Adopting low-risk dietary and lifestyle factors related to lower incidence of high blood pressure

July 21, 2009,

Adherence to modifiable lifestyle and dietary factors including maintaining normal weight, daily vigorous exercise, eating a diet high in fruits, vegetables, low-fat dairy products and low in sodium and taking a folic acid supplement was associated with a significantly lower incidence of self-reported hypertension among women, according to a study in the July 22/29 issue of JAMA.

Hypertension (high ) contributes to more excess deaths in than any other preventable factor. "Pharmacological treatment of established has proven benefits, yet these efforts are costly, require medical intervention, and have adverse effects," the authors write. "Primary prevention of hypertension, therefore, would have major positive public health ramifications." While several modifiable risk factors have been identified, the proportion of patients with new-onset hypertension that could conceivably be prevented by modification of a combination of lifestyle factors has not previously been evaluated.

John P. Forman, M.D., M.Sc., of Brigham and Women's Hospital and Harvard Medical School, Boston, and colleagues examined the association between combinations of low-risk lifestyle factors and the risk of developing hypertension. The study included 83,882 adult women (age 27 to 44 years) in the second Nurses' Health Study who did not have hypertension, cardiovascular disease, diabetes, or cancer in 1991, and who had normal reported blood pressure (defined as systolic blood pressure of ≤120 mm Hg and diastolic blood pressure of ≤80 mm Hg). There was follow-up for new hypertension for 14 years through 2005.

Six modifiable lifestyle and dietary factors for hypertension were identified and included a body mass index (BMI) of less than 25; a daily average of 30 minutes of vigorous exercise; a high score on the Dietary Approaches to Stop Hypertension (DASH) diet based on responses to a food frequency questionnaire; modest alcohol intake; use of nonnarcotic analgesics less than once per week; and intake of 400 μg/d or more of supplemental folic acid. A DASH score was determined based on high intake of fruits, vegetables, nuts and legumes, low-fat dairy products, and whole grains, and low intake of sodium, sweetened beverages, and red and processed meats.

The association between combinations of 3 (normal BMI, daily vigorous exercise, and DASH-style diet), 4 (3 low-risk factors plus modest alcohol intake), 5 (4 low-risk factors plus avoidance of nonnarcotic analgesics), and 6 (folic acid supplementation ≥400 g/d) low-risk factors and the risk of developing hypertension was analyzed.

During the follow-up, a total of 12,319 new cases of hypertension were reported. All 6 modifiable risk factors were independently associated with the risk of developing hypertension during follow-up after also adjusting for age, race, family history of hypertension, smoking status, and use of oral contraceptives. For women who had all 6 low-risk factors (0.3 percent of the population), they had about an 80 percent lower risk of developing high blood pressure.

The hypothetical population attributable risks (PARs; an estimate of the percentage of new hypertension cases occurring in this population that hypothetically could have been prevented if all women had been in the low-risk group) was 78 percent for women who lacked these low-risk factors. The PARs were 72 percent for 5 low-risk factors (0.8 percent of the population); 58 percent for 4 low-risk factors (1.6 percent of the population); and 53 percent for 3 low-risk factors (3.1 percent of the population). Body mass index alone was the most powerful predictor of hypertension, with a BMI of 25 or greater having an adjusted PAR of 40 percent compared with a BMI of less than 25.

The authors add that their "data indicate that adherence to a combination of low-risk lifestyle factors could have the potential to prevent the majority of new-onset hypertension in young women irrespective of family history of hypertension and irrespective of oral contraceptive use. The former conclusion is particularly poignant given that some women may mistakenly believe that their parental history signifies that their own development of hypertension may be unavoidable; rather, these women may conceivably at least delay onset of hypertension by reducing their risk factors."

"In conclusion, adherence to low-risk dietary and factors was associated with significant reductions in the incidence of self-reported hypertension and could have the potential to prevent a large proportion of new-onset hypertension occurring among young women. Prevention of hypertension would, in turn, have major public health benefits."

More information: JAMA. 2009;302[4]:401-411.

Source: JAMA and Archives Journals (news : web)

Related Stories

Recommended for you

Sweet, bitter, fat: New study reveals impact of genetics on how kids snack

February 22, 2018
Whether your child asks for crackers, cookies or veggies to snack on could be linked to genetics, according to new findings from the Guelph Family Health Study at the University of Guelph.

The good and bad health news about your exercise posts on social media

February 22, 2018
We all have that Facebook friend—or 10—who regularly posts photos of his or her fitness pursuits: on the elliptical at the gym, hiking through the wilderness, crossing a 10K finish line.

Smartphones are bad for some teens, not all

February 21, 2018
Is the next generation better or worse off because of smartphones? The answer is complex and research shows it largely depends on their lives offline.

Tackling health problems in the young is crucial for their children's future

February 21, 2018
A child's growth and development is affected by the health and lifestyles of their parents before pregnancy - even going back to adolescence - according to a new study by researchers at the Murdoch Children's Research Institute, ...

Lead and other toxic metals found in e-cigarette 'vapors': study

February 21, 2018
Significant amounts of toxic metals, including lead, leak from some e-cigarette heating coils and are present in the aerosols inhaled by users, according to a study from scientists at Johns Hopkins Bloomberg School of Public ...

Why teens need up to 10 hours' sleep

February 21, 2018
Technology, other distractions and staying up late make is difficult, but researchers say teenagers need to make time for 8-10 hours of sleep a night to optimise their performance and maintain good health and wellbeing.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.