Individual and Combined Effects of Dietary Factors on Risk of Incident Hypertension Prospective Analysis From the NutriNet-Sante Cohort
Individual and Combined Effects of Dietary Factors on Risk of Incident Hypertension Prospective Analysis From the NutriNet-Sante Cohort
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DOI：
10.1161/hypertensionaha.117.09622
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发表时间：
2017-10-01
期刊：
影响因子：
8.3
通讯作者：
Kesse-Guyot, Emmanuelle
中科院分区：
文献类型：
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作者：
Lelong, Helene;Blacher, Jacques;Kesse-Guyot, Emmanuelle
饮食摄入被认为是高血压发展的主要决定因素之一。该地区的数据大多来自横断面研究。我们的目的是在一项大型队列研究中调查(1)个体营养因素和(2)坚持饮食方法来停止高血压和发生高血压的风险之间的前瞻性关联。我们对参加NutriNetSante队列研究的80426名法国成年人的高血压发病率进行了前瞻性研究。自我报告的社会人口统计、生活方式健康问卷和饮食消费通过三个24小时记录在基线和之后每年完成。通过多变量Cox比例风险模型评估营养物质和食物组的四分位数(Q)与坚持饮食方法以停止高血压饮食和高血压风险之间的关系。在平均3.4±2.1年的随访期间，记录了2413例高血压事件。膳食摄入钠（Q4 vs Q1）：风险比(HR)=1.17(95%可信区间[CI]， 1.02-1.35)，钾：风险比=0.82 (95% CI, 0.72-0.94)，动物蛋白：风险比=1.26 (95% CI, 1.11-1.43)，植物蛋白：风险比=0.85 (95% CI, 0.75-0.95)，纤维：风险比=0.81 (95% CI, 0.71-0.93)，镁：风险比=0.77 (95% CI, 0.67-0.89)，水果和蔬菜：风险比=0.85 (95% CI, 0.74-0.97)，全谷物：风险比=0.84(95% CI, 0.76-0.93)，坚果：风险比=0.72 (95% CI, 0.63-0.83)，红肉和加工肉：HR=1.25 （95% CI, 1.11-0.42）与高血压风险相关。此外，坚持通过饮食方法来停止高血压与高血压的发生呈强烈的负相关：（Q4 vs Q1） HR=0.66 （95% CI, 0.58-0.75）。我们的研究结果证实了几种营养因素的摄入与高血压的发生有关，并强调了采用全球健康饮食可能对高血压的预防有很大的帮助。
Dietary intake is pointed as one of the major determinants in hypertension development. Data in the area are mostly obtained from cross-sectional studies. We aimed to investigate the prospective association between (1) individual nutritional factors and (2) adherence to the Dietary Approach to Stop Hypertension and the risk of incident hypertension in a large cohort study. We prospectively examined the incidence of hypertension among 80 426 French adults participating in the NutriNetSante cohort study. Self-reported sociodemographic, lifestyle health questionnaires and dietary consumption assessed by three 24-hour records were completed at baseline and yearly thereafter. Associations between quartiles (Q) of nutrients and food groups and adherence to Dietary Approach to Stop Hypertension diet and hypertension risk were assessed by multivariable Cox proportional hazards models. During a mean follow-up of 3.4 +/- 2.1 years, 2413 cases of incident hypertension were documented. Dietary intakes of sodium (Q4 versus Q1): hazard ratio (HR)=1.17 (95% confidence interval [CI], 1.02-1.35), potassium: HR=0.82 (95% CI, 0.72-0.94), animal protein: HR=1.26 (95% CI, 1.11-1.43), vegetable protein: HR=0.85 (95% CI, 0.75-0.95), fiber: HR =0.81 (95% CI, 0.71-0.93), magnesium: HR=0.77 (95% CI, 0.67-0.89), fruit and vegetables: HR=0.85 (95% CI, 0.74-0.97), whole grain: HR=0.84(95% CI, 0.76-0.93), nuts: HR=0.72 (95% CI, 0.63-0.83), and red and processed meat: HR=1.25 (95% CI, 1.11-0.42) were associated with risk of hypertension. Besides, adherence to the Dietary Approach to Stop Hypertension was strongly inversely associated with incident hypertension: (Q4 versus Q1) HR=0.66 (95% CI, 0.58-0.75). Our results confirmed the association of several nutritional factors intake and incident hypertension and highlighted that adopting a global healthy diet could strongly contribute to the prevention of hypertension.