Hypertension and the fat-soluble vitamins A, D and E

Association between fat-soluble vitamin co-exposure patterns and blood pressure in people with hypertension: a cross-sectional study

Background

Existing epidemiological studies investigated the association between a single vitamin and hypertension. However, the potential relationship between the level of circulating multivitamins and blood pressure has not been explored. We aimed to investigate the association between multiple fat-soluble vitamin levels and blood pressure.

Methods

A total of 2052 participants with essential hypertension were sampled nationwide. The plasma concentrations of fat-soluble vitamins (A, E, D, and K) were assessed using liquid chromatography coupled with the mass spectrometry method. Participants were categorized into different co-exposure patterns using the unsupervised K-means clustering method. The multiple linear regression model was used for subsequent analyses.

Results

Participants were classified into two co-exposure patterns of fat-soluble vitamins. The levels of vitamins were relatively low in pattern 1, compared to pattern 2. Participants in pattern 2 had no significantly different blood pressure levels compared to pattern 1. However, the plasma 25-hydroxyvitamin D3 (VD3) levels were negatively associated with SBP (logarithmic 10 transformed) (β = -0.002, 95% CI: -0.004, 0); participants in the fourth α-tocopherol quartile had mean SBP levels that were 1.02% (95% CI: 0.43, 1.61%) greater than those in the lowest quartile (p for trend <0.01). In addition, no significant relationships were found between plasma VA/VK concentrations and blood pressure.

Discussion

Although no significant association between fat-soluble vitamin co-exposure patterns and blood pressure was found, further analyses could imply that plasma α-tocopherol levels may offset the potential protective effect of plasma VD3 on blood pressure among hypertensive adults. This provided a novel perspective for exploring the joint effects of fat-soluble vitamins on blood pressure. Further studies are warranted to better understand the implications.

Association of Dietary Intake of Vitamin A With Adolescent Hypertension: A Cross-Sectional Study Based on NHANES 1999-2018

We aimed to investigate the association between dietary intake of vitamin A and risk of hypertension during adolescence. We interrogated the National Health and Nutrition Examination Survey (NHANES) database, from which individual-level data on dietary intake of vitamin A were garnered from 13,909 adolescents (aged 10-19 years) participating in the 1999-2018 study cycle. After dividing vitamin A intake into four quartiles, we leveraged weighted multivariate logistic regression to investigate the association of vitamin A intake with hypertension by each quartile, with the restricted cubic spline (RCS) curve plotted to assess the nonlinearity of association. Additionally, we performed subgroup analysis to examine whether gender remarkably affects vitamin A's effect on hypertension. Of all the adolescent participants, 1477 (10.6%) were found to have hypertension. Following thorough adjustments for confounding factors, per 1-SD increment in vitamin A intake was associated with a 23%, 26%, and 31% reduction in the risk of hypertension for the 2nd, 3rd, and 4th quartiles, respectively. Consistently, the RCS curve indicated that the risk of adolescent hypertension presented a decreasing trend as vitamin A intake creeped up. Intriguingly, gender-stratified subgroup analysis demonstrated that the observed association between vitamin A and adolescent hypertension was more pronounced in boys. Together, our findings outlined vitamin A as a protective dietary factor against hypertension among US adolescents. When using vitamin A supplements for preventing hypertension, boys may gain more practical benefits.

Does dietary intake of vitamin A and beta-carotene increase the risk of hypertension?

Background

Hypertension (HTN) is a major global public health issue influenced by genetics and lifestyle factors such as diet and psychological stress. Previous research suggests a potential link between HTN and dietary vitamin A intake. This study aims to explore the association between HTN and the intake of various forms of vitamin A.

Methods

This cross-sectional study was conducted on 1239 patients with HTN and 2945 normotensive individuals aged 35-70 years in Sabzevar, Iran. Dietary vitamin A intake was assessed using the Nutritionist IV software and a food frequency questionnaire.

Result

A positive association was found between HTN with total vitamin A intake [odds ratio (OR): 1.03, 95% confidence interval (CI): 1.01-1.05, P = 0.04] and β-carotene intake (OR: 1.03, 95% CI: 1.02-1.05, P = 0.03) after adjusting for age and sex. These associations remained statistically significant after adjusting for physical activity and BMI. The association between HTN and β-carotene intake remained significant after additional adjustment for calorie intake. No significant association was observed between dietary retinol intake and HTN.

Conclusion

Increased dietary intake of vitamin A and β-carotene may be associated with a higher risk of HTN. Further longitudinal studies are needed to confirm these findings and elucidate the underlying mechanisms.

The Role of Oxidative Stress in Hypertension: The Insight into Antihypertensive Properties of Vitamins A, C and E

Hypertension stands as a pervasive global health challenge, contributing significantly to mortality rates worldwide. Various factors, including lifestyle choices and dietary habits, contribute to the development of hypertension. In recent years, oxidative stress has garnered significant attention as a factor influencing hypertension risk, prompting a shift in research focus towards exploring it as a potential target for prevention and treatment. Antioxidants found in our diet, such as vitamins C, E and carotenoids exhibit the ability to neutralize reactive oxygen species, thereby mitigating oxidative stress. In addition, Vitamin A has an antioxidant effect despite not being an antioxidant itself. Consequently, supplementation or increased intake of these antioxidants has been hypothesized to potentially lower blood pressure levels and aid in the management of hypertension, thereby potentially prolonging life expectancy. Research findings regarding this effect have been diverse. This paper examines the existing literature demonstrating favorable outcomes associated with antioxidant supplementation.

Combining multiaspect factors to predict the risk of childhood hypertension incidence

Childhood hypertension has become a global public health issue due to its increasing prevalence and association with cerebral-cardiovascular disease in adults. In this study, we developed a predictive model for childhood hypertension based on environmental and genetic factors to identify at-risk individuals. Eighty children diagnosed with childhood hypertension and 84 children in the control group matched by sex and age from an established cohort were included in a nested case-control study. We constructed a multiple logistic regression model to analyze the factors associated with hypertension and applied the 10-fold cross-validation method to verify the prediction stability of the model. Childhood hypertension was found positively correlated with triglyceride level ≥150 mg/dL; low-density lipoprotein cholesterol level ≥110 mg/dL; body mass index Z score; waist-to-height ratio Z score; and red blood cell count (all P < .01) and negatively correlated with the relative expression level of retinol acyltransferase; relative expression level of vitamin D receptor; and dietary intake of fiber, vitamin C and copper (all P < .05) in this study. BMI Z score, triglyceride ≥150 mg/dL, RBC count, VDR/β-actin and LRAT/β-actin ratios were used to construct the predictive model. The area under the receiver operating characteristic curve was 94.45% (95% CI = 89.35%∼98.65%, P < .001). The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were all above 80% in both the training and validation sets. In conclusion, this model can predict the risk of childhood hypertension and could provide a theoretical basis for early prevention and intervention to improve the cardiovascular health of children.

A Systematic Review of Effects of Vitamin E on the Cardiovascular System

Vitamin E is a fat-soluble vitamin and an antioxidant that prevents the peroxidation of lipid in vitro. The antioxidant role of vitamin E in preventing adverse cardiovascular outcomes is controversial as some studies support it, while others reject it. Therefore, this review aims to determine whether there is an association between vitamin E and cardiovascular diseases (CVDs). An electronic search was done to find out relevant articles. Papers were shortlisted after the initial title and abstract screen. A full-text study was done, and inclusion and exclusion criteria were applied before the quality assessment of each paper was done. Only high-quality papers were selected for analysis. Full-text articles of the last ten years were included, while non-English articles, gray literature, and animal studies were excluded. The majority of the papers, including 75% of the total population in this review, suggested no role of vitamin E in preventing CVD and CVD mortality. Some studies also suggested that a high level of vitamin E can be associated with adverse cardiovascular outcomes. Thus, one should be prudent about taking vitamin E supplementation for cardiovascular risk prevention.

Inverse association between dietary vitamin A intake and new-onset hypertension

BACKGROUND & AIMS

The prospective relation of dietary vitamin A intake with hypertension remains uncertain. We aimed to investigate the relationship of dietary vitamin A intake with new-onset hypertension and examine possible effect modifiers in general population.

METHODS

This prospective cohort study included 12,245 participants who were free of hypertension at baseline from China Health and Nutrition Survey (CHNS). Dietary intake was measured by 3 consecutive 24-h dietary recalls combined with a household food inventory. The study outcome was new-onset hypertension, defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg or diagnosed by physician or under antihypertensive treatment during the follow-up.

RESULTS

During a median follow-up duration of 6.1 years, a total of 4,304 (35.1%) participants developed new-onset hypertension. Overall, there was an L-shaped relation of total dietary vitamin A intake with new-onset hypertension (P for nonlinearity <0.001). Accordingly, compared with participants with lower vitamin A intake (quartile 1, <227.3 μg RE/day), those with higher vitamin A intake (quartile 2-4, ≥227.3 μg RE/day) had a significantly lower risk of new-onset hypertension (adjusted HR, 0.73; 95%CI: 0.63, 0.78). Similar results were found for plant-derived vitamin A intake (adjusted HR, 0.65; 95% CI, 0.61, 0.70) or animal-derived vitamin A intake (adjusted HR, 0.76; 95% CI, 0.70, 0.82).

CONCLUSIONS

There was a L-shaped relation of dietary vitamin A intake with new-onset hypertension in general Chinese adults. Our results emphasized the importance of maintaining relatively higher vitamin A intake levels for the prevention of hypertension.

Cohort profile: the Hortega Study for the evaluation of non-traditional risk factors of cardiometabolic and other chronic diseases in a general population from Spain

PURPOSE

The Hortega Study is a prospective study, which investigates novel determinants of selected chronic conditions with an emphasis on cardiovascular health in a representative sample of a general population from Spain.

PARTICIPANTS

In 1997, a mailed survey was sent to a random selection of public health system beneficiaries assigned to the University Hospital Rio Hortega's catchment area in Valladolid (Spain) (n=11 423, phase I), followed by a pilot examination in 1999-2000 of 495 phase I participants (phase II). In 2001-2003, the examination of 1502 individuals constituted the Hortega Study baseline examination visit (phase III, mean age 48.7 years, 49% men, 17% with obesity, 27% current smokers). Follow-up of phase III participants (also termed Hortega Follow-up Study) was obtained as of 30 November 2015 through review of health records (9.5% of participants without follow-up information).

FINDINGS TO DATE

The Hortega Study integrates baseline information of traditional and non-traditional factors (metabolomic including lipidomic and oxidative stress metabolites, genetic variants and environmental factors, such as metals), with 14 years of follow-up for the assessment of mortality and incidence of chronic diseases. Preliminary analysis of time to event data shows that well-known cardiovascular risk factors are associated with cardiovascular incidence rates, which add robustness to our cohort.

FUTURE PLANS

In 2020, we will review updated health and mortality records of this ongoing cohort for a 5-year follow-up extension. We will also re-examine elder survivors to evaluate specific aspects of ageing and conduct geolocation to study additional environmental exposures. Stored biological specimens are available for analysis of new biomarkers. The Hortega Study will, thus, enable the identification of novel factors based on time to event data, potentially contributing to the prevention and control of chronic diseases in ageing populations.

Anthropometric Status and Nutritional Intake in Children (6-9 Years) in Valencia (Spain): The ANIVA Study

The aim of our study was to assess nutritional intake and anthropometric statuses in schoolchildren to subsequently determine nutritional adequacy with Spanish Dietary Reference Intake (DRIs). The ANIVA study, a descriptive cross-sectional study, was conducted in 710 schoolchildren (6–9 years) in 2013–2014 in Valencia (Spain). Children’s dietary intake was measured using 3-day food records, completed by parents. Anthropometric measures (weight and height) were measured according to international standards, and BMI-for-age was calculated and converted into z-scores by WHO-Anthro for age and sex. Nutrient adequacy was assessed using DRI based on estimated average requirement (EAR) or adequate intake (AI). Pearson’s chi-square and Student’s t-test were employed. Of our study group (47.61% boys, 52.39% girls), 53.1% were normoweight and the weight of 46.9% was inadequate; of these, 38.6% had excess body weight (19.6% overweight and 19.0% obesity). We found intakes were lower for biotin, fiber, fluoride, vitamin D (p < 0.016), zinc, iodine, vitamin E, folic acid, calcium and iron (p < 0.017), and higher for lipids, proteins and cholesterol. Our results identify better nutritional adequacy to Spanish recommendations in overweight children. Our findings suggest that nutritional intervention and educational strategies are needed to promote healthy eating in these children and nutritional adequacies.