Dietary Modifications and Lipid Accumulation Product Are Associated with Systolic and Diastolic Blood Pressures in the Women's Health Trial: Feasibility Study in Minority Populations

Abstract

Purpose of review: Approximately 65% of adults over 60 years in the USA are hypertensive. Poor dietary habits and sedentary lifestyles are fueling the hypertension epidemic. The effects of higher intakes of fruits and vegetables and whole-grain products on systolic and diastolic blood pressures were analyzed using data at baseline, 6 months, and 12 months on 349 and 573 subjects, respectively, in the control and intervention groups of the Women's Health Trial: Feasibility Study in Minority Populations.

Recent findings: Models for systolic and diastolic blood pressures have been estimated using cross-sectional and longitudinal data in different settings. However, it is important to estimate comprehensive dynamic random effects models that take into account inter-relationships between systolic and diastolic blood pressures as well as the effects of dietary intakes and biomarkers for making robust inferences. There were significantly greater reductions (P < 0.05) between baseline and 12 months in systolic and diastolic blood pressures in the intervention group. Second, ratios of α-tocopherol to energy intakes were negatively and significantly associated with systolic and diastolic blood pressures in the intervention group. Third, the lipid accumulation product was positively associated with systolic and diastolic blood pressures in the control and intervention groups. The estimated coefficients of diastolic and systolic blood pressure variables in the respective models for systolic and diastolic blood pressures showed that combining the two measures as pulse pressure can lead to misleading inferences. Overall, dietary interventions promoting higher consumption of fruits and vegetables and whole-grain products can help lower blood pressures of women in the USA.

Trial registration: ClinicalTrials.gov NCT00000481.

Keywords: Blood pressure; Diet; Lipid accumulation product; Random effects models; Simultaneity; α-Tocopherol.