膳食因素对高血压发病风险的单独和联合作用：NutriNet-Santé 队列的前瞻性分析。
Individual and Combined Effects of Dietary Factors on Risk of Incident Hypertension: Prospective Analysis From the NutriNet-Santé Cohort.
机构信息
From the AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, France (H.L., J.B.); UREN (Nutritional Epidemiology Research Unit), U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13 Sorbonne Paris Cité University, Bobigny, France (H.L., J. Blacher, J. Baudry, S.A., P.G., L.F., S.H., E.K.-G.); and Department of Public Health, Avicenne Hospital, Bobigny, France (S.H.).
出版信息
Hypertension. 2017 Oct;70(4):712-720. doi: 10.1161/HYPERTENSIONAHA.117.09622. Epub 2017 Jul 31.
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 NutriNet-Santé 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.
饮食摄入被认为是高血压发展的主要决定因素之一。该领域的数据主要来自于横断面研究。我们旨在通过一项大型队列研究，调查（1）个体营养因素和（2）对停止高血压的饮食方法的依从性与高血压发病风险之间的前瞻性关联。我们前瞻性地检查了参加 NutriNet-Santé 队列研究的 80426 名法国成年人的高血压发病率。在基线和此后每年，通过三份 24 小时记录完成自我报告的社会人口统计学、生活方式健康问卷和饮食消费评估。通过多变量 Cox 比例风险模型评估营养素和食物组四分位数（Q）与停止高血压的饮食方法的依从性和高血压风险之间的相关性。在平均 3.4±2.1 年的随访期间，记录了 2413 例新发高血压病例。饮食钠摄入量（Q4 与 Q1）：风险比（HR）=1.17（95%置信区间 [CI]，1.02-1.35），钾：HR=0.82（95% CI，0.72-0.94），动物蛋白：HR=1.26（95% CI，1.11-1.43），植物蛋白：HR=0.85（95% CI，0.75-0.95），纤维：HR=0.81（95% CI，0.71-0.93），镁：HR=0.77（95% CI，0.67-0.89），水果和蔬菜：HR=0.85（95% CI，0.74-0.97），全谷物：HR=0.84（95% CI，0.76-0.93），坚果：HR=0.72（95% CI，0.63-0.83），以及红色和加工肉类：HR=1.25（95% CI，1.11-0.42）与高血压发病风险相关。此外，对停止高血压的饮食方法的依从性与高血压发病呈强烈负相关（Q4 与 Q1）：HR=0.66（95% CI，0.58-0.75）。我们的研究结果证实了多种营养因素摄入与新发高血压之间的关联，并强调采用整体健康饮食可以为预防高血压做出重要贡献。
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