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Adherence to low-risk diet, lifestyle factors associated with lower BP in women
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Women who adopted a low-risk lifestyle had a significantly lower incidence for self-reported hypertension, according to data from a large-scale, prospective study of women included in the Nurses’ Health Study II.
“Adopting low-risk dietary and lifestyle factors has the potential to prevent a large proportion of new-onset hypertension occurring among young women,” the researchers wrote. “Prevention of hypertension would, in turn, have major public health benefits.”
Researchers examined the association between combinations of low-risk lifestyle factors and the risk for developing hypertension. The study included 83,882 women aged 27 to 44 who did not have hypertension, CVD, diabetes or cancer. All women had normal BP at baseline (systolic, ≤120 mm Hg; diastolic, ≤80 mm Hg). Participants received a semi-quantitative food frequency questionnaire at baseline and subsequently every four years thereafter.
Six modifiable lifestyle and dietary factors for hypertension included in the analysis were:
- BMI <25.
- About 30 minutes of vigorous exercise daily.
- High score on the Dietary Approaches to Stop Hypertension (DASH) diet.
- Moderate alcohol consumption.
- Non-narcotic analgesics use <1 time per week.
- Use of ≥400 ug supplemental folic acid per day.
During 14 years of follow-up, 15% of women (n=12,319) reported a new diagnosis of hypertension.
Although all six modifiable risk factors were independently associated with the risk for hypertension, BMI alone was the most powerful predictor of hypertension. Obese women had a higher HR for incident hypertension (4.70) compared with women who had a BMI <23.
The HR for hypertension in women with all six low-risk factors was 0.22. The population attributable risk was 78% for those women who lacked all six low-risk factors, 72% for women with five low-risk factors, 58% for women with four low-risk factors and 53% for women with three low-risk factors.
“At this point, the national cost of treating CV diseases cannot be sustained and prevention is urgent,” Veronique L. Roger, MD, MPH, of the Mayo Clinic, Rochester, Minn., wrote in an accompanying editorial. “Because prevention can benefit from policies aimed at creating a healthier environment, this approach must be expanded.”
Forman JP. JAMA. 2009; 302:401-411.