Eight-Year Blood Pressure Change in Middle-Aged Men Relationship to Multiple Nutrients

Abstract-Relationships of nutrients, alcohol intake, and change in weight to change in blood pressure over 8 years in 1714 employed middle-aged men from the Chicago Western Electric Study were explored. At first and second annual examinations, 2 in-depth interviews were performed to assess usual intake of foods and beverages during the preceding 28 days. Annual follow-up data through examination year 9 were used to determine change in weight and blood pressure. Averages of nutrients from 2 interviews were related to annual blood pressure change from baseline by use of the Generalized Estimating Equation, with control for confounders. In analyses of dietary variables considered individually, total and animal protein; total, saturated, monounsaturated, and polyunsaturated fatty acids; cholesterol; Keys dietary lipid score; calcium; alcohol; and average annual change in weight were positively and significantly related to average annual change in systolic pressure; vegetable protein, total carbohydrate, beta-carotene, and an antioxidant vitamin score based on vitamin C and beta-carotene were inversely and significantly related to average annual change in systolic pressure. In analyses of combinations of dietary factors, cholesterol, Keys score, and alcohol were positively related to change in systolic pressure (eg, Z-scores 2.21, 2.05, and 2.50); vegetable protein and antioxidant index were inversely related to change in systolic and diastolic pressure. Change in weight was directly related to change in systolic and diastolic pressure. These findings support the concept that multiple macro-and micronutrients, alcohol intake, and calorie imbalance relate prospectively to blood pressure change. Key Words: blood pressure Ⅲ diet Ⅲ nutrition Ⅲ alcohol Ⅲ body weight Ⅲ population Ⅲ prospective studies D espite progress in the detection, evaluation, and treatment of high blood pressure (BP), adverse BP levels remain the rule nationally and internationally among adults age Ն35 years. 1-10 Prevalence rates of optimal BP (systolic BP [SBP]/diastolic BP [DBP] Յ120/Յ80 mm Hg) are low, whereas rates of high-normal BP and hypertension are epidemic, resulting in markedly increased risks of major cardiovascular diseases. In contrast, this is not the pattern among young adults, who on average have SBP/DBP within the optimal range. 5,9 Thus, the root of the epidemic of adverse BP levels is the increase in SBP/DBP that most people experience (in varying degrees) during the decades from youth through middle age