Study Title:

Blueberries and High Blood Pressure

Study 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).

From press release:

Eating blueberries can guard against high blood pressure, according to new research by the University of East Anglia (UEA) and Harvard University.

High blood pressure -- or hypertension -- is one of the major cardiovascular diseases worldwide. It leads to stroke and heart disease and costs more than $300 billion each year. Around a quarter of the adult population is affected globally -- including 10 million people in the UK and one in three US adults.

Published next month in the American Journal of Clinical Nutrition, the new findings show that bioactive compounds in blueberries called anthocyanins offer protection against hypertension. Compared with those who do not eat blueberries, those eating at least one serving a week reduce their risk of developing the condition by 10 per cent.

Anthocyanins belong to the bioactive family of compounds called flavonoids and are found in high amounts in blackcurrants, raspberries, aubergines, blood orange juice and blueberries. Other flavonoids are found in many fruits, vegetables, grains and herbs. The flavonoids present in tea, fruit juice, red wine and dark chocolate are already known to reduce the risk of cardiovascular disease.

This is the first large study to investigate the effect of different flavonoids on hypertension.

The team of UEA and Harvard scientists studied 134,000 women and 47,000 men from the Harvard established cohorts, the Nurses' Health Study and the Health Professionals Follow-up Study over a period of 14 years. None of the participants had hypertension at the start of the study. Subjects were asked to complete health questionnaires every two years and their dietary intake was assessed every four years. Incidence of newly diagnosed hypertension during the 14-year period was then related to consumption of various different flavonoids.

During the study, 35,000 participants developed hypertension. Dietary information identified tea as the main contributor of flavonoids, with apples, orange juice, blueberries, red wine, and strawberries also providing important amounts. When the researchers looked at the relation between individual subclasses of flavonoids and hypertension, they found that participants consuming the highest amounts of anthocyanins (found mainly in blueberries and strawberries in this US-based population) were eight per cent less likely to be diagnosed with hypertension than those consuming the lowest amounts. The effect was even stronger in participants under 60.

The effect was stronger for blueberry rather than strawberry consumption. Compared to people who ate no blueberries, those eating at least one serving of blueberries per week were 10 per cent less likely to become hypertensive.

"Our findings are exciting and suggest that an achievable dietary intake of anthocyanins may contribute to the prevention of hypertension," said lead author Prof Aedin Cassidy of the Department of Nutrition at UEA's Medical School.

"Anthocyanins are readily incorporated into the diet as they are present in many commonly consumed foods. Blueberries were the richest source in this particular study as they are frequently consumed in the US. Other rich sources of anthocyanins in the UK include blackcurrants, blood oranges, aubergines and raspberries."

The next stage of the research will be to conduct randomised controlled trials with different dietary sources of anthocyanins to define the optimal dose and sources for hypertension prevention. This will enable the development of targeted public health recommendations on how to reduce blood pressure.

Study Information

Aedín Cassidy, Éilis J O'Reilly, Colin Kay, Laura Sampson, Mary Franz, JP Forman, Gary Curhan, and Eric B Rimm.
Habitual intake of flavonoid subclasses and incident hypertension in adults
American Journal of Clinical Nutrition,
2011 February
School of Medicine, University of East Anglia, Norwich, United Kingdom.

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