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Analysis of NHANES III

Ihab M. Hajjar, MD, MS; Clarence E. Grim, MD; Varghese George, PhD; Theodore A. Kotchen, MD

Arch Intern Med. 2001;161:589-593.

Background  The impact of diet on blood pressure and the age-related changes in blood pressure have been difficult to detect within one population. We designed this analysis to study the association of major dietary factors with blood pressure and with age-related changes in blood pressure in a representative sample of the US population.

Methods  Data were obtained on all individuals 20 years or older (n = 17 030) surveyed in the Third National Health and Nutrition Examination Survey (NHANES III), including demographic data, anthropometric data, dietary intake (sodium, potassium, calcium, magnesium, protein, alcohol, and total energy) based on 24-hour recall, and blood pressure. Multivariate models relating diet to blood pressure were constructed using stepwise regression, best subset regression, and multiple regression.

Results  Systolic blood pressure was positively associated with higher sodium, alcohol, and protein intakes (P<.05) and negatively associated with potassium intake (P = .003). Diastolic blood pressure was negatively associated with potassium and alcohol intakes (P<.001). Pulse pressure was positively associated with sodium, protein, and alcohol intakes (P<.001). A higher intake of calcium (P = .01) was associated with a lower rate of rise in systolic blood pressure with age.

Conclusion  A diet low in sodium, alcohol, and protein is associated with lower systolic blood and pulse pressure. Potassium intake was associated with lower systolic and diastolic blood pressure, whereas alcohol intake was associated with lower diastolic blood pressure. In addition, the age-related changes in systolic blood pressure were attenuated by higher calcium and protein intakes. Magnesium was not associated with any changes in blood pressure.

From the Division of Geriatrics, Department of Medicine, University of South Carolina/Palmetto Health Alliance, Columbia (Dr Hajjar), and the Departments of Medicine (Drs Grim and Kotchen) and Biostatistics (Dr George), Medical College of Wisconsin, Milwaukee.

Corresponding author: Ihab M. Hajjar, MD, MS, University of South Carolina/Palmetto Health Alliance, 9 Medical Park Dr, #230, Columbia, SC 29203 (e-mail: ihab.hajjar{at}rmh.edu).

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