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Open Access 01-06-2018 | Original Contribution

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

Authors: Giuseppe Grosso, Urszula Stepaniak, Agnieszka Micek, Magdalena Kozela, Denes Stefler, Martin Bobak, Andrzej Pajak

Published in: European Journal of Nutrition | Issue 4/2018

Abstract

Purpose

Dietary 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.

Methods

A 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.

Results

During 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).

Conclusion

Certain classes of dietary polyphenols were associated with lower risk of hypertension, but potential differences between men and women should be further investigated.

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D’Archivio M, Filesi C, Di Benedetto R, Gargiulo R, Giovannini C, Masella R (2007) Polyphenols, dietary sources and bioavailability. Ann Ist Super Sanita 43(4):348–361PubMed

Landete JM (2012) Updated knowledge about polyphenols: functions, bioavailability, metabolism, and health. Crit Rev Food Sci Nutr 52(10):936–948. doi:10.1080/10408398.2010.513779 CrossRefPubMed

Manach C, Williamson G, Morand C, Scalbert A, Remesy C (2005) Bioavailability and bioefficacy of polyphenols in humans. I. Review of 97 bioavailability studies. Am J Clin Nutr 81(1 Suppl):230S–242SCrossRefPubMed

Dwyer JT, Peterson JJ (2002) Measuring flavonoid intake: need for advanced tools. Public Health Nutr 5(6A):925–930. doi:10.1079/PHN2002373 CrossRefPubMed

Stedile N, Canuto R, de Col CD, de Sene JS, Stolfo A, Wisintainer GN, Henriques JA, Salvador M (2016) Dietary total antioxidant capacity is associated with plasmatic antioxidant capacity, nutrient intake and lipid and DNA damage in healthy women. Int J Food Sci Nutr 67(4):479–488. doi:10.3109/09637486.2016.1164670 CrossRefPubMed

Goya L, Martin MA, Sarria B, Ramos S, Mateos R, Bravo L (2016) Effect of cocoa and its flavonoids on biomarkers of inflammation: studies of cell culture, animals and humans. Nutrients 8(4):212. doi:10.3390/nu8040212 CrossRefPubMedPubMedCentral

Cassidy A, O’Reilly EJ, Kay C, Sampson L, Franz M, Forman JP, Curhan G, Rimm EB (2011) Habitual intake of flavonoid subclasses and incident hypertension in adults. Am J Clin Nutr 93(2):338–347. doi:10.3945/ajcn.110.006783 CrossRefPubMed

Goodman-Gruen D, Kritz-Silverstein D (2001) Usual dietary isoflavone intake is associated with cardiovascular disease risk factors in postmenopausal women. J Nutr 131(4):1202–1206CrossRefPubMed

Knekt P, Kumpulainen J, Jarvinen R, Rissanen H, Heliovaara M, Reunanen A, Hakulinen T, Aromaa A (2002) Flavonoid intake and risk of chronic diseases. Am J Clin Nutr 76(3):560–568CrossRefPubMed

10.

Lajous M, Rossignol E, Fagherazzi G, Perquier F, Scalbert A, Clavel-Chapelon F, Boutron-Ruault MC (2016) Flavonoid intake and incident hypertension in women. Am J Clin Nutr 103(4):1091–1098. doi:10.3945/ajcn.115.109249 CrossRefPubMed

11.

de Kleijn MJ, van der Schouw YT, Wilson PW, Grobbee DE, Jacques PF (2002) Dietary intake of phytoestrogens is associated with a favorable metabolic cardiovascular risk profile in postmenopausal U.S.women: the Framingham study. J Nutr 132(2):276–282CrossRefPubMed

12.

van der Schouw YT, Sampson L, Willett WC, Rimm EB (2005) The usual intake of lignans but not that of isoflavones may be related to cardiovascular risk factors in U.S. men. J Nutr 135(2):260–266CrossRefPubMed

13.

Sohrab G, Hosseinpour-Niazi S, Hejazi J, Yuzbashian E, Mirmiran P, Azizi F (2013) Dietary polyphenols and metabolic syndrome among Iranian adults. Int J Food Sci Nutr 64(6):661–667. doi:10.3109/09637486.2013.787397 CrossRefPubMed

14.

Tresserra-Rimbau A, Rimm EB, Medina-Remon A, Martinez-Gonzalez MA, de la Torre R, Corella D, Salas-Salvado J, Gomez-Gracia E, Lapetra J, Aros F, Fiol M, Ros E, Serra-Majem L, Pinto X, Saez GT, Basora J, Sorli JV, Martinez JA, Vinyoles E, Ruiz-Gutierrez V, Estruch R, Lamuela-Raventos RM, Investigators PS (2014) Inverse association between habitual polyphenol intake and incidence of cardiovascular events in the PREDIMED study. Nutr Metab Cardiovasc Dis 24(6):639–647. doi:10.1016/j.numecd.2013.12.014 CrossRefPubMed

15.

Peasey A, Bobak M, Kubinova R, Malyutina S, Pajak A, Tamosiunas A, Pikhart H, Nicholson A, Marmot M (2006) Determinants of cardiovascular disease and other non-communicable diseases in Central and Eastern Europe: rationale and design of the HAPIEE study. BMC Public Health 6:255. doi:10.1186/1471-2458-6-255 CrossRefPubMedPubMedCentral

16.

Willett WC, Sampson L, Stampfer MJ, Rosner B, Bain C, Witschi J, Hennekens CH, Speizer FE (1985) Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 122(1):51–65CrossRefPubMed

17.

Brunner E, Stallone D, Juneja M, Bingham S, Marmot M (2001) Dietary assessment in Whitehall II: comparison of 7 d diet diary and food-frequency questionnaire and validity against biomarkers. Br J Nutr 86(3):405–414CrossRefPubMed

18.

Phenol-Explorer: an online comprehensive database on polyphenol contents in foods. (2010). http://www.phenol-explorer.eu. Accessed Aug 2016

19.

Grosso G, Stepaniak U, Topor-Madry R, Szafraniec K, Pajak A (2014) Estimated dietary intake and major food sources of polyphenols in the Polish arm of the HAPIEE study. Nutrition 30(11–12):1398–1403. doi:10.1016/j.nut.2014.04.012 CrossRefPubMedPubMedCentral

20.

Buscemi S, Sprini D, Grosso G, Galvano F, Nicolucci A, Lucisano G, Massenti FM, Amodio E, Rini GB (2014) Impact of lifestyle on metabolic syndrome in apparently healthy people. Eat Weight Disord 19(2):225–232. doi:10.1007/s40519-014-0117-4 CrossRefPubMed

21.

Grosso G, Stepaniak U, Micek A, Stefler D, Bobak M, Pajak A (2016) Dietary polyphenols are inversely associated with metabolic syndrome in Polish adults of the HAPIEE study. Eur J Nutr. doi:10.1007/s00394-016-1187-z CrossRefPubMedPubMedCentral

22.

Medina-Remon A, Zamora-Ros R, Rotches-Ribalta M, Andres-Lacueva C, Martinez-Gonzalez MA, Covas MI, Corella D, Salas-Salvado J, Gomez-Gracia E, Ruiz-Gutierrez V, Garcia de la Corte FJ, Fiol M, Pena MA, Saez GT, Ros E, Serra-Majem L, Pinto X, Warnberg J, Estruch R, Lamuela-Raventos RM, Investigators PS (2011) Total polyphenol excretion and blood pressure in subjects at high cardiovascular risk. Nutr Metab Cardiovasc Dis 21(5):323–331. doi:10.1016/j.numecd.2009.10.019 CrossRefPubMed

23.

Medina-Remon A, Tresserra-Rimbau A, Pons A, Tur JA, Martorell M, Ros E, Buil-Cosiales P, Sacanella E, Covas MI, Corella D, Salas-Salvado J, Gomez-Gracia E, Ruiz-Gutierrez V, Ortega-Calvo M, Garcia-Valdueza M, Aros F, Saez GT, Serra-Majem L, Pinto X, Vinyoles E, Estruch R, Lamuela-Raventos RM, Investigators PS (2015) Effects of total dietary polyphenols on plasma nitric oxide and blood pressure in a high cardiovascular risk cohort. The PREDIMED randomized trial. Nutr Metab Cardiovasc Dis 25(1):60–67. doi:10.1016/j.numecd.2014.09.001 CrossRefPubMed

24.

Vitaglione P, Donnarumma G, Napolitano A, Galvano F, Gallo A, Scalfi L, Fogliano V (2007) Protocatechuic acid is the major human metabolite of cyanidin-glucosides. J Nutr 137(9):2043–2048CrossRefPubMed

25.

Liu XX, Li SH, Chen JZ, Sun K, Wang XJ, Wang XG, Hui RT (2012) Effect of soy isoflavones on blood pressure: a meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis 22(6):463–470. doi:10.1016/j.numecd.2010.09.006 CrossRefPubMed

26.

Kay CD, Hooper L, Kroon PA, Rimm EB, Cassidy A (2012) Relative impact of flavonoid composition, dose and structure on vascular function: a systematic review of randomised controlled trials of flavonoid-rich food products. Mol Nutr Food Res 56(11):1605–1616. doi:10.1002/mnfr.201200363 CrossRefPubMed

27.

Desch S, Schmidt J, Kobler D, Sonnabend M, Eitel I, Sareban M, Rahimi K, Schuler G, Thiele H (2010) Effect of cocoa products on blood pressure: systematic review and meta-analysis. Am J Hypertens 23(1):97–103. doi:10.1038/ajh.2009.213 CrossRefPubMed

28.

Zhu Y, Bo Y, Wang X, Lu W, Wang X, Han Z, Qiu C (2016) The effect of anthocyanins on blood pressure: a PRISMA-compliant meta-analysis of randomized clinical trials. Medicine 95(15):e3380. doi:10.1097/MD.0000000000003380 CrossRefPubMedPubMedCentral

29.

Kent K, Charlton KE, Jenner A, Roodenrys S (2016) Acute reduction in blood pressure following consumption of anthocyanin-rich cherry juice may be dose-interval dependant: a pilot cross-over study. Int J Food Sci Nutr 67(1):47–52. doi:10.3109/09637486.2015.1121472 CrossRefPubMed

30.

Grosso G, Stepaniak U, Micek A, Topor-Madry R, Stefler D, Szafraniec K, Bobak M, Pajak A (2015) A Mediterranean-type diet is associated with better metabolic profile in urban Polish adults: results from the HAPIEE study. Metabolism 64(6):738–746. doi:10.1016/j.metabol.2015.02.007 CrossRefPubMedPubMedCentral

31.

Stefler D, Pikhart H, Jankovic N, Kubinova R, Pajak A, Malyutina S, Simonova G, Feskens EJ, Peasey A, Bobak M (2014) Healthy diet indicator and mortality in Eastern European populations: prospective evidence from the HAPIEE cohort. Eur J Clin Nutr 68(12):1346–1352. doi:10.1038/ejcn.2014.134 CrossRefPubMedPubMedCentral

32.

Stepaniak U, Micek A, Grosso G, Stefler D, Topor-Madry R, Kubinova R, Malyutina S, Peasey A, Pikhart H, Nikitin Y, Bobak M, Pajak A (2016) Antioxidant vitamin intake and mortality in three Central and Eastern European urban populations: the HAPIEE study. Eur J Nutr 55(2):547–560. doi:10.1007/s00394-015-0871-8 CrossRefPubMed

33.

Peluso I, Raguzzini A, Serafini M (2013) Effect of flavonoids on circulating levels of TNF-alpha and IL-6 in humans: a systematic review and meta-analysis. Mol Nutr Food Res 57(5):784–801. doi:10.1002/mnfr.201200721 CrossRefPubMed

34.

Steffen Y, Gruber C, Schewe T, Sies H (2008) Mono-O-methylated flavanols and other flavonoids as inhibitors of endothelial NADPH oxidase. Arch Biochem Biophys 469(2):209–219. doi:10.1016/j.abb.2007.10.012 CrossRefPubMed

35.

Steffen Y, Schewe T, Sies H (2007) (-)-Epicatechin elevates nitric oxide in endothelial cells via inhibition of NADPH oxidase. Biochem Biophys Res Commun 359(3):828–833. doi:10.1016/j.bbrc.2007.05.200 CrossRefPubMed

36.

Loke WM, Hodgson JM, Proudfoot JM, McKinley AJ, Puddey IB, Croft KD (2008) Pure dietary flavonoids quercetin and (-)-epicatechin augment nitric oxide products and reduce endothelin-1 acutely in healthy men. Am J Clin Nutr 88(4):1018–1025CrossRefPubMed

37.

Schnorr O, Brossette T, Momma TY, Kleinbongard P, Keen CL, Schroeter H, Sies H (2008) Cocoa flavanols lower vascular arginase activity in human endothelial cells in vitro and in erythrocytes in vivo. Arch Biochem Biophys 476(2):211–215. doi:10.1016/j.abb.2008.02.040 CrossRefPubMed

38.

Actis-Goretta L, Ottaviani JI, Fraga CG (2006) Inhibition of angiotensin converting enzyme activity by flavanol-rich foods. J Agric Food Chem 54(1):229–234. doi:10.1021/jf052263o CrossRefPubMed

39.

Marventano S, Kolacz P, Castellano S, Galvano F, Buscemi S, Mistretta A, Grosso G (2015) A review of recent evidence in human studies of n-3 and n-6 PUFA intake on cardiovascular disease, cancer, and depressive disorders: does the ratio really matter? Int J Food Sci Nutr 66(6):611–622. doi:10.3109/09637486.2015.1077790 CrossRefPubMed

40.

Onakpoya IJ, Spencer EA, Thompson MJ, Heneghan CJ (2015) The effect of chlorogenic acid on blood pressure: a systematic review and meta-analysis of randomized clinical trials. J Hum Hypertens 29(2):77–81. doi:10.1038/jhh.2014.46 CrossRefPubMed

41.

Steffen M, Kuhle C, Hensrud D, Erwin PJ, Murad MH (2012) The effect of coffee consumption on blood pressure and the development of hypertension: a systematic review and meta-analysis. J Hypertens 30(12):2245–2254. doi:10.1097/HJH.0b013e3283588d73 CrossRefPubMed

42.

Marventano S, Salomone F, Godos J, Pluchinotta F, Del Rio D, Mistretta A, Grosso G (2016) Coffee and tea consumption in relation with non-alcoholic fatty liver and metabolic syndrome: a systematic review and meta-analysis of observational studies. Clin Nutr. doi:10.1016/j.clnu.2016.03.012 CrossRefPubMed

43.

Grosso G, Stepaniak U, Micek A, Topor-Madry R, Pikhart H, Szafraniec K, Pajak A (2015) Association of daily coffee and tea consumption and metabolic syndrome: results from the Polish arm of the HAPIEE study. Eur J Nutr 54(7):1129–1137. doi:10.1007/s00394-014-0789-6 CrossRefPubMed

44.

Grosso G, Galvano F (2016) Mediterranean diet adherence in children and adolescents in southern European countries. NFS J 3:13–19. doi:10.1016/j.nfs.2016.02.004 CrossRef

45.

Godos J, Pluchinotta FR, Marventano S, Buscemi S, Li Volti G, Galvano F, Grosso G (2014) Coffee components and cardiovascular risk: beneficial and detrimental effects. Int J Food Sci Nutr 65(8):925–936. doi:10.3109/09637486.2014.940287 CrossRefPubMed

46.

Zhao Y, Wang J, Ballevre O, Luo H, Zhang W (2012) Antihypertensive effects and mechanisms of chlorogenic acids. Hypertens Res 35(4):370–374. doi:10.1038/hr.2011.195 CrossRefPubMed

47.

Ochiai R, Sugiura Y, Otsuka K, Katsuragi Y, Hashiguchi T (2015) Coffee bean polyphenols ameliorate postprandial endothelial dysfunction in healthy male adults. Int J Food Sci Nutr 66(3):350–354. doi:10.3109/09637486.2015.1007453 CrossRefPubMed

48.

Gencoglu H, Tuzcu M, Hayirli A, Sahin K (2015) Protective effects of resveratrol against streptozotocin-induced diabetes in rats by modulation of visfatin/sirtuin-1 pathway and glucose transporters. Int J Food Sci Nutr 66(3):314–320. doi:10.3109/09637486.2014.1003534 CrossRefPubMed

49.

Riccioni G, Gammone MA, Tettamanti G, Bergante S, Pluchinotta FR, D’Orazio N (2015) Resveratrol and anti-atherogenic effects. Int J Food Sci Nutr 66(6):603–610. doi:10.3109/09637486.2015.1077796 CrossRefPubMed

50.

Liu Y, Ma W, Zhang P, He S, Huang D (2015) Effect of resveratrol on blood pressure: a meta-analysis of randomized controlled trials. Clin Nutr 34(1):27–34. doi:10.1016/j.clnu.2014.03.009 CrossRefPubMed

51.

Semba RD, Ferrucci L, Bartali B, Urpi-Sarda M, Zamora-Ros R, Sun K, Cherubini A, Bandinelli S, Andres-Lacueva C (2014) Resveratrol levels and all-cause mortality in older community-dwelling adults. JAMA Intern Med 174(7):1077–1084. doi:10.1001/jamainternmed.2014.1582 CrossRefPubMedPubMedCentral

52.

Tome-Carneiro J, Larrosa M, Gonzalez-Sarrias A, Tomas-Barberan FA, Garcia-Conesa MT, Espin JC (2013) Resveratrol and clinical trials: the crossroad from in vitro studies to human evidence. Curr Pharm Des 19(34):6064–6093CrossRefPubMedPubMedCentral

53.

Fistonic I, Situm M, Bulat V, Harapin M, Fistonic N, Verbanac D (2012) Olive oil biophenols and women’s health. Med Glas (Zenica) 9(1):1–9

54.

Waterman E, Lockwood B (2007) Active components and clinical applications of olive oil. Altern Med Rev 12(4):331–342PubMed

55.

Arranz S, Chiva-Blanch G, Valderas-Martinez P, Medina-Remon A, Lamuela-Raventos RM, Estruch R (2012) Wine, beer, alcohol and polyphenols on cardiovascular disease and cancer. Nutrients 4(7):759–781. doi:10.3390/nu4070759 CrossRefPubMedPubMedCentral

56.

Chiva-Blanch G, Arranz S, Lamuela-Raventos RM, Estruch R (2013) Effects of wine, alcohol and polyphenols on cardiovascular disease risk factors: evidences from human studies. Alcohol Alcohol 48(3):270–277. doi:10.1093/alcalc/agt007 CrossRefPubMed

Title: Dietary polyphenol intake and risk of hypertension in the Polish arm of the HAPIEE study
Authors: Giuseppe Grosso
Urszula Stepaniak
Agnieszka Micek
Magdalena Kozela
Denes Stefler
Martin Bobak
Andrzej Pajak
Publication date: 01-06-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nutrition / Issue 4/2018
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI: https://doi.org/10.1007/s00394-017-1438-7

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