Lower intake of refined grains, red meat helps prevent hypertension

The effect of obesity on essential hypertension (EH) is partially mediated by the cumulative triglyceride (TG) burden, according to a study. Obesity may lower the rate of lipid clearance and exacerbate lipid peroxidation, leading to EH.

“Prevention of EH should be achieved by reducing consumption of refined grains and red meat, weight loss, and dynamic lipid monitoring,” the investigators said.

A total of 1,295 participants were enrolled in this study to examine the effect of cumulative lipid profile burden on EH incidence and determine whether cumulative lipid burden facilitates the pathogenesis of the effects of diet and obesity on EH. [Eur J Clin Nutr 2024;78:54-63]

Over a mean follow-up of 2.98 years, 240 patients developed EH. Compared with the reference groups, the highest quartile in cumulative total cholesterol (TC), TG, and high-density lipoprotein (HDL) burden had hazard ratios of 1.747 (95 percent confidence interval [CI], 1.145‒2.664), 1.502 (95 percent CI, 1.038‒2.173), and 0.615 (95 percent CI, 0.413‒0.917), respectively, for the incidence of EH.

Participants with EH tended to have higher consumption of red meat and refined grains. Notably, red meat showed a positive correlation with cumulative TC burden.

In addition, body mass index (BMI) and waist-to-height ratio (WHtR) were associated with an increased EH incidence, while obesity had a positive association with cumulative TG burden.

In mediating analysis, cumulative TG partially mediated the causal relationship between obesity and EH. This result was confirmed in Mendelian randomization. On the other hand, diet showed no effect on EH through cumulative lipid profile burden.

“[T]he accumulation of cumulated TC burden and cumulated TG burden increases the risk of EH, and cumulative HDL burden has a protective effect on EH,” the investigators said. “Participants with EH consumed more red meat and refined grains.”

Dietary effect

Some studies found no link between refined grain intake and hypertension risk, but others reported an association between consumption of refined grains and an increased risk of coronary heart disease in Chinese adults. [Am J Clin Nutr 2007;86:472-479; Am J Epidemiol 2013;178:1542-1549]

“Even so, the 2015 Dietary Guidelines Advisory Committee recommended that most refined grains should be replaced with whole grains,” the investigators said. “The American Heart Association also supports this statement.” [Circulation 2016;134:e505-529]

Similarly, a previous study observed an association between consumption of red and processed meat foods and a higher incidence of hypertension. [Adv Nutr 2019;10:361-371]

“We also found that refined grains and red meat were significantly associated with cumulative TG burden,” the investigators said.

“Unfortunately, we did not find a mediating role of lipids in the effect of diet on EH. It is possible that our follow-up period was insufficient to detect dietary-lipid-EH associations, and diet may influence hypertension through rapid changes in gut microbiota,” they added.

A reduction in obesity and red meat intake can help lower lipid accumulation and prevent hypertension, according to the investigators.