Abstract
We investigate associations of fruit and vegetable intake with the risk of future hypertension using home blood pressure in a general population from Ohasama, Japan. We obtained data from 745 residents aged ⩾35 years without home hypertension at baseline. Dietary intake was measured using a validated 141-item food frequency questionnaire, and subjects were then divided into quartiles according to the fruit and vegetable intake. Home hypertension was defined as home systolic/diastolic blood pressure of ⩾135/85 mm Hg and/or the use of antihypertensive medication. During a 4-year follow-up period, we identified 222 incident cases of home hypertension. After adjustment for all putative confounding factors, the highest quartile of fruit intake was associated with a significantly lower risk of future home hypertension (odds ratio 0.40, 95% confidence interval 0.22–0.74, P=0.004). In conclusion, this study, based on home blood pressure measurement, suggests that higher intake of fruit is associated with a lower risk of future home hypertension.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 digital issues and online access to articles
$119.00 per year
only $9.92 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J . Global burden of hypertension: analysis of worldwide data. Lancet 2005; 365: 217–223.
Lawes CM, Rodgers A, Bennett DA, Parag V, Suh I, Ueshima H et al. Blood pressure and cardiovascular disease in the Asia Pacific region. J Hypertens 2003; 21: 707–716.
Lewington S, Clarke R, Qizilbash N, Peto R, Collins R . Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002; 360: 1903–1913.
Ascherio A, Hennekens C, Willett WC, Sacks F, Rosner B, Manson J et al. Prospective study of nutritional factors, blood pressure, and hypertension among US women. Hypertension 1996; 27: 1065–1072.
Ascherio A, Rimm EB, Giovannucci EL, Colditz GA, Rosner B, Willett WC et al. A prospective study of nutritional factors and hypertension among US men. Circulation 1992; 86: 1475–1484.
Stamler J, Liu K, Ruth KJ, Pryer J, Greenland P . Eight-year blood pressure change in middle-aged men: relationship to multiple nutrients. Hypertension 2002; 39: 1000–1006.
Miura K, Greenland P, Stamler J, Liu K, Daviglus ML, Nakagawa H . Relation of vegetable, fruit, and meat intake to 7-year blood pressure change in middle-aged men: the Chicago Western Electric Study. Am J Epidemiol 2004; 159: 572–580.
Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM et al. A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 1997; 336: 1117–1124.
Lairon D, Arnault N, Bertrais S, Planells R, Clero E, Hercberg S et al. Dietary fiber intake and risk factors for cardiovascular disease in French adults. Am J Clin Nutr 2005; 82: 1185–1194.
Psaltopoulou T, Naska A, Orfanos P, Trichopoulos D, Mountokalakis T, Trichopoulou A . Olive oil, the Mediterranean diet, and arterial blood pressure: the Greek European Prospective Investigation into Cancer and Nutrition (EPIC) study. Am J Clin Nutr 2004; 80: 1012–1018.
Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med 2001; 344: 3–10.
Srinath Reddy K, Katan MB . Diet, nutrition and the prevention of hypertension and cardiovascular diseases. Public Health Nutr 2004; 7: 167–186.
Svetkey LP, Simons-Morton D, Vollmer WM, Appel LJ, Conlin PR, Ryan DH et al. Effects of dietary patterns on blood pressure: subgroup analysis of the Dietary Approaches to Stop Hypertension (DASH) randomized clinical trial. Arch Intern Med 1999; 159: 285–293.
Whelton PK, He J, Appel LJ, Cutler JA, Havas S, Kotchen TA et al. Primary prevention of hypertension: clinical and public health advisory from The National High Blood Pressure Education Program. JAMA 2002; 288: 1882–1888.
Takachi R, Inoue M, Ishihara J, Kurahashi N, Iwasaki M, Sasazuki S et al. Fruit and vegetable intake and risk of total cancer and cardiovascular disease: Japan Public Health Center-Based Prospective Study. Am J Epidemiol 2008; 167: 59–70.
Hung HC, Joshipura KJ, Jiang R, Hu FB, Hunter D, Smith-Warner SA et al. Fruit and vegetable intake and risk of major chronic disease. J Natl Cancer Inst 2004; 96: 1577–1584.
Utsugi M, Ohkubo T, Kikuya M, Kurimoto A, Sato R, Suzuki K et al. Fruit and vegetable consumption and the risk of hypertension determined by self measurement of blood pressure at home: the Ohasama study. Hypertens Res 2008; 31: 1435–1443.
Pickering TG, James GD, Boddie C, Harshfield GA, Blank S, Laragh JH . How common is white coat hypertension? JAMA 1988; 259: 225–228.
Ohkubo T . Prognostic significance of variability in ambulatory and home blood pressure from the Ohasama study. J Epidemiol 2007; 17: 109–113.
Parati G, Stergiou GS, Asmar R, Bilo G, de Leeuw P, Imai Y et al. European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the Second International Consensus Conference on Home Blood Pressure Monitoring. J Hypertens 2008; 26: 1505–1526.
Imai Y, Otsuka K, Kawano Y, Shimada K, Hayashi H, Tochikubo O et al. Japanese society of hypertension (JSH) guidelines for self-monitoring of blood pressure at home. Hypertens Res 2003; 26: 771–782.
Pickering TG, Miller NH, Ogedegbe G, Krakoff LR, Artinian NT, Goff D . Call to action on use and reimbursement for home blood pressure monitoring: executive summary: a joint scientific statement from the American Heart Association, American Society of Hypertension, and Preventive Cardiovascular Nurses Association. Hypertension 2008; 52: 1–9.
Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G et al. 2007 Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2007; 28: 1462–1536.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo Jr JL et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289: 2560–2572.
Dauchet L, Ferrieres J, Arveiler D, Yarnell JW, Gey F, Ducimetiere P et al. Frequency of fruit and vegetable consumption and coronary heart disease in France and Northern Ireland: the PRIME study. Br J Nutr 2004; 92: 963–972.
Yusuf S, Reddy S, Ounpuu S, Anand S . Global burden of cardiovascular diseases: part II: variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation 2001; 104: 2855–2864.
Imai Y, Satoh H, Nagai K, Sakuma M, Sakuma H, Minami N et al. Characteristics of a community-based distribution of home blood pressure in Ohasama in northern Japan. J Hypertens 1993; 11: 1441–1449.
Imai Y, Abe K, Sasaki S, Minami N, Munakata M, Sakuma H et al. Clinical evaluation of semiautomatic and automatic devices for home blood pressure measurement: comparison between cuff-oscillometric and microphone methods. J Hypertens 1989; 7: 983–990.
Ogawa K, Tsubono Y, Nishino Y, Watanabe Y, Ohkubo T, Watanabe T et al. Validation of a food-frequency questionnaire for cohort studies in rural Japan. Public Health Nutr 2003; 6: 147–157.
Tsubono Y, Ogawa K, Watanabe Y, Nishino Y, Tsuji I, Watanabe T et al. Food frequency questionnaire and a screening test. Nutr Cancer 2001; 39: 78–84.
Brown CC, Kipnis V, Freedman LS, Hartman AM, Schatzkin A, Wacholder S . Energy adjustment methods for nutritional epidemiology: the effect of categorization. Am J Epidemiol 1994; 139: 323–338.
Willett W . Nutritional Epidemiology, 2nd edn. Oxford University Press: New York, 1998.
Willett W, Stampfer MJ . Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 1986; 124: 17–27.
Alonso A, de la Fuente C, Martin-Arnau AM, de Irala J, Martinez JA, Martinez-Gonzalez MA . Fruit and vegetable consumption is inversely associated with blood pressure in a Mediterranean population with a high vegetable-fat intake: the Seguimiento Universidad de Navarra (SUN) Study. Br J Nutr 2004; 92: 311–319.
Newby PK, Tucker KL . Empirically derived eating patterns using factor or cluster analysis: a review. Nutr Rev 2004; 62: 177–203.
Niiranen TJ, Jula AM, Kantola IM, Reunanen A . Comparison of agreement between clinic and home-measured blood pressure in the Finnish population: the Finn-HOME Study. J Hypertens 2006; 24: 1549–1555.
Brunner EJ, Thorogood M, Rees K, Hewitt G . Dietary advice for reducing cardiovascular risk. Cochrane Database Syst Rev 2005, Art. no. CD002128.
Takahashi Y, Sasaki S, Okubo S, Hayashi M, Tsugane S . Blood pressure change in a free-living population-based dietary modification study in Japan. J Hypertens 2006; 24: 451–458.
Acknowledgements
This study was supported in part by Grants for Scientific Research (15790293, 16590433, 17790381, 18390192, 18590587, 19590929 and 19790423) from the Ministry of Education, Culture, Sports, Science and Technology, Japan; Grants-in-Aid (H17-Kenkou-007, H18-Junkankitou (Seishuu)-Ippan-012 and H20-Junkankitou (Seishuu)-Ippan-009, 013) from the Ministry of Health, Labour and Welfare, Health and Labor Sciences Research Grants, Japan; Grants-in-Aid for Japan Society for the Promotion of Science (JSPS) fellows (16.54041, 18.54042, 19.7152, 20.7198, 20.7477 and 20.54043); Health Science Research Grants and Medical Technology Evaluation Research Grants from the Ministry of Health, Labour and Welfare, Japan; Japan Atherosclerosis Prevention Fund; Uehara Memorial Foundation; Takeda Medical Research Foundation; National Cardiovascular Research Grants; and Biomedical Innovation Grants.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Tsubota-Utsugi, M., Ohkubo, T., Kikuya, M. et al. High fruit intake is associated with a lower risk of future hypertension determined by home blood pressure measurement: the OHASAMA study. J Hum Hypertens 25, 164–171 (2011). https://doi.org/10.1038/jhh.2010.48
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/jhh.2010.48
Keywords
This article is cited by
-
Fruit and vegetable consumption and the risk of hypertension: a systematic review and meta-analysis of prospective studies
European Journal of Nutrition (2023)
-
A personal history of research on hypertension From an encounter with hypertension to the development of hypertension practice based on out-of-clinic blood pressure measurements
Hypertension Research (2022)
-
Association between fruit and vegetable intake and the risk of hypertension among Chinese adults: a longitudinal study
European Journal of Nutrition (2018)
-
Fruit and vegetables consumption and incident hypertension: dose–response meta-analysis of prospective cohort studies
Journal of Human Hypertension (2016)
-
Clinical significance of home blood pressure and its possible practical application
Clinical and Experimental Nephrology (2014)