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Intake of total protein, plant protein and animal protein in relation to blood pressure: a meta-analysis of observational and intervention studies

Journal of Human Hypertension volume 27, pages 564–571 (2013)Cite this article

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Abstract

There is growing evidence from epidemiological studies that dietary protein may beneficially influence blood pressure (BP), but findings are inconclusive. We performed a meta-analysis of 29 observational studies and randomized controlled trials (RCTs) of dietary protein and types of protein in relation to BP or incident hypertension, published until January 2012. The analysis included eight cross-sectional studies (n=48 985), four prospective studies (n=11 761) and 17 RCTs (n=1449). A modest inverse association between total protein intake and BP (−0.20 mm Hg systolic (95% CI: −0.39, −0.01) per 25 g (∼1 s.d.)) was found in cross-sectional studies, but not in prospective studies (relative risk of 0.99 (95% CI: 0.96, 1.02)). For RCTs that used carbohydrate as a control treatment, the pooled BP effect was −2.11 mm Hg systolic (95% CI: −2.86, −1.37) for a weighed mean contrast in protein intake of 41 g per day. A non-significant inverse association of −0.52 mm Hg systolic (95% CI: −1.10, +0.05) per 11 g (∼1 s.d.) was found for plant protein in cross-sectional studies, whereas animal protein was not associated with BP. In prospective studies and RCTs, however, the associations of plant protein and animal protein with BP were broadly similar. These findings suggest that increasing the intake of protein at the expense of carbohydrates may have a beneficial effect on BP. The BP effect of specific types of protein remains to be established.

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Acknowledgements

This study was supported by the Top Institute Food and Nutrition, Wageningen, The Netherlands, a public private partnership of science, industry and government (www.tifn.nl).

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Author notes

  1. S M A J Tielemans and W Altorf-van der Kuil: These authors contributed equally to this work.

Authors and Affiliations

  1. Top Institute Food and Nutrition, Wageningen, The Netherlands

    S M A J Tielemans, W Altorf-van der Kuil, M F Engberink, E J Brink, M A van Baak, S J L Bakker & J M Geleijnse

  2. Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands

    S M A J Tielemans, W Altorf-van der Kuil, M F Engberink & J M Geleijnse

  3. Department of Human Biology, NUTRIM School for Nutrition, Toxicology and Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands

    M A van Baak

  4. Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    S J L Bakker

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  1. S M A J Tielemans
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Correspondence to J M Geleijnse.

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Tielemans, S., Altorf-van der Kuil, W., Engberink, M. et al. Intake of total protein, plant protein and animal protein in relation to blood pressure: a meta-analysis of observational and intervention studies. J Hum Hypertens 27, 564–571 (2013). https://doi.org/10.1038/jhh.2013.16

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Keywords

  • meta-analysis
  • protein intake
  • diet
  • blood pressure
  • randomized controlled trials
  • prospective cohort studies

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