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Improved folate intake during young adulthood reduces the incidence of hypertension later

Improved folate intake during young adulthood halves the incidence of hypertension later

Tuesday, April 17, 2012. A study reported online on April 4, 2012 in the American Journal of Clinical Nutrition found that young adults who had a higher intake of folate experienced a significantly lower risk of developing high blood pressure over a 20 year follow-up period.

Pengchung Xun of the University of North Carolina at Chapel Hill and colleagues evaluated data from 4,400 African American and Caucasian men and women who were between the ages of 18 and 30 upon enrollment in the Coronary Artery Risk Development in Young Adults (CARDIA) Study in 1985. Dietary questionnaires were analyzed for total folate intake from dietary and supplemental sources at the beginning of the study and at follow-up visits during 1992 and 2005, and blood pressure was assessed upon enrollment and in 1987, 1990, 1992, 1995 and 2000. Serum folate levels were analyzed in a subset of participants.

Nine hundred eighty-nine cases of hypertension were diagnosed over the 20 year follow-up. Men and women whose folate levels were among the top one-fifth of participants had a 52 percent lower incidence of hypertension compared to those whose intake was among the lowest fifth. When participants were examined by race, Caucasians who were among the top one-fifth of folate intake had a 67 percent lower risk and African Americans had a 46 percent lower risk of having high blood pressure in comparison with the lowest groups. Having a higher serum level of folate at baseline was also found to be protective, confirming the conclusion drawn by the dietary analysis.

The authors suggest improved endothelial function as a possible mechanism for folate in helping to prevent hypertension, but remark that further research is needed to clarify this hypothesis. "Our findings provide prospective evidence that a higher intake of folate is associated with a lower incidence of hypertension," they conclude. "This inverse association was more pronounced in whites than in African Americans. Further studies are warranted to establish causal inference."

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Meta-analysis concludes that supplementing with vitamin C is associated with lower blood pressure

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In a review published online on April 4, 2012 in the American Journal of Clinical Nutrition, researchers from Johns Hopkins in Baltimore report a reduction in systolic and diastolic blood pressure is associated with vitamin C supplementation.

For their analysis, Edgar R. Miller III and his colleagues selected 29 randomized clinical trials conducted between 1996 and 2011 that involved the oral administration of vitamin C for at least two weeks. Average pretreatment systolic blood pressure ranged from 117 to 175 mmHg, and diastolic from 73 to 97 mmHg. The dose of vitamin C used in the studies varied from 60 to 4000 milligrams per day, with a median dose of 500 milligrams.

In a pooled analysis of the trials' participants, vitamin C supplementation was associated with a 3.84 mmHg reduction in systolic blood pressure and a 1.48 mmHg reduction in diastolic pressure. When trials involving patients with hypertension were analyzed, reductions averaged 4.85 mmHg and 1.67 mmHg. Mechanisms posited for vitamin C in reducing blood pressure include an increase in a cofactor for endothelial nitric oxide synthase (which increases the production of nitric oxide), and improvement of endothelial function of brachial and coronary arteries.

"This meta-analysis is the first quantitative review of randomized trials evaluating the effect of vitamin C supplementation on blood pressure," the authors announce. "In short-term trials, vitamin C supplementation reduced systolic blood pressure and diastolic blood pressure. Long-term trials on the effects of vitamin C supplementation on blood pressure and clinical events are needed."

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