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Nutritional influence on risk of high blood pressure in Bangladesh: a population-based cross-sectional study^1,2,3

¹ From the Department of Epidemiology (YC, PF-L, GRH, and HA) and the Department of Environmental Health Sciences (PF-L and FP), Mailman School of Public Health, Columbia University, New York, NY; the Department of Environmental Medicine and the New York University Cancer Institute, New York University School of Medicine, New York, NY (YC); and the Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY (HA)

Background: The nutritional determinants of hypertension in Bangladesh and other low-income countries are largely unknown.

Objective: We assessed the associations of general hypertension with nutrient intakes and diet patterns in Bangladesh.

Design: This was a cross-sectional analysis of 11 116 participants enrolled in the Health Effects of Arsenic Longitudinal Study in Bangladesh. Dietary intakes were measured by use of a validated food-frequency questionnaire.

Results: Three major dietary patterns were identified by using principal component analysis: 1) the "balanced" pattern, which was characterized by rice, some meat, small fish, fruit, and vegetables; 2) the "animal protein" pattern, which was more heavily weighted on meat, milk, poultry, eggs, bread, large fish, and fruit; and 3) the "gourd and root vegetable" pattern, which consisted largely of squashes and root and leafy vegetables. Adjusted prevalence odds ratios for general hypertension in increasing quintiles of balanced pattern scores were 1.00 (reference), 0.81 (95% CI: 0.79, 0.97), 0.82 (0.68, 0.97), 0.79 (0.66, 0.94), and 0.71 (0.59, 0.85) (P for trend < 0.01). Prevalence odds ratios for general hypertension in increasing quintiles of animal protein pattern scores were 1.00 (reference), 1.30 (1.01, 1.52), 1.20 (1.01, 1.47), 1.22 (1.00, 1.44), and 1.21 (1.03, 1.49) (P for trend = 0.23). Markers of high socioeconomic status were positively associated with the animal protein pattern.

Conclusion: Our findings suggest the importance of dietary patterns in general hypertension in a low-income population undergoing the early stage of the epidemiologic transition.

Key Words: Nutritional epidemiology • hypertension • high blood pressure • cross-sectional study • diet patterns

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