title: Dietary patterns and hypertension among Chinese adults: a nationally representative cross-sectional study.
abstract: BACKGROUND
  Several healthful dietary patterns appear to be effective at lowering blood pressure and preventing hypertension. However, the relationship between dietary patterns and hypertension among a representative Chinese population sample is unclear.
  
  
  METHODS
  A nationally representative sample of 23 671 participants aged 18-59 years were recruited by the 2002 China National Nutrition and Health Survey. All participants had their blood pressure measured with standardized mercury sphygmomanometers. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. We conducted factor analysis using dietary information from a validated food frequency questionnaire to derive dietary patterns. Information of participants on physical activities, education level, annual household income, smoking status and family history of hypertension was collected by interviewer-administrated questionnaires.
  
  
  RESULTS
  Three major dietary patterns, defined as 'Western', 'traditional northern', and 'traditional southern', were identified. Participants with the highest quartile for the score of the Western pattern had significantly higher blood pressure comparing with counterparts in the lowest quartile. In contrast, participants in the top quartile for the score of the traditional southern pattern presented significantly lower blood pressure comparing with counterparts in the lowest quartile. In multivariate analyses the traditional northern pattern score was associated with an odds ratio (OR) of 1.30 (95% confidence interval (CI) 1.11-1.53, P for trend = 0.0001) comparing with the lowest quartile. The OR for the top quartile of score for the traditional southern pattern was 0.73 (95% CI, 0.59-0.89, P for trend = 0.0040) compared with the lowest quartile of traditional southern pattern score. However, the significant association between the traditional northern pattern and prevalence of hypertension disappeared after further adjusting for body mass index (BMI) (P for trend = 0.3), whereas the association between the traditional southern pattern and prevalence of hypertension persisted after further adjusting for BMI (P for trend = 0.01).
  
  
  CONCLUSIONS
  We observed a positive relationship between the traditional northern pattern and hypertension that was mediated through differences in BMI. In addition, the traditional southern pattern was significantly associated with lower odds of presenting with hypertension.
authors.affiliation: National Institute for Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, 7 Pan Jia Yuan Nan Li, Chaoyang District, Beijing 100021, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Wang
authors.forename: Yuna
authors.initials: Y
authors.lastname: He
authors.forename: Yanping
authors.initials: Y
authors.lastname: Li
authors.forename: Dechun
authors.initials: D
authors.lastname: Luan
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Yang
authors.forename: Fengying
authors.initials: F
authors.lastname: Zhai
authors.forename: Guansheng
authors.initials: G
authors.lastname: Ma
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000235:genetics / Q000502:physiology*; D001795:Blood Pressure Determination; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D004032:Diet / Q000145:classification / Q000523:psychology* / Q000639:trends; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000235:genetics; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D012959:Socioeconomic Factors; D019722:Sphygmomanometers; D011795:Surveys and Questionnaires