Department of Clinical Nutrition, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing, 100083, China.
Eur J Nutr. 2023 Dec;62(8):3251-3262. doi: 10.1007/s00394-023-03230-9. Epub 2023 Aug 9.
Evidence is limited regarding the long-term impact of dietary iron intake on the development of hypertension. We investigated the association between dietary intakes of total, nonheme, and heme iron and hypertension risk in a large prospective cohort of Chinese populations over 26 years.
A total of 16,122 adults (7810 men and 8312 women) who participated in the China Health and Nutrition Survey (1989-2015) were included. Dietary intake was repeatedly assessed by combining three consecutive 24‑h individual dietary recalls with household food inventory weighing at each survey round. Incident hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg, diagnosis by physicians, or current use of anti-hypertensive drugs.
During a median follow‑up of 11.1 years, 2863 men and 2532 women developed hypertension. After adjustment for non-dietary and dietary factors, a lower risk of hypertension was found in men and women with higher intakes of total, nonheme, or heme iron. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the highest vs. lowest quartiles were 0.76 (0.67, 0.87) in men and 0.85 (0.74, 0.97) in women for total iron intake, 0.77 (0.67, 0.87) in men and 0.85 (0.74, 0.98) in women for nonheme iron intake, and 0.73 (0.62, 0.87) in men and 0.69 (0.58, 0.82) in women for heme iron intake. Dose-response analyses further revealed a U-shaped association of total and nonheme iron intake and an L-shaped association of heme iron intake with hypertension risk in both men and women (all P for non-linearity < 0.001).
Our findings emphasize the importance of maintaining moderate iron intake in the prevention of hypertension. Both insufficient and excess intake of iron might increase the risk of hypertension.
关于饮食铁摄入量对高血压发展的长期影响，证据有限。我们在一项针对中国人群的大型前瞻性队列研究中，调查了总铁、非血红素铁和血红素铁的饮食摄入量与高血压风险之间的关系，随访时间长达 26 年。
共纳入 16122 名成年人（7810 名男性和 8312 名女性），他们参加了中国健康与营养调查（1989-2015 年）。通过将三次连续的 24 小时个人饮食回忆与每次调查轮次的家庭食物称重相结合，对饮食摄入量进行了重复评估。高血压的发病定义为收缩压≥140mmHg 和/或舒张压≥90mmHg，由医生诊断，或正在使用抗高血压药物。
在中位随访 11.1 年期间，有 2863 名男性和 2532 名女性发生了高血压。在校正非饮食和饮食因素后，男性和女性的总铁、非血红素铁或血红素铁摄入量较高，患高血压的风险较低。最高四分位数与最低四分位数相比，男性的调整后危险比（HR）和 95%置信区间（CI）为 0.76（0.67，0.87），女性为 0.85（0.74，0.97）；男性的调整后 HR 和 95%CI 为 0.77（0.67，0.87），女性为 0.85（0.74，0.98）；男性的调整后 HR 和 95%CI 为 0.73（0.62，0.87），女性为 0.69（0.58，0.82）。剂量反应分析进一步显示，男性和女性的总铁和非血红素铁摄入量呈 U 形关联，血红素铁摄入量呈 L 形关联，与高血压风险相关（所有 P 非线性<0.001）。
我们的研究结果强调了保持适量铁摄入对于预防高血压的重要性。铁摄入不足和过量都可能增加患高血压的风险。
