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Association Between Protein Intake and Blood Pressure
The INTERMAP Study
Paul Elliott, MB, PhD;
Jeremiah Stamler, MD;
Alan R. Dyer, PhD;
Lawrence Appel, MD;
Barbara Dennis, PhD;
Hugo Kesteloot, MD;
Hirotsugu Ueshima, MD;
Akira Okayama, MD;
Queenie Chan, MSc;
Daniel B. Garside, BS;
Beifan Zhou, MD; for the INTERMAP Cooperative Research Group
Arch Intern Med. 2006;166:79-87.
Background Findings from epidemiological studies suggest an inverse relationship between individuals’ protein intake and their blood pressure.
Methods Cross-sectional epidemiological study of 4680 persons, aged 40 to 59 years, from 4 countries. Systolic and diastolic blood pressure was measured 8 times at 4 visits. Dietary intake based on 24-hour dietary recalls was recorded 4 times. Information on dietary supplements was noted. Two 24-hour urine samples were obtained per person.
Results There was a significant inverse relationship between vegetable protein intake and blood pressure. After adjusting for confounders, blood pressure differences associated with higher vegetable protein intake of 2.8% kilocalories were –2.14 mm Hg systolic and –1.35 mm Hg diastolic (P<.001 for both); after further adjustment for height and weight, these differences were –1.11 mm Hg systolic (P<.01) and –0.71 mm Hg diastolic (P<.05). For animal protein intake, significant positive blood pressure differences did not persist after adjusting for height and weight. For total protein intake (which had a significant interaction with sex), there was no significant association with blood pressure in women, nor in men after adjusting for dietary confounders. There were significant differences in the amino acid content of the diets of persons with high vegetable and low animal protein intake vs the diets of persons with low vegetable and high animal protein intake.
Conclusions Vegetable protein intake was inversely related to blood pressure. This finding is consistent with recommendations that a diet high in vegetable products be part of healthy lifestyle for prevention of high blood pressure and related diseases.
Author Affiliations: Department of Epidemiology and Public Health, Faculty of Medicine, St Mary’s Campus, Imperial College London, London, England (Dr Elliott and Ms Chan); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill (Drs Stamler and Dyer and Mr Garside); Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, Md (Dr Appel); Department of Biostatistics, Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill (Dr Dennis); Central Laboratory, Akademisch Ziekenhuis St Rafael, Leuven, Belgium (Dr Kesteloot); Department of Health Science, Shiga University of Medical Science, Otsu, Shiga (Dr Ueshima), and Department of Cardiology, National Cardiovascular Center, Suita (Dr Okayama), Japan; and Department of Epidemiology, Fu Wai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China (Dr Zhou).
Group Information: A partial listing of the members of the INTERMAP Cooperative Research Group was published in J Human Hypertension (2003;17:603-606).
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