Whole Plant Foods and Hypertension

  • Mark L. Dreher
Part of the Nutrition and Health book series (NH)


Whole (and minimally processed) plant foods usually contain some mixture of blood pressure (BP) lowering bioactive nutrients and phytochemicals such as dietary fiber, potassium, magnesium, carotenoids, polyphenols, unsaturated fat, and plant protein and are lower in sodium and sugar compared to highly processed plant foods. Whole plant foods are more effective at reducing BP in adults who are ≥45 years, hypertensive and obese than adults <45 years, normotensive, or lean. Prospective studies show that the consumption of healthy diet with ≥3 daily servings of whole grains, especially oats and barley rich in β-glucan, and ≥5 daily servings of fruits and vegetables, especially when including ≥4 weekly servings of broccoli, carrots, tofu or soybeans, raisins, grapes and apples, are associated with lower hypertension risk compared to Western diets. RCTs support the effectiveness of whole grains in lowering BP, especially at 50 g/1000 kcals or those rich in β-glucan; fruits and vegetables rich in polyphenols or nitrates and their 100% juices have been found to lower systolic BP; and two daily servings of dietary pulses or 40 g soy protein are effective in lowering BP. Flaxseeds and sesame seeds tend to be more effective than nuts in lowering BP. Tea and coffee have different effects on BP. Both black and green tea (>2 cups/d) modestly lower BP in hypertensive individuals. Coffee (>3 cups/d) does not increase hypertension risk in normotensive people but hypertensive individuals may be more sensitive to acute increases in BP after coffee consumption. The potential mechanisms by which whole plant foods may reduce blood pressure and hypertension risk are; reducing the risk of weight gain, enhancing insulin sensitivity, improving vascular endothelial function, slowing the rate of arterial plaque build-up, maintaining electrolyte balance, and stimulating a healthier microbiota ecosystem.


Blood pressure Hypertension Aging Overweight Obesity Microbiota Electrolytes Whole grains Fruit Vegetables Legumes Soy Nuts Flaxseed 


  1. 1.
    WHO. In: Mendis S, Puska P, Norrving B, editors. Global atlas on cardiovascular disease prevention and control. Geneva: World Health Organization; 2011.Google Scholar
  2. 2.
    World Health Organization. A global brief on hypertension. Silent killer, global public health crisis. Geneva: WHO; 2013. brief. hypertension/en/. Accessed April 2017Google Scholar
  3. 3.
    Mozaffarian D, Benjamin EJ, Go AS, on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics-2016 update: a report from the American Heart Association. Circulation. 2016;133:e38–e360.PubMedCrossRefGoogle Scholar
  4. 4.
    Atlas SA. The renin-angiotensin aldosterone system: pathophysiological role and pharmacologic inhibition. J Manag Care Pharm. 2007;13(8):S9–S20.Google Scholar
  5. 5.
    Livingstone KM, McNaughton SA. Dietary patterns by reduced rank regression are associated with obesity and hypertension in Australian adults. Br Nutr J. 2017;117:248–59. Scholar
  6. 6.
    Castro I, Waclawovsky G, Marcadenti A. Nutrition and physical activity on hypertension: implication of current evidence and guidelines. Curr Hypertens Rev. 2015;11(2):91–9.PubMedCrossRefGoogle Scholar
  7. 7.
    Savica V, Bellinghieri G, Kopple JD. Effect of nutrition on blood pressure. Ann Rev Nutr. 2010;30:365–402.CrossRefGoogle Scholar
  8. 8.
    Dietary Guidelines Advisory Committee (DGAC). Scientific report. Advisory report to the Secretary of Health and Human Services and the Secretary of Agriculture. Part D. Chapter 2: Dietary patterns, foods and nutrients and health outcomes. 2015:1–35.Google Scholar
  9. 9.
    Frisoli TM, Schmieder RE, Grodzicki T, Messerli FH. Beyond salt: lifestyle modifications and blood pressure. Eur Heart J. 2011;32:3081–7.PubMedCrossRefGoogle Scholar
  10. 10.
    Rosvall M, Persson M, Ostling G, et al. Risk factors for the progression of carotid intima-media thickness over a 16-year follow-up period: the Malmo Diet and Cancer Study. Atherosclerosis. 2015;239:615–21. Scholar
  11. 11.
    Dickinson HO, Mason JM, Nicolson DJ, et al. Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials. J Hypertens. 2006;24(2):215–33.PubMedCrossRefGoogle Scholar
  12. 12.
    Liu X, Zhang D, Liu Y, et al. Dose-response association between physical activity and incident hypertension. A systematic review and meta-analysis of cohort studies. Hypertension. 2017;69(5):813–20. PubMedCrossRefGoogle Scholar
  13. 13.
    Briasoulis A, Agarwal V, Messerli FH. Alcohol consumption and the risk of hypertension in men and women: a systematic review and meta-analysis. J Clin Hypertens (Greenwich). 2012;14:792–8.CrossRefGoogle Scholar
  14. 14.
    Steffen LM, Kroenke CH, Yu X, et al. Associations of plant food, dairy product, and meat intakes with 15-y incidence of elevated blood pressure in young black and white adults: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Clin Nutr. 2005;82:1169–77.PubMedGoogle Scholar
  15. 15.
    Gay HC, Rao SG, Vaccarino V, Ali MK. Effects of different dietary interventions on blood pressure systematic review and meta-analysis of randomized controlled trials. Hypertension. 2016;67:733–9. Scholar
  16. 16.
    Alonso A, de la Fuente C, Martin-Arnau AM, et al. Fruit and vegetable consumption is inversely associated with blood pressure in a Mediterranean population with a high vegetable-fat intake: the Seguimiento Universidad de Navarra (SUN) Study. Br J Nutr. 2004;92:311–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Appel LJ, Moore TJ, Obarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med. 1997;336:1117–24.PubMedCrossRefGoogle Scholar
  18. 18.
    Feng J, He FJ, Li J, MacGregor GA. Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials. BMJ. 2013;346:f1325. Scholar
  19. 19.
    Doménech M, Roman P, Lapetra J, et al. Mediterranean diet reduces 24-hour ambulatory blood pressure, blood glucose, and lipids one-year randomized, clinical trial. Hypertension. 2014;64:69–76.PubMedCrossRefGoogle Scholar
  20. 20.
    Jayalath VH, de Souza RJ, Sievenpiper JL, et al. Effect of dietary pulses on blood pressure: a systematic review and meta-analysis of controlled feeding trials. Am J Hypertens. 2014;27(1):56–64.PubMedCrossRefGoogle Scholar
  21. 21.
    Khalesi S, Irwin C, Schubert M. Flaxseed consumption may reduce blood pressure: a systematic review and meta-analysis of controlled trials. J Nutr. 2015;145(4):758–65. 205302. PubMedCrossRefGoogle Scholar
  22. 22.
    Kochar J, Gaziano M, Djoussé L. Breakfast cereals and risk of hypertension in the physicians’ health study. Clin Nutr. 2012;31(1):89–92.PubMedCrossRefGoogle Scholar
  23. 23.
    Mohammadifard N, Salehi-Abargouei A, Salas-Salvadó J, et al. The effect of tree nut, peanut, and soy nut consumption on blood pressure: a systematic review and meta-analysis of randomized controlled clinical trials. Am J Clin Nutr. 2015;101:966–82.PubMedCrossRefGoogle Scholar
  24. 24.
    Pins JJ, Geleva D, Keenan JM. Do whole-grain oat cereals reduce the need for antihypertensive medications and improve blood pressure control? J Fam Pract. 2002;14:353–9.Google Scholar
  25. 25.
    Ahhmed AM, Muguruma M. A review of meat protein hydrolysates and hypertension. Meat Sci. 2010;86(1):110–8.PubMedCrossRefGoogle Scholar
  26. 26.
    Appleby PN, Davey GK, Key TJ. Hypertension and blood pressure among meat eaters, fish eaters, vegetarians and vegans in EPIC–Oxford. Public Health Nutr. 2002;5(5):645–54.PubMedCrossRefGoogle Scholar
  27. 27.
    Mattei J, Noel S, Tucker KL. A meat, processed meat, and French fries dietary pattern is associated with high allostatic load in Puerto Rican older adults. J Am Diet Assoc. 2011;111(10):1498–506.PubMedPubMedCentralCrossRefGoogle Scholar
  28. 28.
    Lajous M, Bijon A, Fagherazzi G, et al. Processed and unprocessed red meat consumption and hypertension in women. Am J Clin Nutr. 2014;100:948–52.PubMedCrossRefGoogle Scholar
  29. 29.
    Soedamah-Muthu SS, Verberne LDM, Ding EL, et al. Dairy consumption and incidence of hypertension a dose-response meta-analysis of prospective cohort studies. Hypertension. 2012;60:1131–7.PubMedCrossRefGoogle Scholar
  30. 30.
    Ballard KD, Bruno RS. Protective role of dairy and its constituents on vascular function independent of blood pressure-lowering activities. Nutr Rev. 2014;3(1):36–50.Google Scholar
  31. 31.
    U.S. Department of Agriculture, Agriculture Research Service, Nutrient Data Laboratory. 2014. USDA National Nutrient Database for Standard Reference, Release 27. http://www.ars. Accessed 17 Feb 2015.
  32. 32.
    Ros E, Hu FB. Consumption of plant seeds and cardiovascular health epidemiological and clinical trial evidence. Circulation. 2013;128:553–65.PubMedPubMedCentralCrossRefGoogle Scholar
  33. 33.
    USDA. What we eat in America, NHANES 2011-2012, individuals 2 years and over (excluding breast-fed children). Available:
  34. 34.
    Slavin JL, Lloyd B. Health benefits of fruits and vegetables. Adv Nutr. 2012;3:506–16.PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Rebello CJ, Greenway FL, Finley JW. A review of the nutritional value of legumes and their effects on obesity and its related co-morbidities. Obes Rev. 2014;15:392–407.PubMedCrossRefGoogle Scholar
  36. 36.
    Gebhardt SE, Thomas RG. Nutritive value of foods. Washington, DC: U.S. Department of Agriculture, Agricultural Research Service, Home and Garden Bulletin 72; 2002.Google Scholar
  37. 37.
    Holden JM, Eldridge AL, Beecher GR, et al. Carotenoid content of U.S. foods: an update of the database. J Food Comp An. 1999;12:169–96.CrossRefGoogle Scholar
  38. 38.
    Lu Q-Y, Zhang Y, Wang Y, et al. California Hass avocado: profiling of carotenoids, tocopherol, fatty acid, and fat content during maturation and from different growing areas. J Agric Food Chem. 2009;57(21):10408–13.PubMedPubMedCentralCrossRefGoogle Scholar
  39. 39.
    Wu X, Beecher GR, Holden JM, et al. Lipophilic and hydrophilic antioxidant capacities of common foods in the United States. J Agric Food Chem. 2004;52:4026–37.PubMedCrossRefGoogle Scholar
  40. 40.
    Bhupathiraju SN, Tucker KL. Coronary heart disease prevention: nutrients, foods, and dietary patterns. Clin Chim Acta. 2011;412:1493–514.PubMedCrossRefGoogle Scholar
  41. 41.
    Dietary Guidelines Advisory Committee. Scientific Report. Advisory Report to the Secretary of Health and Human Services and the Secretary of Agriculture. Part D. Chapter 1: Food and nutrient intakes, and health: current status and trends 2015;1–78. dietary guidelines/2015/guidelines/. Accessed 26 Jan 2016.
  42. 42.
    Sanchez-Muniz FJ. Dietary fibre and cardiovascular health. Nutr Hosp. 2012;27(1):31–45.PubMedGoogle Scholar
  43. 43.
    Yang T, Santisteban MM, Rodriguez V, et al. Gut dysbiosis is linked to hypertension. Hypertension. 2015;65:1331–40.PubMedPubMedCentralCrossRefGoogle Scholar
  44. 44.
    Pluznick JL. A novel SCFA receptor, the microbiota, and blood pressure regulation. Gut Microbes. 2014;5(2):202–7.PubMedCrossRefGoogle Scholar
  45. 45.
    Leermakers ETM, Darweesh SKL, Baena CP, et al. The effects of lutein on cardiometabolic health across the life course: a systematic review and meta-analysis. Am J Clin Nutr. 2016;103:481–94.PubMedCrossRefGoogle Scholar
  46. 46.
    Lillioja S, Neal AL, Tapsell L, et al. Whole grains, type 2 diabetes, coronary heart disease, and hypertension: links to the aleurone preferred over indigestible fiber. Biofactors. 2013;39(3):242–58.PubMedPubMedCentralCrossRefGoogle Scholar
  47. 47.
    Karl JP, Saltzman E. The role of whole grains in body weight regulation. Adv Nutr. 2012;3:697–707.PubMedPubMedCentralCrossRefGoogle Scholar
  48. 48.
    Seal CJ. Whole grains and CVD risk. Proc Nutr Soc. 2006;65:24–34.PubMedCrossRefGoogle Scholar
  49. 49.
    Medina-Remón A, Tresserra-Rimbau A, Pons A, et al. Effects of total dietary polyphenols on plasma nitric oxide and blood pressure in a high cardiovascular risk cohort. The PREDIMED randomized trial. Nutr Metab Cardiovasc Dis. 2015;25(1):60–7. 2014.09.001.PubMedCrossRefGoogle Scholar
  50. 50.
    Clark JL, Zahradka P, Taylor CG. Efficacy of flavonoids in the management of high blood pressure. Nutr Rev. 2015;73(12):799–822.PubMedCrossRefGoogle Scholar
  51. 51.
    Hobbs DA, George TW, Lovegrove JA. The effects of dietary nitrate on blood pressure and endothelial function: a review of human intervention studies. Nutr Res Rev. 2013;26:210–22.PubMedCrossRefGoogle Scholar
  52. 52.
    Micha R, Peñalvo JL, Cudhea F, et al. Association between dietary factors and mortality from heart disease, stroke, and type 2 diabetes in the United States. JAMA. 2017;317(9):912–24. PubMedCrossRefGoogle Scholar
  53. 53.
  54. 54.
    Seal CJ, Brownlee IA. Whole-grain foods and chronic disease: evidence from epidemiological and intervention studies. Proc Nutr Soc. 2015;74:313–9.PubMedCrossRefGoogle Scholar
  55. 55.
    Karl JP, Meydani M, Barnett JB, et al. Substituting whole grains for refined grains in a 6-wk randomized trial favorably affects energy-balance metrics in healthy men and postmenopausal women. Am J Clin Nutr. 2017;105:589–99.PubMedCrossRefGoogle Scholar
  56. 56.
    Mellen PB, Walsh TF, Herrington DM. Whole grain intake and cardiovascular disease: a meta-analysis. Nutr Metab Cardiovasc Dis. 2008;18(4):283–90.PubMedCrossRefGoogle Scholar
  57. 57.
    Tang G, Wang D, Long J, et al. Meta-analysis of the association between whole grain intake and coronary heart disease risk. Am J Cardiol. 2015;115(5):625–9.PubMedCrossRefGoogle Scholar
  58. 58.
    Ye EQ, Chacko SA, Chou EL, et al. Greater whole-grain intake is associated with lower risk of type 2 diabetes, cardiovascular disease, and weight gain. J Nutr. 2012;142:1304–13.PubMedCrossRefGoogle Scholar
  59. 59.
    Flint AJ, FB H, Glynn RJ, et al. Whole grains and incident hypertension in men. Am J Clin Nutr. 2009;90:493–8.PubMedPubMedCentralCrossRefGoogle Scholar
  60. 60.
    Wang L, Gaziano JM, Liu S, et al. Whole- and refined-grain intakes and the risk of hypertension in women. Am J Clin Nutr. 2007;86:472–9.PubMedGoogle Scholar
  61. 61.
    Evans CEL, Greenwood DC, Threapleton DE, et al. Effects of dietary fibre type on blood pressure: a systematic review and meta-analysis of randomized controlled trials of health individuals. J Hypertension. 2015;33(5):897–911.CrossRefGoogle Scholar
  62. 62.
    Thies F, Masson LF, Boffetta P, Kris-Etherton P. Oats and CVD risk markers: a systematic literature review. Br J Nutr. 2014;112:S19–30.PubMedCrossRefGoogle Scholar
  63. 63.
    Kirwan JP, Malin SK, Scelsi AR, et al. Whole-grain diet reduces cardiovascular risk factors in overweight and obese adults: a randomized controlled trial. J Nutr. 2016;146:2244–51.PubMedPubMedCentralCrossRefGoogle Scholar
  64. 64.
    Tighe P, Duthie G, Vaughan N, et al. Effect of increased consumption of whole-grain foods on blood pressure and other cardiovascular risk markers in healthy middle-aged persons: a randomized controlled trial. Am J Clin Nutr. 2010;92:733–40.PubMedCrossRefGoogle Scholar
  65. 65.
    Maki KC, Galant R, Samuel P, et al. Effects of consuming foods containing oat beta-glucan on blood pressure, carbohydrate metabolism and biomarkers of oxidative stress in men and women with elevated blood pressure. Eur J Clin Nutr. 2007;61:786–95.PubMedCrossRefGoogle Scholar
  66. 66.
    Behall KM, Scholfield DJ, Hallfrisch J. Whole-grain diets reduce blood pressure in mildly hypercholesterolemic men and women. J Am Diet Assoc. 2006;106:1445–9.PubMedCrossRefGoogle Scholar
  67. 67.
    He J, Streiffer RH, Muntner P, et al. Effect of dietary fiber intake on blood pressure: a randomized, double-blind, placebo-controlled trial. J Hypertens. 2004;22:73–80.PubMedCrossRefGoogle Scholar
  68. 68.
    Davy BM, Melby CL, Beske SD, et al. Oat consumption does not affect resting casual and ambulatory 24-h arterial blood pressure in men with high-normal blood pressure to stage I hypertension. J Nutr. 2002;132:394–8.PubMedCrossRefGoogle Scholar
  69. 69.
    Keenan JM, Joel J, Pins JJ, et al. Oat ingestion reduces systolic and diastolic blood pressure in patients with mild or borderline hypertension: a pilot trial. J Fam Pract. 2002;51:369–75.PubMedGoogle Scholar
  70. 70.
    Saltzman E, Das SK, Lichtenstein AH, et al. An oat-containing hypocaloric diet reduces systolic blood pressure and improves lipid profile beyond effects of weight loss in men and women. J Nutr. 2001;131:1465–70.PubMedCrossRefGoogle Scholar
  71. 71.
    Kestin M, Moss R, Clifton PM, Nestel PJ. Comparative effects of three cereal brans on plasma lipids, blood pressure, and glucose metabolism in mildly hypercholesterolemic men. Am J Clin Nutr. 1990;52:661–6.PubMedCrossRefGoogle Scholar
  72. 72.
    Fehily AM, Burr ML, Butland BK, Eastham RD. A randomised controlled trial to investigate the effect of a high fibre diet on blood pressure and plasma fibrinogen. J Epid Commun Health. 1986;40:334–7.CrossRefGoogle Scholar
  73. 73.
    Rooney C, McKinley MC, Appleton KM, et al. How much is ‘5-a-day’? A qualitative investigation into consumer understanding of fruit and vegetable intake guidelines. J Hum Nutr Diet. 2017;30(1):105–13. Scholar
  74. 74.
    United States Department of Agriculture. 2013. Choose my plate. http://www choosemyplategov/. Accessed 17 Feb 2015.
  75. 75.
    Micha R, Khatibzadeh S, Shi P, et al. Global, regional and national consumption of major food groups in 1990 and 2010: a systematic analysis including 266 country-specific nutrition surveys worldwide. BMJ Open. 2015;5(9):e008705. Scholar
  76. 76.
    Li B, Li F, Wang L, Zhang D. Fruit and vegetables consumption and risk of hypertension: a meta-analysis. J Clin Hypertens (Greenwich). 2016;18(5):468–76. Scholar
  77. 77.
    Wu L, Sun D, He Y. Fruit and vegetable consumption and incident hypertension: dose response meta-analysis of prospective cohort studies. J Hum Hypertens. 2016;30(10):573–80. Scholar
  78. 78.
    Borgi L, Muraki I, Satija A, et al. Fruit and vegetable consumption and the incidence of hypertension in three prospective cohort studies. Hypertension. 2016;67:288–93.PubMedGoogle Scholar
  79. 79.
    Wang L, Manson JE, Gaziano JM, et al. Fruit and vegetable intake and the risk of hypertension in middle-aged and older women. Am J Hypertens. 2012;25(2):180–9.PubMedCrossRefGoogle Scholar
  80. 80.
    Tsubota-Utsugi M, Ohkubo T, Kikuya M. High fruit intake is associated with a lower risk of future hypertension determined by home blood pressure measurement: the OHASAMA study. J Hum Hypertens. 2011;25(3):164–71.PubMedCrossRefGoogle Scholar
  81. 81.
    Nunez-Cordoba JM, Alonso A, Beunza JJ, et al. Role of vegetables and fruits in Mediterranean diets to prevent hypertension. Eur J Clin Nutr. 2009;63:605–12.PubMedCrossRefGoogle Scholar
  82. 82.
    Griep LMO, Stamler J, Chan Q, et al. Association of raw fruit and fruit juice consumption with blood pressure: the INTERMAP study. Am J Clin Nutr. 2013;97:1083–91.CrossRefGoogle Scholar
  83. 83.
    Chan Q, Stamler J, Brown IJ, et al. Relation of raw and cooked vegetable consumption to blood pressure: the INTERMAP study. J Hum Hypertens. 2014;28:353–9.PubMedCrossRefGoogle Scholar
  84. 84.
    Medina-Remon A, Vallverdu-Queralt A, Arranz S, et al. Gazpacho consumption is associated with lower blood pressure and reduced hypertension in a high cardiovascular risk cohort. Cross-sectional study of the PREDIMED trial. Nutr Metab Cardiov Dis. 2013;23(10):944–52.CrossRefGoogle Scholar
  85. 85.
    Pase MP, Grima N, Cockerell R, Pipingas A. Habitual intake of fruit juice predicts central blood pressure. Appetite. 2015;84:68–72.PubMedCrossRefGoogle Scholar
  86. 86.
    Hartley L, Igbinedion E, Holmes J, et al. Increased consumption of fruit and vegetables for the primary prevention of cardiovascular diseases. Cochrane Database of Systematic Rev. 2013;6:CD009874. Scholar
  87. 87.
    Liu K, Xing A, Chen K. Effect of fruit juice on cholesterol and blood pressure in adults: a meta-analysis of 19 randomized controlled trials. PLoS One. 2013;8(4). pone. 0061420.
  88. 88.
    Jovanovski E, Bosco L, Khan K, et al. Effect of spinach, a high dietary nitrate source, on arterial stiffness and related hemodynamic measures: a randomized, controlled trial in healthy adults. Clin Nutr Res. 2015;4:160–7.PubMedPubMedCentralCrossRefGoogle Scholar
  89. 89.
    Tjelle TE, Holtung L, Bøhn SK, et al. Polyphenol-rich juices reduce blood pressure measures in a randomised controlled trial in high normal and hypertensive volunteers. Br J Nutr. 2015;114:1054–63.PubMedCrossRefGoogle Scholar
  90. 90.
    Novotny JA, Baer DJ, Khoo C, et al. Cranberry juice consumption lowers markers of cardiometabolic risk, including blood pressure and circulating C-reactive protein, triglyceride, and glucose concentrations in adults. J Nutr. 2015;145:1185–93.PubMedCrossRefGoogle Scholar
  91. 91.
    Vinson JA, Demkosky CA, Navarre DA, Smyda MA. High-antioxidant potatoes: acute in vivo antioxidant source and hypotensive agent in humans after supplementation to hypertensive subjects. J Agric Food Chem. 2012;60:6749–54.PubMedCrossRefGoogle Scholar
  92. 92.
    Berry SE, Mulla UZ, Chowienczyk PJ, et al. Increased potassium intake from fruit and vegetables or supplements does not lower blood pressure or improve vascular function in UK men and women with early hypertension: a randomised controlled trial. Br J Nutr. 2010;104:1839–47.PubMedCrossRefGoogle Scholar
  93. 93.
    McCall DO, McGartland CP, McKinley MC, et al. Dietary intake of fruits and vegetables improves microvascular function in hypertensive subjects in a dose-dependent manner. Circulation. 2009;119:2153–60.PubMedCrossRefGoogle Scholar
  94. 94.
    John JH, Ziebland S, Yudkin P, et al. Effects of fruit and vegetable consumption on plasma antioxidant concentrations and blood pressure: a randomized controlled trial. Lancet. 2002;359:1969–74.PubMedCrossRefGoogle Scholar
  95. 95.
    Broekmans WMR, Klopping-Ketelaars WAA, Kluft C, et al. Fruit and vegetables and cardiovascular FV intake and risk of CVD risk profile: a diet controlled intervention study. Eur J Clin Nutr. 2001;55:636–42.PubMedCrossRefGoogle Scholar
  96. 96.
    Smith-Warner SA, Elmer PJ, Tharp TM, et al. Increasing vegetable and fruit intake: randomized intervention and monitoring in an at-risk population. Cancer Epidemiol Biomarkers Prev. 2000;9(3):307–17.PubMedGoogle Scholar
  97. 97.
    Zheng J, Zhou Y, Li S, et al. Effects and mechanisms of fruit and vegetable juices on cardiovascular diseases. Int J Mol Sci. 2017;18:555. Scholar
  98. 98.
    Sahebkar A, Ferri C, Giorgini P, et al. Effects of pomegranate juice on blood pressure: a systematic review and meta-analysis of randomized controlled trials. Pharmacological Res. 2017;115:149–61.Google Scholar
  99. 99.
    Bouchenak M, Lamri-Senhadji M. Nutritional quality of legumes, and their role in cardiometabolic risk prevention: a review. J Med Food. 2013;16(3):185–98.PubMedCrossRefGoogle Scholar
  100. 100.
    Tielemans SMAJ, Altorf-van der Kuil W, Engberink MF, et al. Intake of total protein, plant protein and animal protein in relation to blood pressure: a meta-analysis of observational and intervention studies. J Human Hypertension. 2013;27:564–71.CrossRefGoogle Scholar
  101. 101.
    Messina V. Nutritional and health benefits of dried beans. Am J Clin Nutr. 2014;100(suppl 1):437S–42S.PubMedCrossRefGoogle Scholar
  102. 102.
    Afshin A, Micha R, Khatibzadeh S, Mozaffarian D. Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: a systematic review and meta-analysis. Am J Clin Nutr. 2014;100(1):278–88.PubMedPubMedCentralCrossRefGoogle Scholar
  103. 103.
    Jayalath VH, de Souza RJ, Sievenpiper JL, et al. Effect of dietary pulses on blood pressure: a systematic review and meta-analysis of controlled feeding trials. Am J Hypertension. 2014;27(1):56–64.CrossRefGoogle Scholar
  104. 104.
    Lee YP, Puddey IB, Hodgson JM. Protein, fibre and blood pressure: potential benefit of legumes. Clin Exp Pharm Physiol. 2008;35:473–6.CrossRefGoogle Scholar
  105. 105.
    Appel LJ, Sacks FM, Carey VJ, et al. Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids results of the OmniHeart Randomized Trial. JAMA. 2005;294:2455–64.PubMedCrossRefGoogle Scholar
  106. 106.
    Yang G, Shu XO, Jin F, et al. Longitudinal study of soy food intake and blood pressure among middle-aged and elderly Chinese women. Am J Clin Nutr. 2005;81:1012–7.PubMedGoogle Scholar
  107. 107.
    Nagata C, Shimizu H, Takami R, et al. Association of blood pressure with intake of soy products and other food groups in Japanese men and women. Prev Med. 2003;36:692–7.PubMedCrossRefGoogle Scholar
  108. 108.
    Dong J-Y, Tong X, Z-W W, et al. Meta-analysis: effect of soya protein on blood pressure: a meta-analysis of randomised controlled trials. Br J Nutr. 2011;106:317–26.PubMedCrossRefGoogle Scholar
  109. 109.
    Rivas M, Garay RP, Escanero JF, et al. Soy milk lowers blood pressure in men and women with mild to moderate essential hypertension. J Nutr. 2002;132:1900–2.PubMedCrossRefGoogle Scholar
  110. 110.
    He J, Wofford MR, Reynolds K, et al. Effect of dietary protein supplementation on blood pressure: a randomized controlled trial. Circulation. 2011;124(5):589–95.PubMedPubMedCentralCrossRefGoogle Scholar
  111. 111.
    He J, Gu D, Xigui W, et al. Effect of soybean protein on blood pressure: a randomized, controlled trial. Ann Intern Med. 2005;143(1):1–9.PubMedCrossRefGoogle Scholar
  112. 112.
    Ros E. Nuts and CVD. Br J Nutr. 2015;113:S111–20.PubMedCrossRefGoogle Scholar
  113. 113.
    Prasad K. Flaxseed and cardiovascular disease. J Cardiovasc Pharmacol. 2009;54(5):369–77.PubMedCrossRefGoogle Scholar
  114. 114.
    Novotny JA, Gebauer SK, Baer DJ. Discrepancy between the Atwater factor predicted and empirically measured energy values of almonds in human diets. Am J Clin Nutr. 2012;96:296–301.PubMedPubMedCentralCrossRefGoogle Scholar
  115. 115.
    Mattes RD, Kris-Etherton PM, Foster GD. Impact of peanuts and tree nuts on body weight and healthy weight loss in adults. J Nutr. 2008;138(suppl):1741S–5S.PubMedCrossRefGoogle Scholar
  116. 116.
    Traoret CJ, Lokko P, Cruz ACRF, et al. Peanut digestion and energy balance. Int J Obes. 2008;32:322–8.CrossRefGoogle Scholar
  117. 117.
    Brown RC, Tey SL, Gray AR, et al. Nut consumption is associated with better nutrient intakes: results from the 2008/09 New Zealand Adult Nutrition Survey. Br J Nutr. 2016;115:105–12.PubMedCrossRefGoogle Scholar
  118. 118.
    Nielsen SJ, Kit BK, Ogden CL. Nut consumption among U.S. adults, 2009-2010. NCHS data brief, no 176. Hyattsville, MD: National Center for Health Statistics 2014.Google Scholar
  119. 119.
    Luu HN, Blot WJ, Xiang Y-B, et al. Prospective evaluation of the association of nut/peanut consumption with total and cause-specific mortality. JAMA Intern Med. 2015;175(5):755–66.PubMedPubMedCentralCrossRefGoogle Scholar
  120. 120.
    Ma L, Wang F, Guo W, et al. Nut consumption and the risk of coronary artery disease: a dose-response meta-analysis of 13 prospective studies. Thromb Res. 2014;134(4):790–4.PubMedCrossRefGoogle Scholar
  121. 121.
    Yazdekhasti N, Mohammadifard N, Sarrafzadegan N, et al. The relationship between nut consumption and blood pressure in an Iranian adult population: Isfahan Healthy Heart. Program. 2013;23(10):929–36.Google Scholar
  122. 122.
    Djoussé L, Rudich T, Gaziano JM. Nut consumption and risk of hypertension in US male physicians. Clin Nutr. 2009;28(1):10–4.PubMedCrossRefGoogle Scholar
  123. 123.
    Weng L-C, Steffen LM, Szklo M, et al. Diet pattern with more dairy and nuts, but less meat is related to lower risk of developing hypertension in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) study. Forum Nutr. 2013;5:1719–33.Google Scholar
  124. 124.
    Martınez-Lapiscina EH, Pimenta AM, Beunza JJ, et al. Nut consumption and incidence of hypertension: the SUN prospective cohort. Nutr Metab Cardiov Dis. 2010;20(5):359–65.CrossRefGoogle Scholar
  125. 125.
    Del Gobbo LC, Falk MC, Feldman R, et al. Effects of tree nuts on blood lipids, apolipoproteins, and blood pressure: systematic review, meta-analysis, and dose-response of 61 controlled intervention trials. Am J Clin Nutr. 2015;102(6):1347–56. 115.110965.PubMedPubMedCentralCrossRefGoogle Scholar
  126. 126.
    Rodriguez-Leyva D, Weighell W, Edel AL, et al. Potent antihypertensive action of dietary flaxseed in hypertensive patients. Hypertension. 2013;62:1081–89.Google Scholar
  127. 127.
    Khosravi-Boroujeni H, Nikbakht E, Natanelov E, Khalesi S. Can sesame consumption improve blood pressure? A systematic review and meta-analysis of controlled trials. J Sci Food Agric. 2017; doi:
  128. 128.
    Cardoso CA, de Oliveira GM, Gouveia LA, et al. The effect of dietary intake of sesame (Sesamumindicum L.) derivatives related to the lipid profile and blood pressure: a systematic review. Crit Rev Food Sci Nutr. 2016; doi:
  129. 129.
    Yarmolinsky J, Gon G, Edwards P. Effect of tea on blood pressure for secondary prevention of cardiovascular disease: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev. 2015;73(4):236–46.Google Scholar
  130. 130.
    Peng X, Zhou R, Wang B, et al. Effect of green tea consumption on blood pressure: a meta-analysis of 13 randomized controlled trials. Sci Rep. 2014;4:6251.Google Scholar
  131. 131.
    Greyling A, Ras RT, Zock PL et al. The effect of black tea on blood pressure: a systematic rReview with meta-analysis of randomized controlled trials. PLoS ONE. 2014;9(7):e103247.Google Scholar
  132. 132.
    Liu G, Mi X-N, Zheng X-X, et al. Effects of tea intake on blood pressure: a meta-analysis of randomised controlled trials. Br J Nutr. 2014;112(7):1043–54.Google Scholar
  133. 133.
    Cook NR. Implications of small reductions in diastolic blood pressure for primary prevention. Arch Intern Med. 1995;155(7):701–9.Google Scholar
  134. 134.
    Miranda A, Steluti J, Fisberg R, Marchioni D. Association between coffee consumption and its polyphenols with cardiovascular risk factors: a population-based study. Nutrients. 2017;9(3):276.Google Scholar
  135. 135.
    Loader TB, Taylor cG, Zahradka P, Jones PJH. Chlorogenic acid from coffee beans: evaluating the evidence for a blood pressure – regulating health claim. Nutr Rev. 2017;75(2):114–33.Google Scholar
  136. 136.
    Horst K, Robinson WD, Jenkins WL, Bao DL. The effect of caffeine, coffee and decaffeinated coffee upon blood pressure, pulse rate and certain motor reactions of normal young men. J Pharmacol Exp. 1934;52:307–21.Google Scholar
  137. 137.
    Turnbull D, Rodricks JV, Mariano GF, Chowdhury F. Caffeine and cardiovascular health. Regul Toxicol Pharmacol. 2017;89:165–85.Google Scholar
  138. 138.
    Zhang Z, Hu G, Caballero B, et al. Habitual coffee consumption and risk of hypertension: a systematic review and meta-analysis of prospective observational studies. Am JClin Nutr. 2011;93(6):1212–19.Google Scholar
  139. 139.
    Rhee JJ, Qin F, Hedlin HK, et al. Coffee and caffeine consumption and the risk of hypertension in postmenopausal women. Am J Clin Nutr. 2016;103(1):210–17.Google Scholar
  140. 140.
    Mesas AE, Leon-Munoz LM, Rodriguez-Artalejo F, Lopez-Garcia E. The effect of coffee on blood pressure and cardiovascular disease in hypertensive individuals: a systematic review and meta-analysis. Am J Clin Nutr. 2011;94(4):1113–26.Google Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Mark L. Dreher
    • 1
  1. 1.Nutrition Science Solutions LLCWimberleyUSA

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