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Long-term yogurt consumption and risk of incident hypertension in adults

Buendia, Justin R.a; Li, Yanpingb; Hu, Frank B.b; Cabral, Howard J.c; Bradlee, M. Loringa; Quatromoni, Paula A.d; Singer, Martha R.a; Curhan, Gary C.e; Moore, Lynn L.a

doi: 10.1097/HJH.0000000000001737
ORIGINAL PAPERS: Epidemiology

Objective: To evaluate the relation between yogurt consumption as well as cheese, milk, and total dairy, and high blood pressure (HBP) in two Nurses’ Health Study cohorts (NHS, n = 69 298), NHS II (n = 84 368) and the Health Professionals Follow-Up Study (HPFS, n = 30 512).

Methods: NHS, NHS II, and HPFS participants were followed for incident HBP for up to 30, 20, and 24 years, respectively. Hazard ratios were calculated using time-dependent multivariate-adjusted Cox proportional hazards models. Pooled risk estimates were derived from fixed effects meta-analyses.

Results: Participants consuming at least five servings per week (vs. <1 serving per month) of yogurt in NHS, NHS II, and HPFS had 19% (95% CI 0.75–0.87), 17% (95% CI 0.77–0.90), and 6% (95% CI 0.83–1.07) lower HBP risks, respectively. In pooled analyses of these cohorts, higher yogurt consumption was linked with 16% (95% CI 0.80–0.88) lower HBP risk; higher total dairy (3 to <6 vs. <0.5 servings/day), milk (2 to <6/day vs. <4/week) and cheese (1 to 4/day vs. <1/week) were associated with 16% (95% CI 0.81–0.87), 12% (95% CI 0.86–0.90), and 6% (95% CI 0.90–0.97) lower HBP risks, respectively. After controlling for BMI as a possible causal intermediate, total dairy, yogurt, milk, and cheese were associated with 13, 10, 8, and 8% lower HBP risks, respectively. The combination of higher yogurt intake and higher DASH (’Dietary Approaches to Stop Hypertension’) diet scores was associated with 30% (95% CI 0.66–0.75) lower HBP risk compared with lower levels of both factors.

Conclusion: Higher total dairy intake, especially in the form of yogurt, was associated with lower risk of incident HBP in middle-aged and older adult men and women.

aDepartment of Medicine/Preventive Medicine and Epidemiology, Boston University School of Medicine

bDepartment of Nutrition, Harvard T. H. Chan School of Public Health

cDepartment of Biostatistics, Boston University School of Public Health

dDepartment of Health Sciences/Programs in Nutrition, Sargent College of Health and Rehabilitation Sciences, Boston University

eChanning Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA

Correspondence to Justin R. Buendia, PhD, Department of Medicine/Preventive Medicine and Epidemiology, Boston University School of Medicine, 801 Massachusetts Avenue, Suite 470, Boston, MA 02118, USA. Tel: +1 908 917 7201; e-mail: jbuen@bu.edu

Abbreviations: ACE, angiotensin-converting enzyme; ARIC, Atherosclerosis Risk in Communities; BP, blood pressure; CI, confidence intervals; DASH, Dietary Approaches to Stop Hypertension; FFQ, Food Frequency Questionnaire; HBP, high blood pressure; HPFS, Health Professionals Follow-Up Study; IPP, isoleucine–proline–proline; MET, metabolic equivalents; MI, myocardial infarction; NHS, Nurses’ Health Study; S/month, serving per month; S/week, servings per week; SHR, spontaneously hypertensive rats; T2DM, type II diabetes mellitus; VPP, valine–proline–proline

Received 6 November, 2017

Revised 22 February, 2018

Accepted 1 March, 2018

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