Department of Cardiology, Second Xiangya Hospital of Central South University, Changsha 410011, China.
Department of Emergency, The First Affiliated Hospital of University of South China, Hengyang 421001, China.
Nutrients. 2024 May 20;16(10):1534. doi: 10.3390/nu16101534.
The effect of flavonoid consumption on all-cause and special-cause mortality remains unclear among populations with hypertension.
A total of 6110 people with hypertension from three NHANES survey cycles (2007-2008, 2009-2010, and 2017-2018) were enrolled in this study. Cox proportional hazard models were conducted to estimate the association between the intake of total flavonoids and flavonoid subclasses and all-cause, cancer-related, and cardiovascular disease (CVD)-related mortality. Nonlinear relationships were identified using restricted cubic splines (RCS).
During 43,977 person-years of follow-up, 1155 participants died from any cause, 282 participants died from CVD, and 265 participants died from cancer. After adjusting for relevant confounders, including demographic, lifestyle, and dietary intake, a higher intake of total flavonoids was significantly associated with lower all-cause mortality but not CVD-related and cancer-related mortality among the population with hypertension. Compared with extreme quartiles, the hazard ratio (HR) and 95% confidence interval (CI) were 0.74 (0.56-0.97) for all-cause mortality, 0.77 (0.40-1.46) for CVD-related mortality, and 0.62 (0.35-1.08) for cancer-related mortality. In terms of all-cause mortality, this inverse association was optimized at total flavonoid consumption of approximately 375 mg/day. In addition, the negative association between total flavonoid consumption and all-cause mortality was more pronounced in non-obese (BMI < 30 kg/m) compared to obese (BMI ≥ 30 kg/m) populations. Higher intakes of anthocyanidin, flavan-3-ol, flavonol, and isoflavone were significantly associated with lower all-cause mortality (HR (95%CI): 0.70 (0.55-0.89); 0.76 (0.59-0.96); 0.66 (0.46-0.94); 0.79 (0.67-0.93), respectively). Higher intakes of anthocyanidin, flavan-3-ol, and flavonol were significantly associated with lower cancer-related mortality (HR (95%CI): 0.55 (0.32-0.93); 0.51 (0.31-0.82); 0.52 (0.28-0.96), respectively).
This study suggests that a heightened consumption of total flavonoids and some flavonoid subclasses was linked to lower mortality, which supports the proposal of increasing flavonoid intake as part of healthy diets in patients with hypertension.
黄酮类化合物的摄入对高血压人群的全因死亡率和特殊原因死亡率的影响仍不清楚。
本研究共纳入了来自三个 NHANES 调查周期（2007-2008 年、2009-2010 年和 2017-2018 年）的 6110 名高血压患者。采用 Cox 比例风险模型估计总黄酮和黄酮类化合物亚类的摄入量与全因、癌症相关和心血管疾病（CVD）相关死亡率之间的关联。使用限制性立方样条（RCS）确定非线性关系。
在 43977 人年的随访期间，有 1155 名参与者死于任何原因，282 名参与者死于 CVD，265 名参与者死于癌症。在调整了相关混杂因素，包括人口统计学、生活方式和饮食摄入后，较高的总黄酮摄入量与高血压人群的全因死亡率降低显著相关，但与 CVD 相关死亡率和癌症相关死亡率无关。与极端四分位组相比，全因死亡率的危险比（HR）和 95%置信区间（CI）分别为 0.74（0.56-0.97）、0.77（0.40-1.46）和 0.62（0.35-1.08）。就全因死亡率而言，这种负相关在总黄酮摄入量约为 375mg/天时达到最佳。此外，总黄酮摄入量与全因死亡率之间的负相关在非肥胖（BMI<30kg/m）人群中比肥胖（BMI≥30kg/m）人群更为明显。较高的花青素、黄烷-3-醇、黄酮醇和异黄酮摄入量与全因死亡率降低显著相关（HR（95%CI）：0.70（0.55-0.89）；0.76（0.59-0.96）；0.66（0.46-0.94）；0.79（0.67-0.93））。较高的花青素、黄烷-3-醇和黄酮醇摄入量与癌症相关死亡率降低显著相关（HR（95%CI）：0.55（0.32-0.93）；0.51（0.31-0.82）；0.52（0.28-0.96））。
本研究表明，总黄酮和一些黄酮类化合物亚类的摄入量增加与死亡率降低有关，这支持了增加黄酮类化合物摄入作为高血压患者健康饮食的一部分的建议。
