Generic placeholder image

Current Vascular Pharmacology

Editor-in-Chief

ISSN (Print): 1570-1611
ISSN (Online): 1875-6212

Research Article

Association between Dietary Vitamin E Intake and the Risk of Hypertension in US Adults

Author(s): Chang Liu* and Dan Liang

Volume 22, Issue 6, 2024

Published on: 30 April, 2024

Page: [391 - 403] Pages: 13

DOI: 10.2174/0115701611297956240425115501

Price: $65

Open Access Journals Promotions 2
conference banner
Abstract

Background: Many studies have shown that Vitamin E (VitE) intake has beneficial effects on human health, but the relationship between VitE intake and Blood Pressure (BP) is not well understood. Thus, our present study aimed to assess the relationship between VitE intake and hypertension, systolic and diastolic BP in US (United States) adults.

Method: We used data from the 2003-2018 National Health and Nutrition Examination Survey (NHANES). Weighted multivariate regression analysis, subgroup analysis, and Restricted Cubic Splines (RCS) were used to explore the independent associations between VitE intake and hypertension, systolic and diastolic BP. A total of 32,371 participants were included in this study. The mean VitE intake of participants was 8.50 ± 0.08 mg/d. The prevalence of hypertension in subjects was 37.76% and it decreased with increasing VitE intake quartiles (quartile 1: 40.97%, quartile 2: 37.60%, quartile 3: 37.47%, quartile 4: 35.66%). A significant negative correlation was found between VitE intake and hypertension.

Result: We also observed a significant negative association between VitE intake and systolic BP (model 1: β = -0.11, 95% CI: -0.15 ~ -0.07; model 2: β = -0.09, 95% CI: -0.12 ~ -0.05; and model 3: β = -0.05, 95% CI: -0.10 ~ -0.01). Quartile 2 of dietary VitE intake significantly correlated to a lower diastolic BP compared to the lowest quartile of VitE intake (model 3: β = -0.72, 95%CI: -1.26~-0.18).

Conclusion: In US adults, VitE intake has not been significantly found to be associated with hypertension, but it has been found to exhibit a negative association with both systolic and diastolic BP in US adults.

Keywords: Vitamin E, hypertension, blood pressure, NHANES, hypertensive patients, systolic and diastolic BP.

Graphical Abstract
[1]
Zhou B, Larco CRM, Danaei G, et al. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: A pooled analysis of 1201 population-representative studies with 104 million participants. Lancet 2021; 398(10304): 957-80.
[http://dx.doi.org/10.1016/S0140-6736(21)01330-1] [PMID: 34450083]
[2]
Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol 2020; 16(4): 223-37.
[http://dx.doi.org/10.1038/s41581-019-0244-2] [PMID: 32024986]
[3]
Ibrahim MM, Damasceno A. Hypertension in developing countries. Lancet 2012; 380(9841): 611-9.
[http://dx.doi.org/10.1016/S0140-6736(12)60861-7] [PMID: 22883510]
[4]
Forouzanfar MH, Liu P, Roth GA, et al. Global burden of hypertension and systolic blood pressure of at least 110 to 115 mm Hg, 1990-2015. JAMA 2017; 317(2): 165-82.
[http://dx.doi.org/10.1001/jama.2016.19043] [PMID: 28097354]
[5]
Ettehad D, Emdin CA, Kiran A, et al. Blood pressure lowering for prevention of cardiovascular disease and death: A systematic review and meta-analysis. Lancet 2016; 387(10022): 957-67.
[http://dx.doi.org/10.1016/S0140-6736(15)01225-8] [PMID: 26724178]
[6]
Bundy JD, Li C, Stuchlik P, et al. Systolic blood pressure reduction and risk of cardiovascular disease and mortality. JAMA Cardiol 2017; 2(7): 775-81.
[http://dx.doi.org/10.1001/jamacardio.2017.1421] [PMID: 28564682]
[7]
Karakayalı M, Püşüroğlu H, Altunova M. Predictive value of the SCORE, SCORE2, and pooled cohort risk equation systems in patients with hypertension. Turk Kardiyol Dern Ars 2023; 51(6): 407-14.
[8]
Xiong Z, Liu L, Jian Z, et al. Vitamin E and multiple health outcomes: An umbrella review of meta-analyses. Nutrients 2023; 15(15): 3301.
[http://dx.doi.org/10.3390/nu15153301] [PMID: 37571239]
[9]
Clarke MW, Burnett JR, Croft KD. Vitamin E in human health and disease. Crit Rev Clin Lab Sci 2008; 45(5): 417-50.
[http://dx.doi.org/10.1080/10408360802118625] [PMID: 18712629]
[10]
Regner-Nelke L, Nelke C, Schroeter CB, et al. Enjoy carefully: The multifaceted role of vitamin E in neuro-nutrition. Int J Mol Sci 2021; 22(18): 10087.
[http://dx.doi.org/10.3390/ijms221810087] [PMID: 34576251]
[11]
Schirinzi T, Martella G, Imbriani P, et al. Dietary vitamin E as a protective factor for parkinson’s disease: Clinical and experimental evidence. Front Neurol 2019; 10: 148.
[http://dx.doi.org/10.3389/fneur.2019.00148] [PMID: 30863359]
[12]
Dietrich M, Jacques PF, Pencina MJ, et al. Vitamin E supplement use and the incidence of cardiovascular disease and all-cause mortality in the Framingham Heart Study: Does the underlying health status play a role? Atherosclerosis 2009; 205(2): 549-53.
[http://dx.doi.org/10.1016/j.atherosclerosis.2008.12.019] [PMID: 19195657]
[13]
Lee CH, Chan R, Wan H, et al. Dietary intake of anti-oxidant vitamins A, C, and E is inversely associated with adverse cardiovascular outcomes in chinese—A 22-years population-based prospective study. Nutrients 2018; 10(11): 1664.
[http://dx.doi.org/10.3390/nu10111664] [PMID: 30400367]
[14]
Shah S, Shiekh Y, Lawrence JA, et al. A systematic review of effects of vitamin E on the cardiovascular system. Cureus 2021; 13(6): e15616.
[http://dx.doi.org/10.7759/cureus.15616] [PMID: 34277234]
[15]
Gu W, Wu H, Hu C, et al. The association of dietary vitamin intake time across a day with cardiovascular disease and all-cause mortality. Front Cardiovasc Med 2022; 9: 822209.
[http://dx.doi.org/10.3389/fcvm.2022.822209] [PMID: 35402523]
[16]
Violi F, Nocella C, Loffredo L, Carnevale R, Pignatelli P. Interventional study with vitamin E in cardiovascular disease and meta-analysis. Free Radic Biol Med 2022; 178: 26-41.
[http://dx.doi.org/10.1016/j.freeradbiomed.2021.11.027] [PMID: 34838937]
[17]
Wong SK, Chin KY, Suhaimi FH, Ahmad F, Nirwana IS. Vitamin E as a potential interventional treatment for metabolic syndrome: Evidence from animal and human studies. Front Pharmacol 2017; 8: 444.
[http://dx.doi.org/10.3389/fphar.2017.00444] [PMID: 28725195]
[18]
Baburao Jain A, Anand Jain V, Vitamin E. Vitamin E, its beneficial role in diabetes mellitus (DM) and its complications. J Clin Diagn Res 2012; 6(10): 1624-8.
[PMID: 23373014]
[19]
Rafighi Z, Shiva A, Arab S, Yousof MR. Association of dietary vitamin C and e intake and antioxidant enzymes in type 2 diabetes mellitus patients. Glob J Health Sci 2013; 5(3): 183-7.
[http://dx.doi.org/10.5539/gjhs.v5n3p183] [PMID: 23618488]
[20]
Mune M, Uto-Kondo H, Iteya I, Fujii Y, Ikeda S, Ikewaki K. Vitamin E supplementation improves high-densitiy lipoprotein and endothelial functions in end-stage kidney disease patients undergoing hemodialysis
. Clin Nephrol 2018; 90(3): 212-21.
[http://dx.doi.org/10.5414/CN109197] [PMID: 29628022]
[21]
Kuwabara A, Nakade M, Tamai H, Kasaoka TN, Tanaka K. The association between vitamin E intake and hypertension: results from the re-analysis of the National Health and Nutrition Survey. J Nutr Sci Vitaminol 2014; 60(4): 239-45.
[http://dx.doi.org/10.3177/jnsv.60.239] [PMID: 25297612]
[22]
Zhang Y, Yang S, Wu Q, et al. Dietary vitamin E intake and new-onset hypertension. Hypertens Res 2023; 46(5): 1267-75.
[http://dx.doi.org/10.1038/s41440-022-01163-0]
[23]
Wang Z, Wang C, Qiu J, et al. The association between dietary vitamin C/E and gestational hypertensive disorder: A case-control study. J Nutr Sci Vitaminol 2018; 64(6): 454-65.
[http://dx.doi.org/10.3177/jnsv.64.454] [PMID: 30606968]
[24]
Emami MR, Safabakhsh M, Alizadeh S, Asbaghi O, Khosroshahi MZ. Effect of vitamin E supplementation on blood pressure: A systematic review and meta-analysis. J Hum Hypertens 2019; 33(7): 499-507.
[http://dx.doi.org/10.1038/s41371-019-0192-0] [PMID: 30846828]
[25]
Godala MM, Kuśmierkiewicz MI, Moczulski D, et al. Lower plasma levels of antioxidant vitamins in patients with metabolic syndrome: A case control study. Adv Clin Exp Med : Off Organ Wroclaw Med Univ 2016; 25(4): 689-700.
[26]
Johnson CL, Ram PR, Ogden CL, et al. National health and nutrition examination survey: Analytic guidelines, 1999-2010. Vital Health Stat 2 2013; 2013(161): 1-24.
[27]
Moshfegh AJ, Rhodes DG, Baer DJ, et al. The US department of agriculture automated multiple-pass method reduces bias in the collection of energy intakes. Am J Clin Nutr 2008; 88(2): 324-32.
[http://dx.doi.org/10.1093/ajcn/88.2.324] [PMID: 18689367]
[28]
Zhang L, Shi X, Yu J, Zhang P, Ma P, Sun Y. Dietary vitamin E intake was inversely associated with hyperuricemia in US adults: NHANES 2009–2014. Ann Nutr Metab 2020; 76(5): 354-60.
[http://dx.doi.org/10.1159/000509628] [PMID: 32957105]
[29]
Li W, Li S, Zhuang W, et al. Non-linear relationship between dietary vitamin E intake and cognitive performance in older adults. Public Health 2023; 219: 10-7.
[http://dx.doi.org/10.1016/j.puhe.2023.03.012] [PMID: 37075487]
[30]
Fryar CD, Ostchega Y, Hales CM, Zhang G, Moran KD. Hypertension prevalence and control among adults: United States, 2015-2016. NCHS Data Brief 2017; (289): 1-8.
[PMID: 29155682]
[31]
Menke A, Casagrande S, Geiss L, Cowie CC. Prevalence of and trends in diabetes among adults in the United States, 1988-2012. JAMA 2015; 314(10): 1021-9.
[http://dx.doi.org/10.1001/jama.2015.10029] [PMID: 26348752]
[32]
Boshtam M, Rafiei M, Sadeghi K, et al. Vitamin E can reduce blood pressure in mild hypertensives. Int J Vitam Nutr Res 2002; 72(5): 309-14.
[33]
Ward NC, Wu JHY, Clarke MW, et al. The effect of vitamin E on blood pressure in individuals with type 2 diabetes: A randomized, double-blind, placebo-controlled trial. J Hypertens 2007; 25(1): 227-34.
[http://dx.doi.org/10.1097/01.hjh.0000254373.96111.43] [PMID: 17143195]
[34]
Annor FB, Goodman M, Okosun IS, et al. Oxidative stress, oxidative balance score, and hypertension among a racially diverse population. J Am Soc Hypertens 2015; 9(8): 592-9.
[http://dx.doi.org/10.1016/j.jash.2015.05.014] [PMID: 26160262]
[35]
Ho JE, Enserro D, Brouwers FP, et al. Predicting heart failure with preserved and reduced ejection fraction. Circ Heart Fail 2016; 9(6): e003116.
[http://dx.doi.org/10.1161/CIRCHEARTFAILURE.115.003116] [PMID: 27266854]
[36]
Williamson JD, Supiano MA, Applegate WB, et al. Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged ≥75 years. JAMA 2016; 315(24): 2673-82.
[http://dx.doi.org/10.1001/jama.2016.7050] [PMID: 27195814]
[37]
Cangemi R, Pignatelli P, Carnevale R, et al. Cholesterol-adjusted vitamin E serum levels are associated with cardiovascular events in patients with non-valvular atrial fibrillation. Int J Cardiol 2013; 168(4): 3241-7.
[http://dx.doi.org/10.1016/j.ijcard.2013.04.142] [PMID: 23651827]
[38]
Rimm EB, Stampfer MJ, Ascherio A, Giovannucci E, Colditz GA, Willett WC. Vitamin E consumption and the risk of coronary heart disease in men. N Engl J Med 1993; 328(20): 1450-6.
[http://dx.doi.org/10.1056/NEJM199305203282004] [PMID: 8479464]
[39]
Stampfer MJ, Hennekens CH, Manson JE, Colditz GA, Rosner B, Willett WC. Vitamin E consumption and the risk of coronary disease in women. N Engl J Med 1993; 328(20): 1444-9.
[http://dx.doi.org/10.1056/NEJM199305203282003] [PMID: 8479463]
[40]
Mirmiran P, Hosseini-Esfahani F, Esfandiar Z, Hosseinpour-Niazi S, Azizi F. Associations between dietary antioxidant intakes and cardiovascular disease. Sci Rep 2022; 12(1): 1504.
[http://dx.doi.org/10.1038/s41598-022-05632-x] [PMID: 35087166]
[41]
Jayedi A, Rahimi K, Bautista LE, Nazarzadeh M, Zargar MS, Shab-Bidar S. Inflammation markers and risk of developing hypertension: A meta-analysis of cohort studies. Heart 2019; 105(9): 686-92.
[http://dx.doi.org/10.1136/heartjnl-2018-314216] [PMID: 30700522]
[42]
Alexander MR, Norlander AE, Elijovich F, et al. Human monocyte transcriptional profiling identifies IL‐18 receptor accessory protein and lactoferrin as novel immune targets in hypertension. Br J Pharmacol 2019; 176(12): 2015-27.
[http://dx.doi.org/10.1111/bph.14364] [PMID: 29774543]
[43]
Higaki A, Mahmoud AUM, Paradis P, Schiffrin EL. Role of interleukin-23/interleukin-17 axis in T-cell-mediated actions in hypertension. Cardiovasc Res 2021; 117(5): 1274-83.
[http://dx.doi.org/10.1093/cvr/cvaa257] [PMID: 32870976]
[44]
Wu J, Thabet SR, Kirabo A, et al. Inflammation and mechanical stretch promote aortic stiffening in hypertension through activation of p38 mitogen-activated protein kinase. Circ Res 2014; 114(4): 616-25.
[http://dx.doi.org/10.1161/CIRCRESAHA.114.302157] [PMID: 24347665]
[45]
Madhur MS, Lob HE, McCann LA, et al. Interleukin 17 promotes angiotensin II-induced hypertension and vascular dysfunction. Hypertension 2010; 55(2): 500-7.
[46]
Zhang Y, Lacolley P, Protogerou AD, Safar ME. Arterial Stiffness in Hypertension and Function of Large Arteries. Am J Hypertens 2020; 33(4): 291-6.
[http://dx.doi.org/10.1093/ajh/hpz193] [PMID: 32060496]
[47]
Guzik TJ, Touyz RM. Oxidative stress, inflammation, and vascular aging in hypertension. Hypertension 2017; 70(4): 660-7.
[48]
Carlisle RE, Werner KE, Yum V, et al. Endoplasmic reticulum stress inhibition reduces hypertension through the preservation of resistance blood vessel structure and function. J Hypertens 2016; 34(8): 1556-69.
[http://dx.doi.org/10.1097/HJH.0000000000000943] [PMID: 27115336]
[49]
Dikalova AE, Pandey A, Xiao L, et al. Mitochondrial deacetylase sirt3 reduces vascular dysfunction and hypertension while sirt3 depletion in essential hypertension is linked to vascular inflammation and oxidative stress. Circ Res 2020; 126(4): 439-52.
[http://dx.doi.org/10.1161/CIRCRESAHA.119.315767] [PMID: 31852393]
[50]
Rossman MJ, Parker SJR, Steward CAC, et al. Chronic supplementation with a mitochondrial antioxidant (MitoQ) improves vascular function in healthy older adults. Hypertension 2018; 71(6): 1056-63.
[51]
Higgins M, Izadi A, Kaviani M. Antioxidants and exercise performance: With a focus on vitamin E and C supplementation. Int J Environ Res Public Health 2020; 17(22): 8452.
[http://dx.doi.org/10.3390/ijerph17228452] [PMID: 33203106]
[52]
Ajibade TO, Bolaji-Alabi FB, Oyagbemi AA, Ajileye IW, Omobowale TO. Supplementation of antihypertensive drug regimen with vitamin E ameliorates alterations of primary haemodynamic parameters and total antioxidant capacity in ovariectomised rats. J Basic Clin Physiol Pharmacol 2023; 34(1): 33-9.
[http://dx.doi.org/10.1515/jbcpp-2020-0097] [PMID: 34363382]
[53]
Huang H, Liu Q, Zhu L, et al. Prognostic value of preoperative systemic immune-inflammation index in patients with cervical cancer. Sci Rep 2019; 9(1): 3284.
[http://dx.doi.org/10.1038/s41598-019-39150-0] [PMID: 30824727]
[54]
Fu H, Zheng J, Cai J, et al. Systemic immune-inflammation index (SII) is useful to predict survival outcomes in patients after liver transplantation for hepatocellular carcinoma within hangzhou criteria. Cell Physiol Biochem 2018; 47(1): 293-301.
[55]
Xu JP, Zeng RX, Zhang YZ, et al. Systemic inflammation markers and the prevalence of hypertension: A NHANES cross-sectional study. Hypertens Res 2023; 46(4): 1009-19.
[http://dx.doi.org/10.1038/s41440-023-01195-0]
[56]
Karakayali M, Omar T, Artac I, Rencuzogullari İ, Karabag Y, Demir O. The relationship between the systemic immune‐inflammation index and reverse‐dipper circadian pattern in newly diagnosed hypertensive patients. J Clin Hypertens 2023; 25(8): 700-7.
[http://dx.doi.org/10.1111/jch.14688] [PMID: 37464585]
[57]
Cheng W, Du Y, Zhang Q, et al. Age-related changes in the risk of high blood pressure. Front Cardiovasc Med 2022; 9: 939103.
[http://dx.doi.org/10.3389/fcvm.2022.939103] [PMID: 36187016]
[58]
Yoo HJ, Kim M, Lee SH, Lee JH. Elevated lipoprotein-associated phospholipase A 2 independently affects age-related increases in systolic blood pressure: A nested case-control study in a prospective korean cohort. Int J Hypertens 2020; 2020: 1-7.
[http://dx.doi.org/10.1155/2020/5693271] [PMID: 32292598]
[59]
Kim M, Jung S, Kim SY, Lee SH, Lee JH. Prehypertension-associated elevation in circulating lysophosphatidlycholines, Lp-PLA2 activity, and oxidative stress. PLoS One 2014; 9(5): e96735.
[http://dx.doi.org/10.1371/journal.pone.0096735] [PMID: 24800806]
[60]
Li Z, Liu J, Shen Y, Zeng F, Zheng D. Increased Lipoprotein-associated phospholipase A2 activity portends an increased risk of resistant hypertension. Lipids Health Dis 2016; 15(1): 15.
[http://dx.doi.org/10.1186/s12944-016-0184-9] [PMID: 26801405]
[61]
Čelovská D, Vlčková K, Gonsorčík J. Negative association between lipoprotein associated phospholipase A2 activity and baroreflex sensitivity in subjects with high normal blood pressure and a positive family history of hypertension. Physiol Res 2021; 70(2): 183-91.
[http://dx.doi.org/10.33549/physiolres.934467] [PMID: 33676381]
[62]
Minamiyama Y, Takemura S, Bito Y, et al. Supplementation of α -tocopherol improves cardiovascular risk factors via the insulin signalling pathway and reduction of mitochondrial reactive oxygen species in type II diabetic rats. Free Radic Res 2008; 42(3): 261-71.
[http://dx.doi.org/10.1080/10715760801898820] [PMID: 18344121]
[63]
Jin L, Xue HY, Jin LJ, Li SY, Xu YP. Antioxidant and pancreas-protective effect of aucubin on rats with streptozotocin-induced diabetes. Eur J Pharmacol 2008; 582(1-3): 162-7.
[http://dx.doi.org/10.1016/j.ejphar.2007.12.011] [PMID: 18230397]
[64]
Piarulli F, Sartore G, Ceriello A, et al. Relationship between glyco-oxidation, antioxidant status and microalbuminuria in type 2 diabetic patients. Diabetologia 2009; 52(7): 1419-25.
[http://dx.doi.org/10.1007/s00125-009-1367-y] [PMID: 19401824]
[65]
Gray B, Swick J, Ronnenberg AG. Vitamin E and adiponectin: Proposed mechanism for vitamin E-induced improvement in insulin sensitivity. Nutr Rev 2011; 69(3): 155-61.
[http://dx.doi.org/10.1111/j.1753-4887.2011.00377.x] [PMID: 21348879]
[66]
Selvaraj N, Bobby Z, Sridhar MG. Oxidative stress: Does it play a role in the genesis of early glycated proteins? Med Hypotheses 2008; 70(2): 265-8.
[http://dx.doi.org/10.1016/j.mehy.2007.04.049] [PMID: 17693039]
[67]
Tosatti JAG, Alves MT, Gomes KB. The role of the mediterranean dietary pattern on metabolic control of patients with diabetes mellitus: A narrative review. Adv Exp Med Biol 2020; 1307: 115-28.
[http://dx.doi.org/10.1007/5584_2020_513] [PMID: 32253710]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy