title: Breakfast cereals and risk of hypertension in the Physicians' Health Study I.
abstract: OBJECTIVE
  Hypertension is a major public health problem. While many dietary factors affect the risk of developing hypertension, limited data are available on the association between consumption of breakfast cereal and incident hypertension. We examined the association between breakfast cereal consumption and the risk of hypertension.
  
  
  METHODS
  We prospectively analyzed data from 13,368 male participants of the Physicians' Health Study I. Consumption of breakfast cereals was estimated using an abbreviated food frequency questionnaire and incident hypertension was ascertained through yearly follow-up questionnaires.
  
  
  RESULTS
  The average age of study participants was 52.4 ± 8.9 years (range 39.7-85.9) during the initial assessment of cereal intake (1981-1983). During a mean follow up of 16.3 years, 7267 cases of hypertension occurred. The crude incidence rates of hypertension were 36.7, 34.0, 31.7, and 29.6 cases/1000 person-years for people reporting breakfast cereal intake of 0, ≤1, 2-6, and ≥7 servings/week, respectively. In a Cox regression model adjusting for age, smoking, body mass index, alcohol consumption, fruit and vegetable consumption, physical activity, and history of diabetes mellitus, hazard ratios (95% CI) for hypertension were 1.0 (reference), 0.93 (0.88-0.99), 0.88 (0.83-0.94), and 0.81 (0.75-0.86) from the lowest to the highest category of cereal consumption, respectively (p for trend <0.0001). This association was strongest for whole grain cereals and was observed in lean as well as overweight or obese participants.
  
  
  CONCLUSIONS
  The results of this longitudinal cohort study suggest that whole grain breakfast cereal consumption confers a lower risk of hypertension in middle-aged adult males.
authors.affiliation: Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA. jkochar@bidmc.harvard.edu
authors.forename: Jinesh
authors.initials: J
authors.lastname: Kochar
authors.forename: J Michael
authors.initials: JM
authors.lastname: Gaziano
authors.forename: Luc
authors.initials: L
authors.lastname: Djoussé
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D015992:Body Mass Index; D004032:Diet; D004043:Dietary Fiber / Q000008:administration & dosage; D002523:Edible Grain; D005500:Follow-Up Studies; D005638:Fruit; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014675:Vegetables