A Nutrient-Wide Association Study on Blood Pressure
Background—A nutrient-wide approach may be useful comprehensively to test and validate associations between nutrients (derived from foods and supplements) and blood pressure (BP) in an unbiased manner.
Methods and Results—Data from 4,680 participants ages 40-59 in the cross-sectional International Study of Macro/Micro-nutrients and Blood Pressure (INTERMAP) were stratified randomly into training and testing sets. NHANES cross-sectional cohorts of 1999-2000 to 2005-2006 were used for external validation. We performed multiple linear regression analyses associating each of 82 nutrients and 3 urine electrolytes with systolic and diastolic BP in the INTERMAP training set. Significant findings were validated in the INTERMAP testing set and further in the NHANES cohorts (False Discovery Rate <5% in training, p<0.05 for internal and external validation). Among the validated nutrients, alcohol and urinary sodium-to-potassium ratio were directly associated with systolic BP, and dietary phosphorus, magnesium, iron, thiamin, folacin, and riboflavin were inversely associated with systolic BP. In addition, dietary folacin, and riboflavin were inversely associated with diastolic BP. The absolute effect sizes in the validation data (NHANES) ranged from 0.97 mmHg lower systolic BP (phosphorus) to 0.39 mmHg lower systolic BP (thiamin) per 1SD difference in nutrient variable. Inclusion of nutrient intake from supplements in addition to foods gave similar results for some nutrients, though it attenuated the associations of folacin, thiamin and riboflavin intake with BP.
Conclusions—We identified significant inverse associations between B vitamins and BP, relationships hitherto poorly investigated. Our analyses represent a systematic unbiased approach to the evaluation and validation of nutrient-BP associations.
- Received April 26, 2012.
- Accepted September 28, 2012.
- Copyright © 2012, American Heart Association, Inc. All rights reserved. Unauthorized use prohibited