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Dietary Iron Intake and New-Onset Hypertension: A Nationwide Cohort Study from China

  • Original Research
  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

The relationship of dietary iron intake with the risk of hypertension remains uncertain. We aimed to investigate the prospective association between dietary iron intake and new-onset hypertension among Chinese adults.

Design

A nationwide cohort study.

Setting

Using data from seven rounds of the China Health and Nutrition Survey (CHNS) from 1997 to 2015.

Participants

A total of 12,245 participants without hypertension at baseline were included in this study.

Exposures

Dietary intake was measured by three consecutive 24-h dietary recalls combined with a household weighing inventory.

Measurements

The study outcome was new-onset hypertension, defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg or diagnosed by physician or currently under antihypertensive treatment during the follow-up.

Results

During a median follow-up of 6.1 years, 4,304 (35.1%) participants developed hypertension. Overall, there was a U-shaped association between dietary total iron intake and new-onset hypertension (P for nonlinearity <0.001), with the lowest risk observed at 18.2–<22.1 mg/day (quintile 2–3). Similarly, a U-shaped association between dietary nonheme iron intake and new-onset hypertension was found (P for nonlinearity <0.001), with the lowest risk at 17.4–<21.3 mg/day (quintile 2–3). However, the association between dietary heme iron intake and new-onset hypertension followed a L-shape (P for nonlinearity <0.001), and a significantly lower risk of new-onset hypertension was found in participants with quintile 2–5 of dietary heme iron intake (adjusted HR, 0.75; 95% CI: 0.68, 0.82), compared with those in quintile 1 (<0.25 mg/day).

Conclusions

The association between dietary iron and new-onset hypertension was nonlinear in Chinese adults, following a U-shape for total or nonheme iron intake, and a L-shape for heme iron intake.

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Acknowledgements

This research uses data from China Health and Nutrition Survey (CHNS). We thank the National Institute for Nutrition and Health, China Center for Disease Control and Prevention, Carolina Population Center (P2C HD050924, T32 HD007168), the University of North Carolina at Chapel Hill, the NIH (R01-HD30880, DK056350, R24 HD050924, and R01-HD38700) and the NIH Fogarty International Center (D43 TW009077, D43 TW007709) for financial support for the CHNS data collection and analysis files from 1989 to 2015 and future surveys, and the China-Japan Friendship Hospital, Ministry of Health for support for CHNS 2009, Chinese National Human Genome Center at Shanghai since 2009, and Beijing Municipal Center for Disease Prevention and Control since 2011.

Funding

Sources of Funding: The study was supported by the National Key Research and Development Program [2022YFC2009600]; National Key R&D program of China [2020YFC2005000]; the National Natural Science Foundation of China [81973133, 81730019]; and the Project of the First People’s Hospital of Qujing City [2022YJKTY15].

Author information

Authors and Affiliations

  1. Department of Endocrinology, Qujing Affiliated Hospital of Kunming Medical University, Qujing, China

    Z. Zhang

  2. National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China

    Z. Zhang, M. Liu, C. Zhou, P. He, Y. Zhang, H. Li & Xianhui Qin

  3. Institute of Biomedicine, Anhui Medical University, Hefei, China

    C. Liu & Q. Li

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  1. Z. Zhang
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Contributions

Authors’ contributions: Zhuxian Zhang and Xianhui Qin designed and conducted the study; Zhuxian Zhang, Xianhui Qin, Chengzhang Liu and Mengyi Liu performed the data management and statistical analyses; Zhuxian Zhang and Xianhui Qin drafted the manuscript; all authors read and approved the final manuscript.

Corresponding author

Correspondence to Xianhui Qin.

Ethics declarations

Conflict of Interest: No disclosure was reported.

Ethical standards: The institutional review boards of the University of North Carolina at Chapel Hill and the National Institute of Nutrition and Food Safety, and Chinese Center for Disease Control and Prevention, approved the study.

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Zhang, Z., Liu, C., Liu, M. et al. Dietary Iron Intake and New-Onset Hypertension: A Nationwide Cohort Study from China. J Nutr Health Aging 26, 1016–1024 (2022). https://doi.org/10.1007/s12603-022-1861-1

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  • DOI: https://doi.org/10.1007/s12603-022-1861-1

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