
| | - Edward L Giovannucci
- Department of Nutrition (D.D.W., Y.L., S.N.B., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Harvard T. H. Chan School of Public Health, Boston, MA.,Department of Epidemiology (E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Harvard T. H. Chan School of Public Health, Boston, MA
| | - Eric B Rimm
- Channing Division for Network Medicine (D.D.W., S.N.B., B.A.R., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Nutrition (D.D.W., Y.L., S.N.B., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Harvard T. H. Chan School of Public Health, Boston, MA.,Department of Epidemiology (E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Harvard T. H. Chan School of Public Health, Boston, MA
| | - JoAnn E Manson
- Channing Division for Network Medicine (D.D.W., S.N.B., B.A.R., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Division of Preventive Medicine, Department of Medicine (J.E.M.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Nutrition (D.D.W., Y.L., S.N.B., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Harvard T. H. Chan School of Public Health, Boston, MA.,Department of Epidemiology (E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Harvard T. H. Chan School of Public Health, Boston, MA
| | - Walter C Willett
- Channing Division for Network Medicine (D.D.W., S.N.B., B.A.R., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Nutrition (D.D.W., Y.L., S.N.B., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Harvard T. H. Chan School of Public Health, Boston, MA.,Department of Epidemiology (E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Harvard T. H. Chan School of Public Health, Boston, MA
| | - Meir J Stampfer
- Channing Division for Network Medicine (D.D.W., S.N.B., B.A.R., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Nutrition (D.D.W., Y.L., S.N.B., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Harvard T. H. Chan School of Public Health, Boston, MA.,Department of Epidemiology (E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Harvard T. H. Chan School of Public Health, Boston, MA
| | - Frank B Hu
- Channing Division for Network Medicine (D.D.W., S.N.B., B.A.R., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Nutrition (D.D.W., Y.L., S.N.B., Q.S., E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Harvard T. H. Chan School of Public Health, Boston, MA.,Department of Epidemiology (E.L.G., E.B.R., J.E.M., W.C.W., M.J.S., F.B.H.), Harvard T. H. Chan School of Public Health, Boston, MA
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Johns TS, Brown DD, Litwin AH, Goldson G, Buttar RS, Kreimerman J, Lo Y, Reidy KJ, Bauman L, Kaskel F, Melamed ML. Group-Based Care in Adults and Adolescents With Hypertension and CKD: A Feasibility Study. Kidney Med 2020; 2:317-325. [PMID: 32734251 PMCID: PMC7380347 DOI: 10.1016/j.xkme.2020.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Rationale & Objective Group-based care provides an opportunity to increase patient access to providers without increasing physician time and is effective in the management of chronic diseases in the general population. This model of care has not been investigated in chronic kidney disease (CKD). Study Design Randomized controlled trial in adults (n = 50); observational study in adolescents (n = 10). Setting & Participants Adults and adolescents with CKD and hypertension in the Bronx, NY. Intervention Group-based care (monthly sessions over 6 months) versus usual care in adults. All adolescents received group-based care and were analyzed separately. Outcomes Participant attendance and satisfaction with group-based care were used to evaluate intervention feasibility. The primary clinical outcome was change in mean 24-hour ambulatory blood pressure. Secondary outcomes included physical activity, medication adherence, quality of life, and sodium intake as assessed by 24-hour urinary sodium excretion and food frequency questionnaires. Results Among adults randomly assigned to group-based care, attendance was high (77% of participants attended ≥3 sessions) and most reported higher satisfaction. Mean 24-hour ambulatory systolic blood pressure decreased by −4.2 (95% CI, −13.3 to 5.8) mm Hg in group-based care patients compared with usual care at 6 months but this was not statistically significant. Similarly, we did not detect significant differences in health-related behaviors (such as medication adherence, sodium intake, and physical activity) or quality-of-life measures between the 2 groups. Among the adolescents, attendance was very poor; self-reported satisfaction, although high, did not change from baseline compared with the 6-month follow-up. Limitations Small study size, missing data. Conclusions Group-based care is feasible and acceptable among adults with hypertension and CKD. However, a larger trial is needed to determine the effect on blood pressure and health-related behaviors. Patient participation may limit the effectiveness of group-based care models in adolescents. Funding National Institutes of Health R34 DK102174. Trial registration https://clinicaltrials.gov/show/NCT02467894.
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Affiliation(s)
- Tanya S Johns
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
| | - Denver D Brown
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
| | - Alain H Litwin
- University of South Carolina School of Medicine-Greenville, Greenville, SC.,Greenville Health System, Greenville, SC
| | | | - Rupinder S Buttar
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
| | | | - Yungtai Lo
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
| | - Kimberly J Reidy
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
| | - Laurie Bauman
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
| | - Frederick Kaskel
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
| | - Michal L Melamed
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY
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Kolahdooz F, Nader F, Jang SL, Daemi M, Ezekowitz JA, Johnston N, Cruickshank K, Sharma S. Elevated Blood Pressure and Associations with Sodium Intake Among Multiethnic Youth in Edmonton, Canada: Findings from WHY ACT NOW. High Blood Press Cardiovasc Prev 2020; 27:239-249. [PMID: 32266707 DOI: 10.1007/s40292-020-00377-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/25/2020] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION This study examined the prevalence of pre-hypertension (PHT) and hypertension (HT) in urban youth, and assessed the effects of sodium intake and obesity on blood pressure (BP) by ethnicity. METHODS A convenience sample of 557 multiethnic youth, aged 11-23 years, was recruited from 12 schools and institutions in Edmonton, Alberta, Canada. Participants were divided by self-identified ethnicity into four groups (Indigenous, African and Middle Eastern (AME), Asian, and European). RESULTS Between October 2013 and March 2014, one-on-one interviews were conducted to collect data on demographics, physical activity, diet, and Body Mass Index (BMI). BP was obtained at two different times during the interview and measured a third time in cases of high variability. The standard deviation scores (SDS) of systolic BP (SBP) and diastolic BP (DBP) were used to estimate associations with sodium intake (per 1000 mg/day). Overall, 18.2% and 5.4% of the participants had PHT and HT, respectively. Indigenous and AME participants showed the highest rates of PHT (23.1%). Indigenous and European participants showed higher rates of HT (8.3% and 5.3%, respectively) than other ethnic groups (AME = 4.4%, Asian = 3.9%). There was a positive association between 1000 mg/day increase in sodium intake and SDS of SBP by 0.041 (95% CI 0.007-0.083; p = 0.04) among pre-hypertensive participants. Over 85% of participants exceeded the recommended dietary sodium intake. Mean BMI and dietary sodium intake were higher among pre-hypertensive participants (4219 mg/day) than normotensive (3475 mg/day). CONCLUSIONS The prevalence of HT varied by ethnicity. High dietary sodium intake was of concern. There is a need for culturally-tailored, population-based interventions to reduce sodium intake.
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Affiliation(s)
- Fariba Kolahdooz
- Indigenous and Global Health Research Group, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Unit 5-10 University Terrace, 8303-112 Street, Edmonton, AB, T6G 2T4, Canada
| | - Forouz Nader
- Indigenous and Global Health Research Group, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Unit 5-10 University Terrace, 8303-112 Street, Edmonton, AB, T6G 2T4, Canada
| | - Se Lim Jang
- Indigenous and Global Health Research Group, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Unit 5-10 University Terrace, 8303-112 Street, Edmonton, AB, T6G 2T4, Canada
| | - Maryam Daemi
- Indigenous and Global Health Research Group, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Unit 5-10 University Terrace, 8303-112 Street, Edmonton, AB, T6G 2T4, Canada
| | - Justin A Ezekowitz
- Canadian VIGOUR Centre, Department of Medicine, Faculty of Medicine and Denistry, University of Alberta, Edmonton, AB, Canada
| | - Nora Johnston
- Alberta Centre for Active Living, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | | | - Sangita Sharma
- Indigenous and Global Health Research Group, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Unit 5-10 University Terrace, 8303-112 Street, Edmonton, AB, T6G 2T4, Canada.
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Wang Y, Kuang ZM, Feng SJ, Jiang L, Chen QX, Ji XY, Cheng WL, Hu HJ. Combined antihypertensive and statin therapy for the prevention of cardiovascular events in patients with hypertension without complications: protocol for a systematic review and meta-analysis. BMJ Open 2018; 8:e019719. [PMID: 29858408 PMCID: PMC5988117 DOI: 10.1136/bmjopen-2017-019719] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION High blood pressure (BP) affects over 40% of adults over the age of 25 worldwide and is the leading global risk factor for death or disability. Hypertension is also the most important risk factor for endovascular atherosclerosis, which, when combined with other cardiovascular risk factors, leads to atherosclerotic cardiovascular disease (ASCVD). Statins are one of the most widely used drugs for the prevention of ASCVD. The recently announced study of Heart Outcomes Prevention Evaluation-3 suggests that cholesterol-lowering agents combined with antihypertensive therapy can prevent cardiovascular events and reduce the combined endpoint. We plan to conduct a systematic review and meta-analysis to evaluate whether combined antihypertensive and statin therapy is more beneficial than antihypertensive therapy alone in patients with hypertension without complications. METHODS AND ANALYSIS We will perform a comprehensive search for randomised controlled trials evaluating combined antihypertensive and statin therapy for the treatment of patients with hypertension. The following English electronic databases will be searched: The Cochrane Library, EMBASE and PubMed. Outcomes will be categorised as short-term (≤6 months) or long-term (>6 months). When evaluating the effects of combined antihypertensive and statin therapy, a short-term outcome is usually defined as a change in BP or lipid levels, while a long-term outcome is usually defined as cardiovascular benefits or risks. The data screening and extraction will be conducted by two different reviewers. The quality of the RCTs will be assessed according to the Cochrane handbook risk of bias tool. ETHICS AND DISSEMINATION This review does not require ethics approval and the results of the meta-analysis will be submitted to a peer-review journal. PROSPERO REGISTRATION NUMBER CRD42017071935.
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Affiliation(s)
- Ying Wang
- Department of Cardiology, The First People’s Hospital of Chenzhou, University of South China, Chenzhou, Hunan, China
| | - Ze-Min Kuang
- Department of Hypertension, Beijing Anzhen Hospital of Capital Medical University, Beijing, China
| | - Shu-Jun Feng
- Department of Cardiology, The First People’s Hospital of Chenzhou, University of South China, Chenzhou, Hunan, China
| | - Long Jiang
- Department of Cardiology, Institute of Cardiovascular Disease, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Qiu-Xian Chen
- Department of Medical Affairs, Hisun Pfizer Pharmaceuticals Co., Ltd, Shanghai, China
| | - Xiao-Yun Ji
- Department of Medical Affairs, Hisun Pfizer Pharmaceuticals Co., Ltd, Shanghai, China
| | - Wen-Li Cheng
- Department of Hypertension, Beijing Anzhen Hospital of Capital Medical University, Beijing, China
| | - Hong-Juan Hu
- Teaching and Research Section of Community Nursing, School of Nursing, University of South China, Hengyang, Hunan, China
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The relationship between obesity and hypertension: an updated comprehensive overview on vicious twins. Hypertens Res 2017; 40:947-963. [DOI: 10.1038/hr.2017.75] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/07/2017] [Accepted: 04/14/2017] [Indexed: 02/07/2023]
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Daily potassium intake and sodium-to-potassium ratio in the reduction of blood pressure: a meta-analysis of randomized controlled trials. J Hypertens 2016; 33:1509-20. [PMID: 26039623 DOI: 10.1097/hjh.0000000000000611] [Citation(s) in RCA: 162] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the efficacy of daily potassium intake on decreasing blood pressure in non-medicated normotensive or hypertensive patients, and to determine the relationship between potassium intake, sodium-to-potassium ratio and reduction in blood pressure. DESIGN Mixed-effect meta-analyses and meta-regression models. DATA SOURCES Medline and the references of previous meta-analyses. STUDIES ELIGIBILITY CRITERIA Randomized controlled trials with potassium supplementation, with blood pressure as the primary outcome, in non-medicated patients. RESULTS Fifteen randomized controlled trials of potassium supplementation in patients without antihypertensive medication were selected for the meta-analyses (917 patients). Potassium supplementation resulted in reduction of SBP by 4.7 mmHg [95% confidence interval (CI) 2.4-7.0] and DBP by 3.5 mmHg (95% CI 1.3-5.7) in all patients. The effect was found to be greater in hypertensive patients, with a reduction of SBP by 6.8 mmHg (95% CI 4.3-9.3) and DBP by 4.6 mmHg (95% CI 1.8-7.5). Meta-regression analysis showed that both increased daily potassium excretion and decreased sodium-to-potassium ratio were associated with blood pressure reduction (P < 0.05). Increased total daily potassium urinary excretion from 60 to 100 mmol/day and decrease of sodium-to-potassium ratio were shown to be necessary to explain the estimated effect. CONCLUSION Potassium supplementation is associated with reduction of blood pressure in patients who are not on antihypertensive medication, and the effect is significant in hypertensive patients. The reduction in blood pressure significantly correlates with decreased daily urinary sodium-to-potassium ratio and increased urinary potassium. Patients with elevated blood pressure may benefit from increased potassium intake along with controlled or decreased sodium intake.
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Dietary and lifestyle patterns in relation to high blood pressure in children: the GRECO study. J Hypertens 2016; 33:1174-81. [PMID: 25715091 DOI: 10.1097/hjh.0000000000000536] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of the present study was to investigate possible associations of dietary patterns with high blood pressure (BP) in a nationwide cross-sectional sample of 10-12 years old Greek schoolchildren. METHODS Anthropometric measurements and information on dietary (by a semi-quantitative food frequency questionnaire) and physical activity habits were obtained from the children. BPs was measured in a single occasion using a standard protocol. Data from 2024 normal energy reporting children were included in the analysis. Principal component analysis was applied to identify dietary patterns. RESULTS Seven dietary components (patterns) were extracted explaining 55% of the total variation in intake. Multiple logistic regression analysis revealed that predictors of high BP (75th percentile of SBP and/or DBP) were a pattern mainly characterized by the high consumption of cheese and red processed meat [odds ratio (OR) 1.15; 95% confidence intervals (CI) 1.03-1.30], being overweight (OR 2.10; 95% CI 1.61-2.73) or obese (OR 3.84; 95% CI 2.44-6.06) and breakfast frequency (OR 0.95; 95% CI 0.90-0.99). After controlling for sodium intake levels, the dietary pattern did not remain a significant predictor of high BP, indicating the potential mediating effect of sodium in the association. CONCLUSION A dietary pattern that is characterized by high cheese and red processed meat consumption increases the likelihood of having high BP in children, probably through increasing dietary sodium intake. These findings could guide future interventions or public health initiatives to prevent the increasing rates of childhood elevated BP levels.
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Borghi C, Cicero AFG. Nutraceuticals with a clinically detectable blood pressure-lowering effect: a review of available randomized clinical trials and their meta-analyses. Br J Clin Pharmacol 2016; 83:163-171. [PMID: 26852373 DOI: 10.1111/bcp.12902] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 02/02/2016] [Accepted: 02/02/2016] [Indexed: 12/19/2022] Open
Abstract
AIMS The aim of the present study was to review and comment on the available evidence on nutraceuticals with a clinically demonstrable blood pressure (BP)-lowering effect. METHODS We reviewed studies published in the English language from 1990 to 2015 on dietary supplements or nutraceuticals claiming to show an effect on human BP. An initial list of possibly effective agents and studies was obtained from the online reference, the Natural Medicine Comprehensive Database. Using PubMed, we searched agents identified from this list using the MeSH terms 'hypertension', 'blood pressure', 'dietary supplement' and 'nutraceuticals', alone and in combination. We then focused our attention on meta-analyses and randomized clinical trials. RESULTS Beyond the well-known effects on BP of the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet, a large number of studies have investigated the possible BP-lowering effect of different dietary supplements and nutraceuticals, most of which are antioxidant agents with a high tolerability and safety profile. In particular, a relatively large body of evidence supports the use of potassium, magnesium, L-arginine, vitamin C, cocoa flavonoids, beetroot juice, coenzyme Q10, controlled-release melatonin and aged garlic extract. The antihypertensive effect of all these nutraceuticals seems to be dose related and the overall tolerability is good. CONCLUSION Some nutraceuticals might have a positive impact on BP in humans. Further clinical research is needed, to identify from the available active nutraceuticals those with the best cost-effectiveness and risk-benefit ratio for widespread and long-term use in the general population with a low-added cardiovascular risk related to uncomplicated hypertension.
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Affiliation(s)
- Claudio Borghi
- Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - Arrigo F G Cicero
- Department of Medical and Surgical Sciences, University of Bologna, Italy
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Hütt P, Songisepp E, Rätsep M, Mahlapuu R, Kilk K, Mikelsaar M. Impact of probiotic Lactobacillus plantarum TENSIA in different dairy products on anthropometric and blood biochemical indices of healthy adults. Benef Microbes 2016; 6:233-43. [PMID: 25524863 DOI: 10.3920/bm2014.0035] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The blood pressure-lowering effect of dairy products holds the potential to decrease the risk of cardiovascular disease (CVD). An open question is if the successful expression of functional properties of the probiotic strain depends on host biomarkers and/or food matrix properties. The probiotic Lactobacillus plantarum strain TENSIA® (DSM 21380) is a novel microorganism with antimicrobial and antihypertensive functional properties. The aim of this study was to characterise the functional properties of the probiotic L. plantarum TENSIA and compare its effects on host anthropometric, clinical, and blood biomarkers when consumed with cheese or yoghurt. This study involved two double-blinded randomised placebo-controlled exploratory trials (ISRCTN15061552 and ISRCTN79645828) of healthy adults over a three-week period. The three-week consumption of probiotic L. plantarum TENSIA in a daily dose of 1×1010 cfu in probiotic cheese or a daily dose of 6×109 cfu in yoghurt with different content of carbohydrates, proteins, and lipids did not significantly change the body mass index (BMI), plasma glucose and lipid levels, or inflammatory markers in the blood. Reduced lowered systolic and diastolic blood pressure values were detected, regardless of food matrix or baseline values for blood pressure and BMI. In conclusion, our study showed that three-week consumption of the probiotic L. plantarum TENSIA either in cheese or yoghurt lowered diastolic and systolic blood pressure regardless of food matrix and baseline values of blood pressure and BMI, confirming the impact of the functional properties of the probiotic strain in decreasing CVD risk.
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Affiliation(s)
- P Hütt
- Bio-Competence Centre of Healthy Dairy Products LLC, Kreutzwaldi 1, 51014, Tartu, Estonia Department of Microbiology, Faculty of Medicine, University of Tartu, Ravila 19, Tartu 50411, Estonia
| | - E Songisepp
- Bio-Competence Centre of Healthy Dairy Products LLC, Kreutzwaldi 1, 51014, Tartu, Estonia
| | - M Rätsep
- Bio-Competence Centre of Healthy Dairy Products LLC, Kreutzwaldi 1, 51014, Tartu, Estonia
| | - R Mahlapuu
- Department of Bio- and Translational Medicine, Faculty of Medicine, University of Tartu, Ravila 19, Tartu 50411, Estonia
| | - K Kilk
- Department of Bio- and Translational Medicine, Faculty of Medicine, University of Tartu, Ravila 19, Tartu 50411, Estonia
| | - M Mikelsaar
- Department of Microbiology, Faculty of Medicine, University of Tartu, Ravila 19, Tartu 50411, Estonia
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Becerra-Tomás N, Guasch-Ferré M, Quilez J, Merino J, Ferré R, Díaz-López A, Bulló M, Hernández-Alonso P, Palau-Galindo A, Salas-Salvadó J. Effect of Functional Bread Rich in Potassium, γ-Aminobutyric Acid and Angiotensin-Converting Enzyme Inhibitors on Blood Pressure, Glucose Metabolism and Endothelial Function: A Double-blind Randomized Crossover Clinical Trial. Medicine (Baltimore) 2015; 94:e1807. [PMID: 26579797 PMCID: PMC4652806 DOI: 10.1097/md.0000000000001807] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Because it has been suggested that food rich in γ-aminobutyric acid (GABA) or angiotensin-converting enzyme inhibitor (ACEI) peptides have beneficial effects on blood pressure (BP) and other cardiovascular risk factors, we tested the effects of low-sodium bread, but rich in potassium, GABA, and ACEI peptides on 24-hour BP, glucose metabolism, and endothelial function.A randomized, double-blind, crossover trial was conducted in 30 patients with pre or mild-to-moderate hypertension, comparing three 4-week nutritional interventions separated by 2-week washout periods. Patients were randomly assigned to consume 120 g/day of 1 of the 3 types of bread for each nutritional intervention: conventional wheat bread (CB), low-sodium wheat bread enriched in potassium (LSB), and low-sodium wheat bread rich in potassium, GABA, and ACEI peptides (LSB + G). For each period, 24-hour BP measurements, in vivo endothelial function, and biochemical samples were obtained.After LSB + G consumption, 24-hour ambulatory BP underwent a nonsignificant greater reduction than after the consumption of CB and LSB (0.26 mm Hg in systolic BP and -0.63 mm Hg in diastolic BP for CB; -0.71 mm Hg in systolic BP and -1.08 mm Hg in diastolic BP for LSB; and -0.75 mm Hg in systolic BP and -2.12 mm Hg in diastolic BP for LSB + G, respectively). Diastolic BP at rest decreased significantly during the LSB + G intervention, although there were no significant differences in changes between interventions. There were no significant differences between interventions in terms of changes in in vivo endothelial function, glucose metabolism, and peripheral inflammatory parameters.Compared with the consumption of CB or LSB, no greater beneficial effects on 24-hour BP, endothelial function, or glucose metabolism were demonstrated after the consumption of LSB + G in a population with pre or mild-to-moderate hypertension. Further studies are warranted to clarify the effect of GABA on BP, preferably using a specific design for noninferiority trials and ambulatory BP monitoring as a measure of BP.This study was registered at Current Controlled Trials as ISRCTN31436822.
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Affiliation(s)
- Nerea Becerra-Tomás
- From the Human Nutrition Unit, Faculty of Medicine and Health Sciences, Biochemistry and Biotechnology Department, Universitat Rovira i Virgili, and Hospital Universitari de Sant Joan de Reus, IISPV, Reus (NB-T, MG-F, AD-L, MB, PH-A, JS-S); CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid (NB-T, MG-F, JQ, AD-L, MB, PH-A, JS-S); Blanquerna School of Health Science, Universitat Ramon Llull (JQ); Vascular Medicine and Metabolism Unit, Lipids and Atherosclerosis Research Unit, Sant Joan University Hospital, IISPV, Faculty of Medicine, Universitat Rovira i Virgili, The Biomedical Research Network in Diabetes and Associated Metabolic Disorders (CIBERDEM), Barcelona (JM, RF); and ABS Reus V. Centre d'Assistència Primària Marià Fortuny, SAGESSA, Reus, Spain (AP-G)
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13
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Mirmiran P, Golzarand M, Bahadoran Z, Mirzaei S, Azizi F. High-fat dairy is inversely associated with the risk of hypertension in adults: Tehran lipid and glucose study. Int Dairy J 2015. [DOI: 10.1016/j.idairyj.2014.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Abstract
Elevated blood pressure arises from a combination of environmental and genetic factors and the interactions of these factors. A substantial body of evidence from animal studies, epidemiologic studies, meta-analyses, and randomized controlled trials has demonstrated that certain dietary patterns and individual dietary elements play a prominent role in the development of hypertension. Changes in diet can lower blood pressure, prevent the development of hypertension, and reduce the risk of hypertension-related complications. Dietary strategies for the prevention of hypertension include reducing sodium intake, limiting alcohol consumption, increasing potassium intake, and adopting an overall dietary pattern such as the DASH (Dietary Approaches to Stop Hypertension) diet or a Mediterranean diet. In order to reduce the burden of blood pressure-related complications, efforts that focus on environmental and individual behavioral changes that encourage and promote healthier food choices are warranted.
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Alessi A, Brandão AA, de Paiva AMG, Nogueira ADR, Feitosa A, Gonzaga CDC, Amodeo C, Mion D, de Souza DDSM, Barbosa E, Lima Junior E, Nobre F, Fuchs FD, Chaves Junior H, Schneider JC, Gemelli J, Villela-Martin JF, Scala LCN, Gomes MAM, Malachias MVB, de Morais NS, Moreira Filho O, Passarelli Junior O, Jardim PCBV, Miranda RD, Póvoa R, Fuchs SC, Baiocchi S, Jardim TV, Barroso WKS. I Brazilian position paper on prehypertension, white coat hypertension and masked hypertension: diagnosis and management. Arq Bras Cardiol 2014; 102:110-8. [PMID: 24676366 PMCID: PMC3987343 DOI: 10.5935/abc.20140011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 12/03/2013] [Accepted: 12/03/2013] [Indexed: 01/22/2023] Open
Affiliation(s)
- Alexandre Alessi
- Brazilian Society of Cardiology Arterial Hypertension Department
| | | | | | | | - Audes Feitosa
- Brazilian Society of Cardiology Arterial Hypertension Department
| | | | - Celso Amodeo
- Brazilian Society of Cardiology Arterial Hypertension Department
| | - Decio Mion
- Brazilian Society of Cardiology Arterial Hypertension Department
| | | | - Eduardo Barbosa
- Brazilian Society of Cardiology Arterial Hypertension Department
| | | | - Fernando Nobre
- Brazilian Society of Cardiology Arterial Hypertension Department
| | | | | | | | - João Gemelli
- Brazilian Society of Cardiology Arterial Hypertension Department
| | | | | | | | | | | | | | | | | | | | - Rui Póvoa
- Brazilian Society of Cardiology Arterial Hypertension Department
| | | | - Sergio Baiocchi
- Brazilian Society of Cardiology Arterial Hypertension Department
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Horrigan LA, Holohan CA, Lawless GA, Murtagh MA, Williams CT, Webster CM. Blueberry juice causes potent relaxation of rat aortic rings via the activation of potassium channels and the H₂S pathway. Food Funct 2013; 4:392-400. [PMID: 23175156 DOI: 10.1039/c2fo30205e] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The objective of this study was to investigate the in vitro effects of blueberry juice on healthy rat aortic rings, and to explore the roles of potassium channels and of the hydrogen sulphide (H(2)S) pathway in mediating the effects of blueberry juice. Firstly, the antioxidant capacity of blueberry juice was compared to other popular juice drinks using the Folin-Ciocalteu and the DPPH assays. Blueberry juice had significantly higher total polyphenol content than any of the other drinks studied (p < 0.01). The effect of blueberry juice on noradrenaline-contracted aortic rings was then observed, and the juice caused significant inhibition of noradrenaline-induced contractions (p < 0.01). Voltage-gated potassium channel (Kv) blockers 4-aminopyridine (1 mM) and 3,4-diaminopyridine (1 mM), as well as the cystathionine γ-lysase (CSE) inhibitor d,l-propargylglycine (2 mM) were then utilised to elucidate the role of Kv channels and the CSE/H(2)S pathway. Kv channel blocker 3,4-diaminopyridine caused significant blockade at 1/100 and 1/50 dilutions of juice (p < 0.01), whilst 4-aminopyridine caused significant blockade of the 1/100 dilution of blueberry juice (p < 0.05). In addition, d,l-propargylglycine potently inhibited the effect of 1/100 and 1/50 dilutions of blueberry juice (p < 0.01). This study indicates that blueberry juice has potent vasorelaxing properties, and thus may be a useful dietary agent for the prevention and treatment of hypertension. This study also provides strong evidence that Kv channels and the CSE/H(2)S pathway may be responsible, at least in part, for mediating the effects of blueberry juice.
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Affiliation(s)
- Louise A Horrigan
- Physiology, School of Medicine, National University of Ireland, Galway, Ireland.
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Brook RD, Appel LJ, Rubenfire M, Ogedegbe G, Bisognano JD, Elliott WJ, Fuchs FD, Hughes JW, Lackland DT, Staffileno BA, Townsend RR, Rajagopalan S. Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the american heart association. Hypertension 2013; 61:1360-83. [PMID: 23608661 DOI: 10.1161/hyp.0b013e318293645f] [Citation(s) in RCA: 359] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Many antihypertensive medications and lifestyle changes are proven to reduce blood pressure. Over the past few decades, numerous additional modalities have been evaluated in regard to their potential blood pressure-lowering abilities. However, these nondietary, nondrug treatments, collectively called alternative approaches, have generally undergone fewer and less rigorous trials. This American Heart Association scientific statement aims to summarize the blood pressure-lowering efficacy of several alternative approaches and to provide a class of recommendation for their implementation in clinical practice based on the available level of evidence from the published literature. Among behavioral therapies, Transcendental Meditation (Class IIB, Level of Evidence B), other meditation techniques (Class III, Level of Evidence C), yoga (Class III, Level of Evidence C), other relaxation therapies (Class III, Level of Evidence B), and biofeedback approaches (Class IIB, Level of Evidence B) generally had modest, mixed, or no consistent evidence demonstrating their efficacy. Between the noninvasive procedures and devices evaluated, device-guided breathing (Class IIA, Level of Evidence B) had greater support than acupuncture (Class III, Level of Evidence B). Exercise-based regimens, including aerobic (Class I, Level of Evidence A), dynamic resistance (Class IIA, Level of Evidence B), and isometric handgrip (Class IIB, Level of Evidence C) modalities, had relatively stronger supporting evidence. It is the consensus of the writing group that it is reasonable for all individuals with blood pressure levels >120/80 mm Hg to consider trials of alternative approaches as adjuvant methods to help lower blood pressure when clinically appropriate. A suggested management algorithm is provided, along with recommendations for prioritizing the use of the individual approaches in clinical practice based on their level of evidence for blood pressure lowering, risk-to-benefit ratio, potential ancillary health benefits, and practicality in a real-world setting. Finally, recommendations for future research priorities are outlined.
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Landsberg L, Aronne LJ, Beilin LJ, Burke V, Igel LI, Lloyd-Jones D, Sowers J. Obesity-related hypertension: pathogenesis, cardiovascular risk, and treatment--a position paper of the The Obesity Society and The American Society of Hypertension. Obesity (Silver Spring) 2013; 21:8-24. [PMID: 23401272 DOI: 10.1002/oby.20181] [Citation(s) in RCA: 175] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 10/18/2012] [Indexed: 01/11/2023]
Abstract
In light of the worldwide epidemic of obesity, and in recognition of hypertension as a major factor in the cardiovascular morbidity and mortality associated with obesity, The Obesity Society and The American Society of Hypertension agreed to jointly sponsor a position paper on obesity-related hypertension to be published jointly in the journals of each society. The purpose is to inform the members of both societies, as well as practicing clinicians, with a timely review of the association between obesity and high blood pressure, the risk that this association entails, and the options for rational, evidenced-based treatment. The position paper is divided into six sections plus a summary as follows: pathophysiology, epidemiology and cardiovascular risk, the metabolic syndrome, lifestyle management in prevention and treatment, pharmacologic treatment of hypertension in the obese, and the medical and surgical treatment of obesity in obese hypertensive patients.
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Affiliation(s)
- Lewis Landsberg
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
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Landsberg L, Aronne LJ, Beilin LJ, Burke V, Igel LI, Lloyd-Jones D, Sowers J. Obesity-related hypertension: pathogenesis, cardiovascular risk, and treatment: a position paper of The Obesity Society and the American Society of Hypertension. J Clin Hypertens (Greenwich) 2012; 15:14-33. [PMID: 23282121 DOI: 10.1111/jch.12049] [Citation(s) in RCA: 283] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In light of the worldwide epidemic of obesity, and in recognition of hypertension as a major factor in the cardiovascular morbidity and mortality associated with obesity, The Obesity Society and the American Society of Hypertension agreed to jointly sponsor a position paper on obesity-related hypertension to be published jointly in the journals of each society. The purpose is to inform the members of both societies, as well as practicing clinicians, with a timely review of the association between obesity and high blood pressure, the risk that this association entails, and the options for rational, evidenced-based treatment. The position paper is divided into six sections plus a summary as follows: pathophysiology, epidemiology and cardiovascular risk, the metabolic syndrome, lifestyle management in prevention and treatment, pharmacologic treatment of hypertension in the obese, and the medical and surgical treatment of obesity in obese hypertensive patients.
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Affiliation(s)
- Lewis Landsberg
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
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Affiliation(s)
- Joan Quilez
- Human Nutrition Unit, School of Medicine, IISSPV, Universitat Rovira i Virgili, Reus, Spain, and CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain.
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Martos E, Bakacs M, Sarkadi-Nagy E, Ráczkevy T, Zentai A, Baldauf Z, Illés E, Lugasi A. [Hungarian Diet and Nutritional Status Survey - the OTAP2009 study. IV. Macroelement intake of the Hungarian population]. Orv Hetil 2012; 153:1132-41. [PMID: 22805039 DOI: 10.1556/oh.2012.29378] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
UNLABELLED The adequate intake of minerals is basically important for healthy nutrition. AIM AND METHOD The Hungarian Diet and Nutritional Status Survey - joining to the European Health Interview Survey - studied the dietary habits of the Hungarian population. The present publication describes the macroelement intake. RESULTS The salt intake is unusually high (17.2 g in men and 12.0 g in women), the potassium intake remains well below the recommendation. These factors substantially increase the risk of cardiovascular diseases including high blood-pressure. The calcium intake stays below the recommendation except in the youngest males, the oldest men and women are at risk from this point of view. While magnesium intake suited the recommendation, the intake of phosphorus exceeded it twice. CONCLUSIONS Focusing on marcroelements, high sodium/salt intake represents the highest public health risk. The implementation of STOP SALT! National Salt Reducing Programme, i.e. decrease the salt content of processed food and provide proper information to the population about excessive salt consumption, should result in a beneficial change of salt intake and ameliorate the public health conditions.
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Affiliation(s)
- Eva Martos
- Országos Élelmezés- és Táplálkozástudományi Intézet Budapest Gyáli.
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Mohanlal V, Parsa A, Weir MR. Role of dietary therapies in the prevention and treatment of hypertension. Nat Rev Nephrol 2012; 8:413-22. [PMID: 22585275 DOI: 10.1038/nrneph.2012.91] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Blood pressure naturally rises with increasing age. The rate of change in blood pressure with age is regulated in part by genetic factors, but can also be altered through sustained dietary modification. Dietary approaches to modify blood pressure remain an important part of cardiovascular health promotion, which is especially important given the aging of the general population coupled with the increasing prevalence of obesity and metabolic disturbances. Specific modification of dietary components such as macronutrients and micronutrients could be helpful to lower blood pressure and alter the slope of blood pressure change whereas nutritional supplements are less likely to have a substantial beneficial effect. Population-wide generalizations regarding diet are impractical as individualized strategies are more likely to be successful in facilitating long-term benefits in improving blood-pressure control. Consequently, more effort needs to be focused on evaluating data from large-scale observational and interventional studies and interpreting their information in a clinically relevant manner, which is likely to be helpful for individual patients. Providing education on the relationship between diet and blood pressure from an early age is most likely to produce tangible benefits.
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Affiliation(s)
- Viresh Mohanlal
- Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201, USA
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Heraclides A, Mishra GD, Hardy RJ, Geleijnse JM, Black S, Prynne CJ, Kuh D, Soedamah-Muthu SS. Dairy intake, blood pressure and incident hypertension in a general British population: the 1946 birth cohort. Eur J Nutr 2011; 51:583-91. [PMID: 21877233 DOI: 10.1007/s00394-011-0242-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Accepted: 08/16/2011] [Indexed: 02/07/2023]
Abstract
PURPOSE We aimed to examine the association between intake of different subgroups of dairy products and blood pressure and incident hypertension 10 years later, adjusting for confounding factors. METHODS We studied 1,750 British men and women from the 1946 British birth cohort from 1989 to 1999 (age 43 and 53 years, respectively). Diet was assessed by 5-day food diaries using photographs in the estimation of portion size. Systolic (sbp) and diastolic (dbp) blood pressure and prevalent hypertension were assessed at age 43 and 53 years. Linear regression and logistic regression were used to examine 10-year blood pressure levels and incident hypertension by baseline dairy intake. RESULTS There was a weak non-significant trend of a protective effect of total dairy intake on blood pressure and incident hypertension, but no evidence for a dose-response relationship (OR for incident hypertension: 0.88 (95% CI 0.68;1.14) 2nd vs. 1st tertile and 0.93 (95% CI 0.72;1.18) 3rd vs. 1st tertile). Higher intake of low-fat and fermented dairy was linked to a higher sbp but in a nonlinear manner. Adjustment for other dietary factors, health behaviours and BMI attenuated these associations. CONCLUSIONS Total dairy intake and specific dairy subgroups were not associated with blood pressure and incident hypertension among a representative sample of British adults after adjustment for confounding factors.
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