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Dairy Consumption, Blood Pressure, and Risk of Hypertension: An Evidence-Based Review of Recent Literature

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Abstract

Hypertension is a major risk factor for development of stroke, coronary heart disease, heart failure, and end-stage renal disease. In a systematic review of the evidence published from 2004 to 2009, the 2010 Dietary Guidelines Advisory Committee (DGAC) concluded there was moderate evidence of an inverse relationship between the intake of milk and milk products (dairy) and blood pressure. This review synthesizes results from studies published over the past year on the relationship between dairy intake, blood pressure, and hypertension risk. The influence of dairy micronutrients including calcium, vitamin D, potassium, and phosphorous on blood pressure and incident hypertension is examined. Emerging research on bioactive dairy peptides is also reviewed. Lastly, recent evidence on effects of dairy fat content on blood pressure and hypertension risk, and the impact of inclusion of low-fat dairy in dietary patterns is also investigated.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension, 1988–2008. JAMA. 2010;303(20):2043–50.

    Article  PubMed  CAS  Google Scholar 

  2. Lawes CM, Vander Hoorn S, Rodgers A. International Society of Hypertension. Global burden of blood-pressure-related disease, 2001. Lancet. 2008;371(9623):1513–8.

    Article  PubMed  Google Scholar 

  3. Lloyd-Jones D, Adams RJ, Brown TM, et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics–2010 update: a report from the American Heart Association. Circulation. 2010;121(7):e46–e215.

    Article  PubMed  Google Scholar 

  4. Danaei G, Ding EL, Mozaffarian D, et al. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med. 2009;6(4):e1000058.

    Article  PubMed  Google Scholar 

  5. Appel LJ, Frohlich ED, Hall JE, et al. The Importance of Population-Wide Sodium Reduction as a Means to Prevent Cardiovascular Disease and Stroke: A Call to Action From the American Heart Association. Circulation 2011, Jan 13. [Epub ahead of print]

  6. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560–72.

    Article  PubMed  CAS  Google Scholar 

  7. Whelton PK, He J, Appel LJ, et al. National High Blood Pressure Education Program Coordinating Committee. Primary prevention of hypertension: clinical and public health advisory from The National High Blood Pressure Education Program. JAMA. 2002;288(15):1882–8.

    Article  PubMed  Google Scholar 

  8. Alvarez-León EE, Román-Viñas B, Serra-Majem L. Dairy products and health: a review of the epidemiological evidence. Br J Nutr. 2006;96 Suppl 1:S94–9.

    Article  PubMed  Google Scholar 

  9. Bowen J, Noakes M, Clifton PM. Effect of calcium and dairy foods in high protein, energy-restricted diets on weight loss and metabolic parameters in overweight adults. Int J Obes (Lond). 2005;29(8):957–65.

    Article  CAS  Google Scholar 

  10. Wang L, Manson JE, Buring JE, et al. Dietary intake of dairy products, calcium, and vitamin D and the risk of HTN in middle-aged and older women. HTN. 2008;51(4):1 073–1079.

    CAS  Google Scholar 

  11. Alonso A, Beunza JJ, Delgado-Rodríguez M, et al. Low-fat dairy consumption and reduced risk of HTN: The Seguimiento Universidad de Navarra (SUN) cohort. Am J Clin Nutr. 2005 Nov;82(5):972–9.

  12. Toledo E, Delgado-Rodríguez M, Estruch R, et al. Low-fat dairy products and blood pressure: Follow-up of 2290 older persons at high cardiovascular risk participating in the PREDIMED study. Br J Nutr. 2009;101(1):59–67.

    Article  PubMed  CAS  Google Scholar 

  13. Engberink MF, Hendriksen MA, Schouten EG, et al. Inverse association between dairy intake and HTN: The Rotterdam Study. Am J Clin Nutr. 2009;89(6):1877–83.

    Article  PubMed  CAS  Google Scholar 

  14. Engberink MF, Geleijnse JM, de Jong N, et al. Dairy intake, blood pressure, and incident HTN in a general Dutch population. J Nutr. 2009;139(3):582–7.

    Article  PubMed  CAS  Google Scholar 

  15. Snijder MB, van Dam RM, Stehouwer CD, et al. A prospective study of dairy consumption in relation to changes in metabolic risk factors: The Hoorn Study. Obesity (Silver Spring). 2008;16(3):706–9.

    Article  Google Scholar 

  16. Beydoun MA, Gary TL, Caballero BH, et al. Ethnic differences in dairy and related nutrient consumption among US adults and their association with obesity, central obesity, and the metabolic syndrome. Am J Clin Nutr. 2008;87(6):1914–25.

    PubMed  CAS  Google Scholar 

  17. Houston DK, Driver KE, Bush AJ, et al. The association between cheese consumption and cardiovascular risk factors among adults. J Hum Nutr Diet. 2008;21(2):129–40.

    Article  PubMed  CAS  Google Scholar 

  18. Djoussé L, Pankow JS, Hunt SC, et al. Influence of saturated fat and linolenic acid on the association between intake of dairy products and blood pressure. HTN. 2006;48(2):335–41.

    Google Scholar 

  19. Azadbakht L, Mirmiran P, Esmaillzadeh A, et al. Dairy consumption is inversely associated with the prevalence of the metabolic syndrome in Tehranian adults. Am J Clin Nutr. 2005;82(3):523–30.

    PubMed  CAS  Google Scholar 

  20. Ruidavets JB, Bongard V, Simon C, et al. Independent contribution of dairy products and calcium intake to blood pressure variations at a population level. J Hypertens. 2006;24(4):671–81.

    Article  PubMed  CAS  Google Scholar 

  21. U.S. Department of Agriculture, Agricultural Research Service. 2010. USDA National Nutrient Database for Standard Reference, Release 23. Nutrient Data Laboratory Home Page, http://www.ars.usda.gov/ba/bhnrc/ndl

  22. McCarron DA, Morris CD, Henry HJ, et al. Blood pressure and nutrient intake in the United States: an analysis of the Health and Nutrition Examination Survey I. Science. 1984;224:1392–8.

    Article  PubMed  CAS  Google Scholar 

  23. Dickinson HO, Nicolson DJ, Cook JV, et al. Calcium supplementation for the management of primary hypertension in adults. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD004639

  24. Pilz S, Tomaschitz A, Ritz E, et al. Vitamin D status and arterial hypertension: a systematic review. Medscape Nat Rev Cardiol. 2009;6(10):621–30.

    Article  CAS  Google Scholar 

  25. • Hilpert KF, West SG, Bagshaw DM, et al. Effects of dairy products on intracellular calcium and blood pressure in adults with essential HTN. J Am Coll Nutr 2009, 28(2):142–149. This RCT compared consumption of dairy foods, BP, and intracellular calcium in 23 stage 1 hypertensive adults in a 5-week crossover trial conducted in the United States. The diets included 1) a dairy-rich, high fruit and vegetable diet; 2) a high fruit and vegetable diet; and 3) an average Western diet. SBP and DBP were significantly decreased following either the high dairy, high fruit and vegetable diet or the high fruit and vegetable diet compared to the Western diet. Only the high dairy diet significantly lowered 1,25[OH] 2 D and intracellular calcium.

    PubMed  CAS  Google Scholar 

  26. • Daly RM, Nowson CA. Long-term effect of calcium-vitamin D(3) fortified milk on blood pressure and serum lipid concentrations in healthy older men. Eur J Clin Nutr 2009, 63(8):993–1000. This RCT was a substudy of a 2-year trial of 167 men over 50 years of age in Australia. The men were randomized to either 400 mL/day of 1% milk fortified with calcium and vitamin D or control group with no additional fortified milk. Results showed that low-fat milk providing 1000 mg calcium and 800 IU of vitamin D per day for 2 years did not change BP in this cohort.

    Article  PubMed  CAS  Google Scholar 

  27. Chung M, Balk EM, Brendel M, et al. Vitamin D and Calcium: Systematic Review of Health Outcomes. Evidence Report/Technology Assessment No. 183. (Prepared by Tufts Evidence-based Practice Center under Contract No. 290-2007-10055-I). AHRQ Publication No. 09-E015, Rockville, MD: Agency for Healthcare Research and Quality. August 2009.

  28. Dickinson HO, Nicolson D, Campbell F, et al. Potassium supplementation for the management of primary hypertension in adults. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD004641. doi:10.1002/14651858.CD004641.

  29. • He FJ, Marciniak M, Carney C, et al. Effects of potassium chloride and potassium bicarbonate on endothelial function, cardiovascular risk factors, and bone turnover in mild hypertensives. HTN 2010, 55(3):681–688. This is RCT on potassium and HTN involving a 12-week randomized crossover trial with 42 adult men and women with untreated HTN. The RCT was conducted to test potassium chloride and potassium bicarbonate treatment, with a 4-week crossover of placebo, potassium chloride, and potassium bicarbonate. No significant differences in BP were reported, but vascular endothelial function, arterial distensibility, and left ventricular diastolic function were significantly improved with both potassium chloride and potassium bicarbonate supplementation.

    CAS  Google Scholar 

  30. Elliott P, Kesteloot H, Appel LJ, et al. INTERMAP Cooperative Research Group. Dietary phosphorus and blood pressure: international study of macro- and micro-nutrients and blood pressure. Hypertension. 2008;51(3):669–75.

    Article  PubMed  CAS  Google Scholar 

  31. • Alonso A, Nettleton JA, Ix JH, et al. Dietary Phosphorus, Blood Pressure, and Incidence of HTN in the Atherosclerosis Risk in Communities Study and the Multi-Ethnic Study of Atherosclerosis HTN 2010, 55:776–784. This article examined phosphorous intake, BP levels, and HTN risk in two prospective US cohort studies: the Atherosclerosis Risk in Communities (ARIC) study and the Multi-Ethnic Study of Atherosclerosis (MESA). The ARIC study included 15,792 middle-aged men and women in four communities. The more recent MESA study included 6814 middle-aged and elderly men and women from six communities. After an average 6.2 years of follow-up of the combined cohort, phosphorus from dairy products, but not from other sources, was associated with lower baseline BP and reduced risk of incident HTN.

    CAS  Google Scholar 

  32. Ricci I, Artacho R, Olalla M. Milk protein peptides with angiotensin I-converting enzyme inhibitory (ACEI) activity. Crit Rev Food Sci Nutr. 2010;50(5):390–402.

    Article  PubMed  CAS  Google Scholar 

  33. Savica V, Bellinghieri G, Kopple JD. The effect of nutrition on blood pressure. Annu Rev Nutr. 2010;30:365–401.

    Article  PubMed  CAS  Google Scholar 

  34. Jauhiainen T, Korpela R. Milk peptides and blood pressure. J Nutr. 2007;137(3 Suppl 2):825S–9S.

    PubMed  CAS  Google Scholar 

  35. Pripp AH. Effect of peptides derived from food proteins on blood pressure: a meta-analysis of randomized controlled trials. Food Nutr Res 2008,52. doi:10.3402/fnr.v52i0.1641.

  36. Boelsma E, Kloek J. Lactotripeptides and antihypertensive effects: a critical review. Br J Nutr. 2009;101(6):776–86.

    Article  PubMed  CAS  Google Scholar 

  37. • Jauhiainen T, Rönnback M, Vapaatalo H, et al. Long-term intervention with Lactobacillus helveticus fermented milk reduces augmentation index in hypertensive subjects. Eur J Clin Nutr 2010, 64(4):424–431. This RCT of 89 hypertensive subjects conducted in Finland showed that treatment with high-dose tripeptides for 12 weeks resulted in a significant decrease in arterial stiffness, measured as augmentation index (AIx), but no change in endothelial function. There were no significant changes in blood pressure between groups.

    Article  PubMed  CAS  Google Scholar 

  38. • Yamasue K, Morikawa N, Mizushima S, et al. The blood pressure lowering effect of lactotripeptides and salt intake in 24-h ambulatory blood pressure measurements. Clin Exp Hypertens 2010, 32(4):214–220. In this RCT in Japan, 30 hypertensive participants were provided sour milk for 8 weeks and the BP-lowering effects of lactotripeptides were documented. It was noted that reduced intake of salt may further increase the BP-lowering effects of lactotripeptides in hypertensive subjects.

    Article  PubMed  CAS  Google Scholar 

  39. • de Leeuw PW, van der Zander K, Kroon AA, et al. Dose-dependent lowering of blood pressure by dairy peptides in mildly hypertensive subjects. Blood Press 2009, 18(1–2):44–50. This RCT of 166 prehypertensive subjects in the Netherlands, with IPP and VPP dairy drinks for 8 weeks, showed that lactotripeptides in dairy drinks with comparable electrolyte and protein composition lowered DBP in a dose-dependent manner.

    Article  PubMed  Google Scholar 

  40. Usinger L, Ibsen H, Linneberg A, et al. Human in vivo study of the renin-angiotensin-aldosterone system and the sympathetic activity after 8 weeks daily intake of fermented milk. Clin Physiol Funct Imaging. 2010;30(2):162–8.

    Article  PubMed  CAS  Google Scholar 

  41. • Usinger L, Jensen LT, Flambard B, et al. The antihypertensive effect of fermented milk in individuals with prehypertension or borderline hypertension. J Hum Hypertens 2010, 24(10):678–683. In two separate reports from one RCT, the authors measured the effects of fermented milk on ambulatory BP and markers of the rennin-angiotensin-aldosterone system in 94 prehypertensive subjects in Denmark. Participants were randomized to three treatment groups with daily intake of 150 mL or 300 mL of fermented milk or placebo. The results showed no significant differences between groups in SBP or DBP with repeated 2- hour ambulatory BP measurements and no inhibition of ACE after 8 weeks, although there was a decrease in sympathetic activity. Although there were no statistically significant differences between the groups, the group with highest fermented milk intake showed reduced BP across the 8-week period of the trial.

    Article  PubMed  CAS  Google Scholar 

  42. Huang TC, Kuksis A. A comparative study of the lipids of globule membrane and fat core and of the milk serum of cows. Lipids. 1967;2(6):453–60.

    Article  PubMed  CAS  Google Scholar 

  43. Pereira MA, Jacobs Jr DR, Van Horn L, et al. Dairy consumption, obesity, and the insulin resistance syndrome in young adults: the CARDIA Study. JAMA. 2002;287:2081–9.

    Article  PubMed  Google Scholar 

  44. • Alonso A, Zozaya C, Vázquez Z, et al. The effect of low-fat versus whole-fat dairy product intake on blood pressure and weight in young normotensive adults. J Hum Nutr Diet 2009, 22(4):336–342. This RCT was conducted among 45 normotensive young men and women who alternatively received 3.5 servings/day of whole-fat or low-fat dairy products during an 8-week crossover trial. Whole-fat dairy intake significantly increased SBP and body weight but not DBP. Low-fat dairy did not change BP or body weight significantly. Overall, there was no significant difference in the effect of low-fat versus whole-fat dairy on BP, although whole-fat dairy increased body weight significantly compared to low-fat dairy.

    Article  PubMed  CAS  Google Scholar 

  45. • Alonso A, Steffen LM, Folsom AR. Dairy intake and changes in blood pressure over 9 years: the ARIC study. Eur J Clin Nutr 2009, 63(10):1272–1275. The authors reported further results from the Atherosclerosis Risk in Communities (ARIC) Study, involving a bi-racial analysis among 6912 white and 1296 African American non-hypertensive men and women. After a 9-year follow-up period, whites consuming more than 3 low-fat dairy servings per day had significantly lower increase in BP than those consuming less than 1 serving per week. However, among African Americans, low-fat dairy product consumption was not associated with changes in BP over time.

    Article  PubMed  CAS  Google Scholar 

  46. Appel LJ, Moore TJ, Obarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med. 1997;336(16):1117–24.

    Article  PubMed  CAS  Google Scholar 

  47. Svetkey LP, Simons-Morton D, Vollmer WM, et al. Effects of Dietary Patterns on Blood Pressure–Subgroup Analysis of the Dietary Approaches to Stop Hypertension (DASH) randomized clinical trial. Arch Intern Med. 1999;159:285–93.

    Article  PubMed  CAS  Google Scholar 

  48. Svetkey LP, Simons-Morton DG, Proschan MA, et al. Effect of the dietary approaches to stop HTN diet and reduced sodium intake on blood pressure control. J Clin Hypertens. 2004;6:373–81.

    Article  Google Scholar 

  49. Ard JD, Coffman CJ, Lin PH, et al. One-year follow-up study of blood pressure and dietary patterns in Dietary Approaches to Stop Hypertension (DASH)-sodium participants. Am J Hypertens. 2004;17:1156–62.

    Article  PubMed  Google Scholar 

  50. • Toledo E, de A Carmona-Torre F, Alonso A, et al. Hypothesis-oriented food patterns and incidence of HTN: 6-year follow-up of the SUN (Seguimiento Universidad de Navarra) prospective cohort. Public Health Nutr 2010, 13(3):338–349. The authors 10,800 men and women who were initially free of HTN for a median of 4.6 years. Over this period, 640 participants reported a first diagnosis of HTN and level of adherence to 15 different healthy food patterns was scored. Overall, adherence to only one dietary pattern, the DASH combination diet pattern, was significantly associated with a lower risk for developing HTN.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. US Department of Agriculture, Center for Nutrition Policy and Promotion, 3101 Park Center Drive, Room 1034, Alexandria, VA, 22302–1594, USA

    Mary M. McGrane, Eve Essery, Julie Obbagy, Joan Lyon, Patricia MacNeil & Joanne Spahn

  2. Department of Preventive Medicine, Northwestern University, 680 N Lake Shore Drive Ste 1400, Chicago, IL, 60611, USA

    Linda Van Horn

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  1. Mary M. McGrane
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  2. Eve Essery
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Correspondence to Linda Van Horn.

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McGrane, M.M., Essery, E., Obbagy, J. et al. Dairy Consumption, Blood Pressure, and Risk of Hypertension: An Evidence-Based Review of Recent Literature. Curr Cardiovasc Risk Rep 5, 287–298 (2011). https://doi.org/10.1007/s12170-011-0181-5

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