title: Association of sweetened beverage intake with incident hypertension.
abstract: BACKGROUND
  Consumption of sugar-sweetened beverages (SSBs) is associated with an increased risk of hypertension in cross-sectional studies. However, prospective data are limited.
  
  
  OBJECTIVE
  To examine the associations between SSBs and artificially sweetened beverages (ASBs) with incident hypertension.
  
  
  METHODS
  Prospective analysis using Cox proportional hazards regression to examine the association between SSBs and ASBs with incident hypertension in three large, prospective cohorts, the Nurses' Health Studies I (n = 88,540 women) and II (n = 97,991 women) and the Health Professionals' Follow-Up Study (n = 37,360 men).
  
  
  METHODS
  Adjusted hazard ratios for incident clinically diagnosed hypertension.
  
  
  RESULTS
  Higher SSB and ASB intake was associated with an increased risk of developing hypertension in all three cohorts. In a pooled analysis, participants who consumed at least one SSB daily had an adjusted HR for incident hypertension of 1.13 (95 % CI, 1.09-1.17) compared with those who did not consume SSBs; for persons who drank at least one ASB daily, the adjusted HR was 1.14 (95 % CI, 1.09-1.18). The association between sweetened beverage intake and hypertension was stronger for carbonated beverages versus non-carbonated beverages, and for cola-containing versus non-cola beverages in the NHS I and NHS II cohorts only. Higher fructose intake from SSBs as a percentage of daily calories was associated with increased hypertension risk in NHS I and NHS II (p-trend = 0.001 in both groups), while higher fructose intake from sources other than SSBs was associated with a decrease in hypertension risk in NHS II participants (p-trend = 0.006).
  
  
  CONCLUSIONS
  Residual confounding factors may interfere with the interpretation of results.
  
  
  CONCLUSIONS
  SSBs and ASBs are independently associated with an increased risk of incident hypertension after controlling for multiple potential confounders. These associations may be mediated by factors common to both SSBs and ASBs (e.g., carbonation or cola), but are unlikely to be due to fructose.
authors.affiliation: Division of Nephrology, University of Maryland Medical Center, Baltimore, MD, USA. lcohen@medicine.umaryland.edu
authors.forename: Lisa
authors.initials: L
authors.lastname: Cohen
authors.forename: Gary
authors.initials: G
authors.lastname: Curhan
authors.forename: John
authors.initials: J
authors.lastname: Forman
mesh_terms: D000328:Adult; D001628:Beverages / Q000009:adverse effects; D002253:Carbonated Beverages / Q000009:adverse effects*; D015331:Cohort Studies; D004327:Drinking Behavior; D005260:Female; D005632:Fructose / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013549:Sweetening Agents / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D013549:Sweetening Agents; D005632:Fructose