Relationship between diet and blood pressure in a representative Mediterranean population.
BACKGROUND
Hypertension is strongly associated with cardiovascular and renal disease. However, despite the efforts made to control hypertension via drug treatment, prevalence of controlled hypertension could be considered low.


OBJECTIVE
We performed the present study to investigate dietary habits among groups with different blood pressure status (normotensive, non-medicated hypertensive, medicated hypertensive) and to analyze the association between blood pressure and intakes of selected nutrients in normotensive and non-medicated hypertensive subjects (n = 1357), and furthermore in those undergoing hypertension drug treatment (n = 210; controlled and non-controlled).


METHODS
The present cross-sectional, population-based survey (Gerona, Spain) included cardiovascular risk measurements and analysis of dietary intake with corresponding questionnaires.


RESULTS
Nutrient intake was similar among groups of different blood pressure status after adjusting for sex, age and energy consumption. Multiple linear regression analysis, after adjustment for several confounders, showed that dietary intake of sodium was directly related to blood pressure. The same was seen for the sodium to potassium ratio and both were independent of hypertension drug treatment. In contrast, an inverse association was observed between blood pressure and dietary calcium intake. Moderate sodium (< 2400 mg Na/d) intake reduced the risk of hypertension by 30 % and 52 % (Odds ratio 0.70; 95 % CI 0.52-0.94, respectively) in normotensive and non-medicated hypertensive subjects. Furthermore, moderate sodium in combination with a calcium intake of more than 800 mg/d reduced the risk of inadequate blood pressure control, by 52 % (Odds ratio 0.48; 95 % CI 0.24-0.95) in subjects undergoing hypertension drug treatment. Controlled hypertension subjects have a significantly higher calcium intake than non-controlled.


CONCLUSIONS
These results emphasize the importance of diet and overall of sodium intake as non-pharmacological approach in the prevention and treatment of hypertension.
Schröder
H
H
Lipids and Cardiovascular Epidemiology Unit, Institut Municipal d'Investigació Mèdicca, Barcelona, Spain.
Schmelz
E
E
Marrugat
J
J
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002136:Calcium, Dietary / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D004032:Diet; D002149:Energy Intake; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000517:prevention & control; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012982:Sodium, Dietary / Q000008:administration & dosage; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires
D002136:Calcium, Dietary; D012982:Sodium, Dietary