Habitual intake of flavonoid subclasses and incident hypertension in adults - PubMed
Habitual intake of flavonoid subclasses and incident hypertension in adults
Aedín Cassidy et al. Am J Clin Nutr. 2011 Feb.
Abstract
Background: Dietary flavonoids have beneficial effects on blood pressure in intervention settings, but there is limited information on habitual intake and risk of hypertension in population-based studies.
Objective: We examined the association between habitual flavonoid intake and incident hypertension in a prospective study in men and women.
Design: A total of 87,242 women from the Nurses' Health Study (NHS) II, 46,672 women from the NHS I, and 23,043 men from the Health Professionals Follow-Up Study (HPFS) participated in the study. Total flavonoid and subclass intakes were calculated from semiquantitative food-frequency questionnaires collected every 4 y by using an updated and extended US Department of Agriculture database.
Results: During 14 y of follow-up, 29,018 cases of hypertension in women and 5629 cases of hypertension in men were reported. In pooled multivariate-adjusted analyses, participants in the highest quintile of anthocyanin intake (predominantly from blueberries and strawberries) had an 8% reduction in risk of hypertension [relative risk (RR): 0.92; 95% CI: 0.86, 0.98; P < 0.03] compared with that for participants in the lowest quintile of anthocyanin intake; the risk reduction was 12% (RR: 0.88; 95% CI: 0.84, 0.93; P < 0.001) in participants ≤60 y of age and 0.96 (0.91, 1.02) in participants >60 y of age (P for age interaction = 0.02). Although intakes of other subclasses were not associated with hypertension, pooled analyses for individual compounds suggested a 5% (95% CI: 0.91, 0.99; P = 0.005) reduction in risk for the highest compared with the lowest quintiles of intake of the flavone apigenin. In participants ≤60 y of age, a 6% (95% CI: 0.88, 0.97; P = 0.002) reduction in risk was observed for the flavan-3-ol catechin when the highest and the lowest quintiles were compared.
Conclusions: Anthocyanins and some flavone and flavan-3-ol compounds may contribute to the prevention of hypertension. These vasodilatory properties may result from specific structural similarities (including the B-ring hydroxylation and methyoxylation pattern).
Figures

Major contributors to dietary intake by subclass of flavonoid in the Nurses' Health Study (NHS 1), the Nurses' Health Study 2 (NHS 2), and the Health Professionals Follow-Up Study (HPFS).

A–D: Incident hypertension by quintiles (Q) of anthocyanin intake (stratified by age <60 y). NHS II, Nurses' Health Study II; NHS I, Nurses' Health Study; HPFS, Health Professionals Follow-Up Study. P for trend < 0.001.

Common flavonoid structures. Catechol flavonoids and their methyl- and 4′-hydroxy derivatives. A: Basic catechol flavonoid structure. B: Structure of apocynin, which is a vasoactive drug (similar in structure to methylated B-ring flavonoids). C: Catechol flavonoids in the diet (anthocyanin, cyanidin; flavan-3-ol, catechin) and a naturally occurring methyl derivative (anthocyanin, peonidin) in plants. D: 4′ Hydroxy flavonoids (anthocyanin, pelargonidin; flavone, apigenin).
Comment in
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Anthocyanin analysis in banana fruit--a mistake.
Drossard C, Fröhling B, Dietrich H, Kersting M. Drossard C, et al. Am J Clin Nutr. 2011 Apr;93(4):865-6; author reply 866-7. doi: 10.3945/ajcn.110.010454. Epub 2011 Feb 2. Am J Clin Nutr. 2011. PMID: 21289224 No abstract available.
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Somerset S. Somerset S. Am J Clin Nutr. 2011 May;93(5):1153-4; author reply 1154. doi: 10.3945/ajcn.111.012856. Epub 2011 Feb 16. Am J Clin Nutr. 2011. PMID: 21325436 No abstract available.
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References
-
- Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003;42:1206–52 - PubMed
-
- Appel LJ, Moore TJ, Obarzanek E, et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 1997;336:1117–24 - PubMed
-
- Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM. Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension 2006;47:296–308 - PubMed
-
- Sacks FM, Svetkey LP, Vollmer WM, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med 2001;344:3–10 - PubMed
-
- Erdman JW, Jr, Balentine D, Arab L, et al. Flavonoids and heart health: proceedings of the ILSI North America Flavonoids Workshop, May 31-June 1, 2005, Washington, DC. J Nutr 2007;137:718S–37S - PubMed
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