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Dietary contributors to hypertension in adults reviewed

Irish Journal of Medical Science (1971 -) volume 184, pages 81–90 (2015)Cite this article

Abstract

Recent national surveys which measured respondents’ blood pressure (BP) levels have shown a high prevalence of hypertension amongst the Irish population, with approximately two-thirds of men and over half of women aged 45 years and over affected. Higher prevalence rates are observed with advancing age. Established diet- and lifestyle-related risk factors for hypertension such as high salt intake, high alcohol consumption and physical inactivity are pervasive in Ireland and are believed to contribute significantly to the high national prevalence of this condition. Additional dietary deficits have been implicated in the development of hypertension, however, including low fruit and vegetable intake, low dairy food consumption and low intake of oily fish. Deficiencies of single micro-nutrients such as folate, riboflavin, vitamin C and vitamin D have also been recently recognised as risk factors for hypertension. For each of these factors, there is evidence that the food and nutrient intakes of many Irish adults fall short of the ideal. These dietary and nutritional deficits, when superimposed on Ireland’s existing health-subversive behaviours and escalating rates of obesity, constitute a potent constellation of risk factors for hypertension. However, they also represent viable and potentially effective targets for health promotion initiatives. This review aims to describe the main nutritional, dietary and lifestyle contributors to hypertension in Ireland with a view to informing future interventions aimed at alleviating Ireland’s burden of hypertensive disease.

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References

  1. Contratto AW, Rogers MB (1948) The use of the rice diet in the treatment of hypertension in nonhospitalized patients. N Engl J Med 239:531–536

    Article  CAS  PubMed  Google Scholar 

  2. Oliver WJ, Cohen EL, Neel JV (1975) Blood pressure, sodium intake, and sodium related hormones in the Yanomamo Indians, a “no-salt” culture. Circulation 52:146–151

    Article  CAS  PubMed  Google Scholar 

  3. Meneely GR, Battarbee HD (1976) High sodium-low potassium environment and hypertension. Am J Cardiol 38:768–785

    Article  CAS  PubMed  Google Scholar 

  4. Morgan T, Adam W, Gillies A et al (1978) Hypertension treated by salt restriction. Lancet 1(8058):227–230

    Article  CAS  PubMed  Google Scholar 

  5. Swaye PS, Gifford RW Jr, Berrettoni JN (1972) Dietary salt and essential hypertension. Am J Cardiol 29:33–38

    Article  CAS  PubMed  Google Scholar 

  6. Pratt JH, Luft FC (1979) The effect of extremely high sodium intake on plasma renin activity, plasma aldosterone concentration, and urinary excretion of aldosterone metabolites. J Lab Clin Med 93:724–729

    CAS  PubMed  Google Scholar 

  7. Luft FC, Weinberger MH (1982) Sodium intake and essential hypertension. Hypertension. 4:III14-9

  8. Law MR, Frost CD, Wald NJ (1991) By how much does dietary salt reduction lower blood pressure? III–Analysis of data from trials of salt reduction. BMJ 302:819–824

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  9. He FJ, MacGregor GA (2009) A comprehensive review on salt and health and current experience of worldwide salt reduction programmes. J Hum Hypertens 23:363–384. doi:10.1038/jhh.2008.144

    Article  CAS  PubMed  Google Scholar 

  10. He FJ, Li J, MacGregor GA (2013) Effect of longer term modest salt reduction on blood pressure: cochrane systematic review and meta-analysis of randomised trials. BMJ 346:f1325. doi:10.1136/bmj.f1325

    Article  PubMed  Google Scholar 

  11. Appel LJ, Moore TJ, Obarzanek E et al (1997) A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 336:1117–1124

    Article  CAS  PubMed  Google Scholar 

  12. Hikmat F, Appel LJ (2014) Effects of the DASH diet on blood pressure in patients with and without metabolic syndrome: results from the DASH trial. J Hum Hypertens 28:170–175. doi:10.1038/jhh.2013.52

    Article  CAS  PubMed  Google Scholar 

  13. Karppanen H, Karppanen P, Mervaala E (2005) Why and how to implement sodium, potassium, calcium, and magnesium changes in food items and diets? J Hum Hypertens 19(Suppl 3):S10–S19

    Article  CAS  PubMed  Google Scholar 

  14. Juraschek SP, Guallar E, Appel LJ et al (2012) Effects of vitamin C supplementation on blood pressure: a meta-analysis of randomized controlled trials. Am J Clin Nutr 95:1079–1088. doi:10.3945/ajcn.111.027995

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Ciccone MM, Cortese F, Gesualdo M et al (2013) Dietary intake of carotenoids and their antioxidant and anti-inflammatory effects in cardiovascular care. Mediators Inflamm 2013:782137. doi:10.1155/2013/782137

    Article  PubMed Central  PubMed  Google Scholar 

  16. Hozawa A, Jacobs DR Jr, Steffes MW et al (2009) Circulating carotenoid concentrations and incident hypertension: the Coronary Artery Risk Development in Young Adults (CARDIA) study. J Hypertens 27:237–242. doi:10.1097/HJH.0b013e32832258c9

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Kukongviriyapan U, Sompamit K, Pannangpetch P et al (2012) Preventive and therapeutic effects of quercetin on lipopolysaccharide-induced oxidative stress and vascular dysfunction in mice. Can J Physiol Pharmacol 90:1345–1353. doi:10.1139/y2012-101

    Article  CAS  PubMed  Google Scholar 

  18. Huang WY, Davidge ST, Wu J (2013) Bioactive natural constituents from food sources-potential use in hypertension prevention and treatment. Crit Rev Food Sci Nutr 53:615–630. doi:10.1080/10408398.2010.550071

    Article  CAS  PubMed  Google Scholar 

  19. Di Tomo P, Canali R, Ciavardelli D et al (2012) β-Carotene and lycopene affect endothelial response to TNF-α reducing nitro-oxidative stress and interaction with monocytes. Mol Nutr Food Res 56:217–227. doi:10.1002/mnfr.201100500

    Article  PubMed  Google Scholar 

  20. Karppi J, Kurl S, Ronkainen K et al (2013) Serum carotenoids reduce progression of early atherosclerosis in the carotid artery wall among Eastern Finnish men. PLoS One 8:e64107. doi:10.1371/journal.pone.0064107

    Article  PubMed Central  PubMed  Google Scholar 

  21. Kim OY, Yoe HY, Kim HJ et al (2010) Independent inverse relationship between serum lycopene concentration and arterial stiffness. Atherosclerosis. 208:581–586. doi:10.1016/j.atherosclerosis.2009.08.009

    Article  CAS  PubMed  Google Scholar 

  22. Sacks FM, Svetkey LP, Vollmer WM et al for the DASH-Sodium Collaborative Research Group (2001) Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med 344:3–10

    Article  Google Scholar 

  23. Svetkey LP, Simons-Morton DG, Proschan MA et al (2004) Effect of the dietary approaches to stop hypertension diet and reduced sodium intake on blood pressure control. J Clin Hypertens (Greenwich). 6:373–381

    Article  Google Scholar 

  24. Needleman P, Whitaker MO, Wyche A et al (1980) Manipulation of platelet aggregation by prostaglandins and their fatty acid precursors: pharmacological basis for a therapeutic approach. Prostaglandins 19:165–181

    Article  CAS  PubMed  Google Scholar 

  25. Lam BK, Marcinkiewicz E, Quilley J et al (1986) Hypotensive effects of eicosapentaenoic acid (EPA) and its influence on eicosanoid metabolism in spontaneously hypertensive rats. J Hypertens 4:S453–S455

    CAS  Google Scholar 

  26. Singer P, Jaeger W, Wirth M et al (1983) Lipid and blood pressure-lowering effect of mackerel diet in man. Atherosclerosis. 49:99–108

    Article  CAS  PubMed  Google Scholar 

  27. Campbell F, Dickinson HO, Critchley JA et al (2013) A systematic review of fish-oil supplements for the prevention and treatment of hypertension. Eur J Prev Cardiol. 20:107–120. doi:10.1177/2047487312437056

    Article  PubMed  Google Scholar 

  28. Erkkilä AT, Schwab US, de Mello VD et al (2008) Effects of fatty and lean fish intake on blood pressure in subjects with coronary heart disease using multiple medications. Eur J Nutr 47:319–328. doi:10.1007/s00394-008-0728-5

    Article  PubMed  Google Scholar 

  29. Ciccone MM, Scicchitano P, Gesualdo M et al (2013) The role of omega-3 polyunsaturated fatty acids supplementation in childhood: a review. Recent Pat Cardiovasc Drug Discov 8:42–55

    Article  CAS  PubMed  Google Scholar 

  30. Puddy IB, Beilin LJ (2006) Alcohol is bad for blood pressure. Clin Exp Pharmacol Physiol 33:847–852

    Article  Google Scholar 

  31. Abramson JL, Lewis C, Murrah NV (2010) Relationship of self-reported alcohol consumption to ambulatory blood pressure in a sample of healthy adults. Am J Hypertens 23:994–999. doi:10.1038/ajh.2010.109

    Article  PubMed  Google Scholar 

  32. Malik VS, Schulze MB, Hu FB (2006) Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr 84:274–288

    PubMed Central  CAS  PubMed  Google Scholar 

  33. Mozaffarian D, Hao T, Rimm EB et al (2011) Changes in diet and lifestyle and long-term weight gain in women and men. N Engl J Med 364:2392–2404. doi:10.1056/NEJMoa1014296

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  34. Laska MN, Murray DM, Lytle LA et al (2012) Longitudinal associations between key dietary behaviors and weight gain over time: transitions through the adolescent years. Obesity (Silver Spring) 20:118–125. doi:10.1038/oby.2011.179

    Article  Google Scholar 

  35. Te Morenga L, Mallard S, Mann J (2013) Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ 345:e7492. doi:10.1136/bmj.e7492

    Google Scholar 

  36. Hu FB (2013) Resolved: there is sufficient scientific evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases. Obes Rev 14:606–619. doi:10.1111/obr.12040

    Article  CAS  PubMed  Google Scholar 

  37. Gibson S, Neate D (2007) Sugar intake, soft drink consumption and body weight among British children: further analysis of National Diet and Nutrition Survey data with adjustment for under-reporting and physical activity. Int J Food Sci Nutr 58:445–460

    Article  CAS  PubMed  Google Scholar 

  38. Stanhope KL (2012) Role of fructose-containing sugars in the epidemics of obesity and metabolic syndrome. Annu Rev Med 63:329–343. doi:10.1146/annurev-med-042010-113026

    Article  CAS  PubMed  Google Scholar 

  39. Green AK, Jacques PF, Rogers G et al (2014) Sugar-sweetened beverages and prevalence of the metabolically abnormal phenotype in the Framingham heart study. Obesity (Silver Spring). 22:E157–E163. doi:10.1002/oby.20724

    Article  CAS  PubMed  Google Scholar 

  40. Stanhope KL, Schwarz JM, Keim NL et al (2009) Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. J Clin Invest. 119:1322–1334. doi:10.1172/JCI37385

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  41. Brown IJ, Stamler J, Van Horn L et al for the International Study of Macro/Micronutrients and Blood Pressure Research Group (2011) Sugar-sweetened beverage, sugar intake of individuals, and their blood pressure: international study of macro/micronutrients and blood pressure. Hypertension 57:695–701. doi:10.1161/HYPERTENSIONAHA.110.165456

    Article  Google Scholar 

  42. Barrio-Lopez MT, Martinez-Gonzalez MA, Fernandez-Montero A et al (2013) Prospective study of changes in sugar-sweetened beverage consumption and the incidence of the metabolic syndrome and its components: the SUN cohort. Br J Nutr 110:1722–1731. doi:10.1017/S0007114513000822

    Article  CAS  PubMed  Google Scholar 

  43. Signorello MG, Viviani GL, Armani U et al (2007) Homocysteine, reactive oxygen species and nitric oxide in type 2 diabetes mellitus. Thromb Res 120:607–613

    Article  CAS  PubMed  Google Scholar 

  44. Dominguez LJ, Galioto A, Pineo A et al (2010) Age, homocysteine, and oxidative stress: relation to hypertension and type 2 diabetes mellitus. J Am Coll Nutr 29:1–6

    Article  CAS  PubMed  Google Scholar 

  45. Ward M, Wilson CP, Strain JJ et al (2011) B-vitamins, methylenetetrahydrofolate reductase (MTHFR) and hypertension. Int J Vitam Nutr Res 81:240–244. doi:10.1024/0300-9831/a000069

    Article  CAS  PubMed  Google Scholar 

  46. Wilson CP, Ward M, McNulty H, Strain JJ, Trouton TG, Horigan G, Purvis J, Scott JM (2012) Riboflavin offers a targeted strategy for managing hypertension in patients with the MTHFR 677TT genotype: a 4-y follow-up. Am J Clin Nutr 95:766–772. doi:10.3945/ajcn.111.026245

    Article  CAS  PubMed  Google Scholar 

  47. Vaidya A, Williams JS (2010) The relationship between vitamin D and the renin-angiotensin system in the pathophysiology of hypertension, kidney disease, and diabetes. Metabolism. 61:450–458. doi:10.1016/j.metabol.2011.09.007

    Article  Google Scholar 

  48. Vaidya A, Sun B, Larson C et al (2012) Vitamin D3 therapy corrects the tissue sensitivity to angiotensin ii akin to the action of a converting enzyme inhibitor in obese hypertensives: an interventional study. J Clin Endocrinol Metab 97:2456–2465. doi:10.1210/jc.2012-1156

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  49. Sypniewska G, Pollak J, Strozecki P et al (2014) 25-hydroxyvitamin D, biomarkers of endothelial dysfunction and subclinical organ damage in adults with hypertension. Am J Hypertens 27:114–121. doi:10.1093/ajh/hpt174

    Article  CAS  PubMed  Google Scholar 

  50. Brenner DR, Arora P, Garcia-Bailo B et al (2011) Plasma vitamin D levels and risk of metabolic syndrome in Canadians. Clin Invest Med 34:E377

    CAS  PubMed  Google Scholar 

  51. Witham MD, Price RJ, Struthers AD et al (2013) Cholecalciferol treatment to reduce blood pressure in older patients with isolated systolic hypertension: the VitDISH randomized controlled trial. JAMA Intern Med. 173:1672–1679

    CAS  PubMed  Google Scholar 

  52. Witham MD, Ireland S, Houston JG et al (2014) Vitamin d therapy to reduce blood pressure and left ventricular hypertrophy in resistant hypertension: randomized, controlled trial. Hypertension 63:706–712. doi:10.1161/HYPERTENSIONAHA.113.02177

    Article  CAS  PubMed  Google Scholar 

  53. Larsen T, Mose FH, Bech JN et al (2012) Effect of cholecalciferol supplementation during winter months in patients with hypertension: a randomized, placebo-controlled trial. Am J Hypertens 25:1215–1222. doi:10.1038/ajh.2012.111

    Article  CAS  PubMed  Google Scholar 

  54. Tabassum F, Batty GD (2013) Are current UK National Institute for Health and Clinical Excellence (NICE) obesity risk guidelines useful? Cross-sectional associations with cardiovascular disease risk factors in a large, representative English population. PLoS One 8:e67764. doi:10.1371/journal.pone.0067764

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  55. Bagby SP (2007) Maternal nutrition, low nephron number, and hypertension in later life: pathways of nutritional programming. J Nutr 137:1066–1072

    CAS  PubMed  Google Scholar 

  56. Thijssen DH, Green DJ, Hopman MT (2011) Blood vessel remodelling and physical inactivity in humans. J Appl Physiol 111:1836–1845. doi:10.1152/japplphysiol.00394.2011

    Article  PubMed  Google Scholar 

  57. Walton J (2011) National Adult Nutrition Survey—summary report on food and nutrient intakes, physical measurements, physical activity patterns and food choice motives. Irish Universities Nutrition Alliance, Dublin

    Google Scholar 

  58. National Dairy Council (2013) Dairy intakes and compliance with food pyramid recommendations among Irish adults—findings from the National Adult Nutrition Survey. National Dairy Council, Dublin

    Google Scholar 

  59. Food Safety Authority of Ireland (2011) Scientific recommendations for healthy eating guidelines in Ireland. FSAI, Dublin

    Google Scholar 

  60. Strategic Task Force on Alcohol (2004) Strategic task force on alcohol—Second Report. Department of Health Children, Dublin

    Google Scholar 

  61. Morgan K, McGee H, Watson D et al. (2008). SLÁN 2007: Survey of Lifestyle, Attitudes & Nutrition in Ireland. Main Report. Dublin: Department of Health and Children

  62. Hoey L, McNulty H, Askin N et al (2007) Effect of a voluntary food fortification policy on folate, related B vitamin status, and homocysteine in healthy adults. Am J Clin Nutr 86:1405–1413

    CAS  PubMed  Google Scholar 

  63. McCartney DM, Younger KM, Walsh J et al (2013) Socio-economic differences in food group and nutrient intakes among young women in Ireland. Br J Nutr 110:2084–2097. doi:10.1017/S0007114513001463

    Article  CAS  PubMed  Google Scholar 

  64. O’Sullivan M, Nic Suibhne T, Cox G et al (2008) High prevalence of vitamin D insufficiency in healthy Irish adults. Ir J Med Sci 177:131–134. doi:10.1007/s11845-008-0129-z

    Article  PubMed  Google Scholar 

  65. McGowan CA, Byrne J, Walsh J et al (2011) Insufficient vitamin D intakes among pregnant women. Eur J Clin Nutr 65:1076–1078. doi:10.1038/ejcn.2011.110

    Article  CAS  PubMed  Google Scholar 

  66. Cashman KD, Muldowney S, McNulty B et al (2013) Vitamin D status of Irish adults: findings from the National Adult Nutrition Survey. Br J Nutr 109:1248–1256. doi:10.1017/S0007114512003212

    Article  CAS  PubMed  Google Scholar 

  67. Flynn MA, O’Brien CM, Faulkner G et al (2012) Revision of food-based dietary guidelines for Ireland, phase 1: evaluation of Ireland’s food guide. Public Health Nutr 15:518–526. doi:10.1017/S1368980011002072

    Article  PubMed  Google Scholar 

  68. Organisation for Economic Cooperation and Development (OECD) (2013) Health at a glance 2013: OECD Indicators. OECD Publishing doi:10.1787/health_glance-2013-en (accessed 18 March 2014)

  69. Lee CM, Huxley RR, Wildman RP et al (2008) Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. J Clin Epidemiol 61:646–653. doi:10.1016/j.jclinepi.2007.08.012

    Article  PubMed  Google Scholar 

  70. Hallal PC, Andersen LB, Bull FC, Lancet Physical Activity Series Working Group et al (2012) Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet 380:247–257. doi:10.1016/S0140-6736(12)60646-1

    Article  PubMed  Google Scholar 

  71. ESRI Health Research and Information Division (2012) Perinatal statistics report 2010—ESRI survey and statistical report series 41. Economic and Social Research Institute, Dublin

    Google Scholar 

  72. Barron S, Balanda K, Hughes J et al (2014) National and sub-national hypertension prevalence estimates for the Republic of Ireland: better outcome and risk factor data are needed to produce better prevalence estimates. BMC Public Health 14:24. doi:10.1186/1471-2458-14-24

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

The authors wish to thank Dr. Kate Younger, DIT School of Biological Sciences, for editorial advice with early drafts of the manuscript.

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Affiliations

  1. School of Biological Sciences, Dublin Institute of Technology, Kevin Street, Dublin 8, Ireland

    D. M. A. McCartney

  2. GEMS Directorate, Department of General Medicine, St. James’s Hospital, James’s Street, Dublin 8, Ireland

    D. G. Byrne

  3. Department of Medical Gerontology at Trinity College Dublin, Dublin, Ireland

    D. G. Byrne

  4. Department of Obstetrics and Gynaecology, UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Cork Street, Dublin 8, Ireland

    M. J. Turner

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  1. D. M. A. McCartney
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  2. D. G. Byrne
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  3. M. J. Turner
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Correspondence to D. M. A. McCartney.

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McCartney, D.M.A., Byrne, D.G. & Turner, M.J. Dietary contributors to hypertension in adults reviewed. Ir J Med Sci 184, 81–90 (2015). https://doi.org/10.1007/s11845-014-1181-5

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Keywords

  • Hypertension
  • Diet
  • Nutrients
  • Adults