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Protein intake and blood pressure in cardiovascular disease
1Department of Epidemiology and Public Health, Imperial College, London, St Mary's Campus, Norfolk Place, London W2 1PG, UK. p.elliott@ic.ac.uk
Insights
High blood pressure (BP) is linked to diet and environment. While Western diets associate protein with higher BP, Asian studies suggest protein intake may protect against hypertension and stroke.
Area of Science:
- Cardiovascular Health
- Nutritional Science
- Epidemiology
Background:
- Elevated blood pressure (BP) is a primary risk factor for coronary heart disease (CHD) and the leading cause of stroke.
- BP typically increases with age, but some populations exhibit stable BP, suggesting environmental influences over genetics.
- Migration to urban environments often correlates with rising BP in previously unaffected populations, highlighting the role of lifestyle and diet.
Purpose of the Study:
- To explore the complex relationship between dietary protein intake and blood pressure (BP).
- To reconcile conflicting findings on protein's effect on BP from Western and Eastern studies.
- To investigate the potential protective role of dietary protein against hypertension and stroke.
Main Methods:
- Review of epidemiological data, including studies on vegetarians and meat-eating populations.
- Analysis of clinical data, particularly concerning protein intake in individuals with renal insufficiency.
- Examination of findings from Japanese and Chinese studies suggesting a protective effect of dietary protein.
Main Results:
- Conflicting evidence exists regarding dietary protein's impact on BP.
- Western studies have suggested an adverse effect of protein, especially in renal insufficiency.
- Eastern epidemiological studies and some clinical trials indicate an inverse association between protein intake and BP, potentially lowering hypertension risk.
Conclusions:
- The role of dietary protein in blood pressure regulation is complex and warrants further investigation.
- Environmental factors, including diet, significantly influence population-wide BP levels.
- Future large-scale epidemiological studies are needed to clarify the association between protein intake and BP.
Abstract:
Raised blood pressure (BP) is a major cause of CHD and the leading cause of stroke. Although BP rises with age in most populations, there are remote populations around the world where BP does not rise with age and where the high prevalence of high BP and frank hypertension seen in the UK and other Western countries in the older age-groups is not found. However, when such populations migrate to urban settings, their BPs rise, indicating that the population-wide BP problem is largely environmental in origin. Thus, a substantial body of evidence has accumulated on the importance of dietary factors in BP (Na and alcohol intakes (direct relationship) and K intake (inverse relationship)) as well as body weight (direct relationship). More recently, attention has shifted to other dietary factors that might affect BP. Data from studies of vegetarians (who tend to have lower BP than meat-eating populations) as well as clinical data on the adverse effects of protein intake in patients with renal insufficiency led to the view in Western countries that dietary (animal or total) protein had an adverse effect on BP. By contrast, studies in Japan and China suggested that dietary protein might be protective of high BP and stroke. Recent epidemiological studies have found inverse associations between dietary protein intake and BP, consistent with this view, and supported by some evidence from animal studies. Recent controlled clinical trials of soyabean supplementation have also suggested a BP-lowering effect of protein intake. Results of further large-scale epidemiological studies of protein and BP are awaited.
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