Increased fructose associates with elevated blood pressure

Abstract

The recent increase in fructose consumption in industrialized nations mirrors the rise in the prevalence of hypertension, but epidemiologic studies have inconsistently linked these observations. We investigated whether increased fructose intake from added sugars associates with an increased risk for higher BP levels in US adults without a history of hypertension. We conducted a cross-sectional analysis using the data collected from the National Health and Nutrition Examination Survey (NHANES 2003 to 2006) involving 4528 adults without a history of hypertension. Median fructose intake was 74 g/d, corresponding to 2.5 sugary soft drinks each day. After adjustment for demographics; comorbidities; physical activity; total kilocalorie intake; and dietary confounders such as total carbohydrate, alcohol, salt, and vitamin C intake, an increased fructose intake of > or =74 g/d independently and significantly associated with higher odds of elevated BP levels: It led to a 26, 30, and 77% higher risk for BP cutoffs of > or =135/85, > or =140/90, and > or =160/100 mmHg, respectively. These results suggest that high fructose intake, in the form of added sugar, independently associates with higher BP levels among US adults without a history of hypertension.

Figure 1.

Cross-sectional association between high fructose intake and clinically relevant BP categories in individuals with no history of hypertension (n = 4528). Data are odds ratios (ORs) and 95% CIs. Adjusted analysis included the following covariates: Age, gender, race/ethnicity, smoking, diabetes, average daily METs, waist circumference, BMI, serum glucose levels, serum uric acid levels, total cholesterol, HDL cholesterol, triglycerides, LDL cholesterol, and eGFR, in addition to 24-hour dietary recalls of kilocalories and total carbohydrate, sodium, potassium, alcohol, and vitamin C intake.

Figure 2.

Cross-sectional association between high fructose intake and SBP in individuals with no history of hypertension (n = 4528). Data are ORs and 95% CIs. Adjusted analysis included the following covariates: Age, gender, race/ethnicity, smoking, diabetes, average daily METs, waist circumference, BMI, serum glucose levels, serum uric acid levels, total cholesterol, HDL cholesterol, triglycerides, LDL cholesterol, and eGFR, in addition to 24-hour dietary recalls of kilocalories and total carbohydrate, sodium, potassium, alcohol, and vitamin C intake.

Figure 3.

Cross-sectional association between high fructose intake and DBP in individuals with no history of hypertension (n = 4528). Data are ORs and 95% CIs. Adjusted analysis included the following covariates: Age, gender, race/ethnicity, smoking, diabetes, average daily METs, waist circumference, BMI, serum glucose levels, serum uric acid levels, total cholesterol, HDL cholesterol, triglycerides, LDL cholesterol, and eGFR, in addition to 24-hour dietary recalls of kilocalories and total carbohydrate, sodium, potassium, alcohol, and vitamin C intake.