美国女性的叶酸摄入量与高血压发病风险

Folate intake and the risk of incident hypertension among US women.

作者信息

Forman John P, Rimm Eric B, Stampfer Meir J, Curhan Gary C

机构信息

Renal Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass, USA.

出版信息

JAMA. 2005 Jan 19;293(3):320-9. doi: 10.1001/jama.293.3.320.

DOI:10.1001/jama.293.3.320

PMID:15657325

Abstract

CONTEXT

Folate has important beneficial effects on endothelial function, but there is limited information about folate intake and risk of incident hypertension.

OBJECTIVE

To determine whether higher folate intake is associated with a lower risk of incident hypertension.

DESIGN, SETTING, AND PARTICIPANTS: Two prospective cohort studies of 93,803 younger women aged 27 to 44 years in the Nurses' Health Study II (1991-1999) and 62,260 older women aged 43 to 70 years in the Nurses' Health Study I (1990-1998), who did not have a history of hypertension. Baseline information on dietary folate and supplemental folic acid intake was derived from semiquantitative food frequency questionnaires and was updated every 4 years.

MAIN OUTCOME MEASURE

Relative risk of incident self-reported hypertension during 8 years of follow-up.

RESULTS

We identified 7373 incident cases of hypertension in younger women and 12,347 cases in older women. After adjusting for multiple potential confounders, younger women who consumed at least 1000 microg/d of total folate (dietary plus supplemental) had a decreased risk of hypertension (relative risk [RR], 0.54; 95% confidence interval [CI], 0.45-0.66; P for trend <.001) compared with those who consumed less than 200 microg/d. Younger women's absolute risk reduction (ARR) was approximately 8 cases per 1000 person-years (6.7 vs 14.8 cases). The multivariable RR for the same comparison in older women was 0.82 (95% CI, 0.69-0.97; P for trend = .05). Older women's ARR was approximately 6 cases per 1000 person-years (34.7 vs 40.4 cases). When the analysis was restricted to women with low dietary folate intake (<200 microg/d), the multivariable RR for younger women with total folate intake at least 800 microg/d compared with less than 200 microg/d was 0.55 (95% CI, 0.32-0.94; P for trend = .03), and 0.61 (95% CI, 0.34-1.11; P for trend = .05) in the older cohort. Among women who did not take folic acid-containing supplements, dietary folate intake of 400 microg/d or more was not significantly associated with risk of hypertension.

CONCLUSION

Higher total folate intake was associated with a decreased risk of incident hypertension, particularly in younger women.

摘要

背景

叶酸对内皮功能有重要的有益作用，但关于叶酸摄入量与新发高血压风险的信息有限。

目的

确定较高的叶酸摄入量是否与较低的新发高血压风险相关。

设计、地点和参与者：两项前瞻性队列研究，护士健康研究II中有93803名年龄在27至44岁的年轻女性（1991 - 1999年），护士健康研究I中有62260名年龄在43至70岁的老年女性（1990 - 1998年），她们均无高血压病史。膳食叶酸和补充叶酸摄入量的基线信息来自半定量食物频率问卷，并每4年更新一次。

主要结局指标

随访8年期间自我报告的新发高血压的相对风险。

结果

我们在年轻女性中确定了7373例高血压新发病例，在老年女性中确定了12347例。在调整了多个潜在混杂因素后，与每日总叶酸（膳食加补充剂）摄入量低于200微克的年轻女性相比，每日总叶酸摄入量至少1000微克的年轻女性患高血压的风险降低（相对风险[RR]为0.54；95%置信区间[CI]为0.45 - 0.66；趋势P值<.001）。年轻女性的绝对风险降低（ARR）约为每1000人年减少8例（6.7例对14.8例）。老年女性相同比较的多变量RR为0.82（95%CI为0.69 - 0.97；趋势P值 =.05）。老年女性的ARR约为每1000人年减少6例（34.7例对40.4例）。当分析仅限于膳食叶酸摄入量低（<200微克/天）的女性时，年轻女性总叶酸摄入量至少800微克/天与低于200微克/天相比，多变量RR为0.55（95%CI为0.32 - 0.94；趋势P值 =.03），在老年队列中为0.61（95%CI为0.34 - 1.11；趋势P值 =.05）。在未服用含叶酸补充剂的女性中，膳食叶酸摄入量400微克/天或更高与高血压风险无显著关联。