Faculty, Staff and Student Publications

Language

English

Publication Date

5-20-2025

Journal

Journal of the American Heart Association

DOI

10.1161/JAHA.124.037813

PMID

40207538

PMCID

PMC12184573

PubMedCentral® Posted Date

4-10-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Dietary guidelines recommend adequate protein intake from diverse sources for optimal blood pressure; however, its role in hypertension risk remains unclear. We examined prospective associations of protein intake and diversity, overall and by source, with hypertension risk in the MESA (Multi-Ethnic Study of Atherosclerosis) study.

Methods and results: Among 2294 participants aged 45 to 84 years without hypertension at baseline, total, animal, and plant protein intake was assessed using a 120-item food frequency questionnaire. Protein diversity was evaluated using count and the dissimilarity index. Over a 9-year median follow-up, 1356 hypertension cases were identified through blood pressure measurements and medication records. Associations with hypertension risk were assessed using Cox proportional hazards models and restricted cubic spline analyses. In multivariable-adjusted models, we found inverse, nonlinear relationships between plant protein intake and count (P-nonlinearity< 0.05), indicating a lower hypertension risk associated with higher consumption and number of different plant protein sources. Greater dissimilarity in plant foods was associated with a higher hypertension risk (hazard ratio [HR], 1.72 [95% CI, 1.06-2.81]). We found no statistically significant associations between total or animal protein (intake or diversity in food sources) and risk of hypertension (HRs for each 20 g/d, 1.05 [95% CI, 0.97-1.14]; and 1.06 [95% CI, 0.99-1.15] for total and animal protein intake, respectively).

Conclusions: These findings suggest that higher consumption and variety of minimally processed plant proteins lower hypertension risk, while minimally processed animal proteins can be included without significantly increasing hypertension risk among middle-aged US adults.

Keywords

Humans, Hypertension, Male, Middle Aged, Female, Aged, United States, Prospective Studies, Aged, 80 and over, Risk Factors, Incidence, Plant Proteins, Dietary, Blood Pressure, Animal Proteins, Dietary, Dietary Proteins, Risk Assessment, Proportional Hazards Models, dietary protein intake, diversity of protein sources, food source, hypertension prevention, plant protein, Cardiovascular Disease, Epidemiology, Diet and Nutrition

Published Open-Access

yes

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.