Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, BT52 1SA, United Kingdom.
Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, BT52 1SA, United Kingdom.
Biochimie. 2020 Jun;173:76-90. doi: 10.1016/j.biochi.2020.03.016. Epub 2020 Apr 11.
Hypertension is the leading cause of preventable mortality worldwide, contributing to over 9 million deaths per annum, predominantly owing to cardiovascular disease. The association of obesity, physical inactivity and alcohol with elevated blood pressure (BP) is firmly established. Weight loss or other dietary strategies, such as the Dietary Approaches to Stop Hypertension (DASH) diet, have been shown to be effective in lowering BP. Additionally, specific nutrients are recognised to contribute to BP, with higher sodium intake linked with an increased risk of hypertension, while potassium is associated with a reduced risk of hypertension. Of note, emerging evidence has identified a novel role for one-carbon metabolism and the related B vitamins, particularly riboflavin, in BP. Specifically in adults genetically at risk of developing hypertension, owing to the common C677T polymorphism in MTHFR, supplemental riboflavin (co-factor for MTHFR) was shown in randomised trials to lower systolic BP by up to 13 mmHg. A BP response to intervention of this magnitude could have important clinical impacts, given that a reduction in systolic BP of 10 mmHg is estimated to decrease stroke risk by 40%. This review aims to explore the factors contributing to hypertension across the lifecycle and to critically evaluate the evidence supporting a role for nutrition, particularly folate-related B vitamins, in BP and risk of hypertension. In addition, gaps in our current knowledge that warrant future research in this area, will be identified.
高血压是全球可预防死亡的主要原因，每年导致超过 900 万人死亡，主要是由于心血管疾病。肥胖、身体活动不足和饮酒与血压升高之间的关联已得到充分证实。减肥或其他饮食策略，如饮食方法阻止高血压（DASH）饮食，已被证明可有效降低血压。此外，特定的营养素被认为与血压有关，摄入更多的钠与高血压风险增加有关，而钾则与高血压风险降低有关。值得注意的是，新出现的证据表明，一碳代谢和相关的 B 族维生素，特别是核黄素，在血压方面发挥着新的作用。具体来说，在由于 MTHFR 中的常见 C677T 多态性而在遗传上易患高血压的成年人中，随机试验表明补充核黄素（MTHFR 的辅助因子）可使收缩压降低高达 13mmHg。鉴于收缩压降低 10mmHg 估计可使中风风险降低 40%，这种干预引起的血压反应可能具有重要的临床影响。本文旨在探讨整个生命周期中导致高血压的因素，并批判性地评估营养，特别是与叶酸有关的 B 族维生素在血压和高血压风险中的作用的证据。此外，还将确定我们目前知识中的空白点，这些空白点需要在该领域进行未来的研究。
