Dietary polyphenol intake and risk of hypertension in the Polish arm of the HAPIEE study

Abstract

PurposeDietary polyphenols have been studied for their potential effects on metabolic disorders, but studies on risk of hypertension are scarce. This study aimed to test the association between total and individual classes of dietary polyphenols and incidence of hypertension in the Polish arm of the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) study.MethodsA total of 2725 participants free of hypertension at baseline were tested for blood pressure or taking hypertensive medication within the last 2 weeks at 2–4-year follow-up visit. A 148-item food frequency questionnaire and the Phenol-Explorer database were used to estimate dietary polyphenol intake. Odds ratios (ORs) and 95% confidence intervals (CIs) of hypertension comparing the various categories of exposure (total and individual classes of polyphenol intake) with the lowest one (reference category) were calculated by performing age- and energy-adjusted and multivariate-adjusted logistic regression models.ResultsDuring follow-up, 1735 incident cases of hypertension occurred. The highest quartile of total polyphenol intake was associated with 31% decreased risk of hypertension compared with the lowest intake (OR 0.69, 95% CI 0.48, 0.98) in women. There was no significant association in men. Among main classes of polyphenols, flavonoids and phenolic acids were independent contributors to this association. The analysis of individual subclasses of polyphenol revealed that, among phenolic acids, hydroxycynnamic acids were independently associated to lower odds of hypertension (OR 0.66, 95% CI 0.47, 0.93), while among flavonoids, most of the association was driven by flavanols (OR 0.56, 95% CI 0.36, 0.87).ConclusionCertain classes of dietary polyphenols were associated with lower risk of hypertension, but potential differences between men and women should be further investigated.Electronic supplementary materialThe online version of this article (doi:10.1007/s00394-017-1438-7) contains supplementary material, which is available to authorized users.

Polyphenols: A concise overview on the chemistry, occurrence, and human health

“…Biological studies on hydroxycinnamic acids have been focused on their possible beneficial effects in neurodegenerative diseases, due to their anti‐inflammatory, antioxidant, and neuroprotective actions (Zhang, Zhang, Ho, & Huang, ), as well as on endothelial functions, via attenuation of oxidative stress, improvement of nitric oxide bioavailability, and decrease of E‐selectin, ICAM‐1, and VCAM‐1 expression (Fuentes & Palomo, ). Accordingly, association between phenolic acids intake and reduced blood pressure and triglycerides has been reported in observational studies (Grosso et al, ).…”

“…Furthermore, a cohort study cross‐sectional population‐based survey including 8,821 adults in Eastern Europe found that dietary polyphenols intake was inversely associated with MetS and its effects such as waist circumference, blood pressure, high lipoprotein cholesterol, and triglycerides in women. It was found also to be associated with fasting plasma glucose in both genders (Grosso et al, ). Among polyphenol subclasses, phenolic acids have been associated with blood pressure and triglycerides, whereas phenolic acids and stilbenes with MetS.…”

“…Flavonoids have been related with fasting plasma glucose and lignans and stilbenes with waist circumference. Hydroxycinnamic acids, flavanols, and dihydrochalcones had the most prominent effect (Grosso et al, ).…”

Hydroxycinnamic acids and human health: recent advances

“…In a cross‐sectional study conducted in Brazil, the highest daily intake of phenolic acids (458 mg) was not associated with hypertension, but the middle category of exposure (∼300 mg) showed an inverse association . Two more studies, conducted in Italy and Poland, have shown a significant inverse association between phenolic acids (and HCAs) and hypertension, although this effect was only seen in women in the Polish cohort …”

“…flavonoids, have a much longer research history in terms of epidemiological evidence of their health effects. [64][65][66] Regarding phenolic acids, recent cohort studies ( Table 2) have focused mainly on cardiovascular disease (CVD), [67][68][69] hypertension, [70][71][72] depression, 73 metabolic syndrome, [74][75][76] diabetes, 77 and colorectal cancer. 78 A higher intake of polyphenols was associated with a statistically significant decrease in CVD risk in two studies from France and Spain, 67,69 whereas no association was found in the third.…”