Evaluation of Dietary Niacin and New-Onset Hypertension Among Chinese Adults

作者：Zhang, Zhuxian; Liu, Mengyi; Zhou, Chun; He, Panpan; Zhang, Yuanyuan; Li, Huan; Li, Qinqin; Liu, Chengzhang^*; Qin, Xianhui^*

来源：JAMA Network Open, 2021, 4(1): e2031669.

DOI：10.1001/jamanetworkopen.2020.31669

• EXTENDED-RELEASE NIACIN
• NICOTINIC-ACID
• OXIDATIVE STRESS
• BLOOD-PRESSURE
• INFLAMMATORY MARKERS
• ENDOTHELIAL FUNCTION
• NUTRITION SURVEY
• BURDEN
• DEGRADATION
• COMBINATION

IMPORTANCE The relationship of dietary niacin intake with the risk of hypertension remains unknown. @@@ OBJECTIVE To determine the prospective association between dietary niacin intake and new-onset hypertension, and examine factors that may modify the association among Chinese adults. @@@ DESIGN, SETTING, AND PARTICIPANTS This nationwide cohort study of 12 243 Chinese adults used dietary intake data from 7 rounds of the China Health and Nutrition Survey. Dietary intake was measured by 3 consecutive 24-hour dietary recalls from participants in combination with a weighing inventory taken over the same 3 days at the household level. Statistical analysis was conducted from May 2020 to August 2020. @@@ EXPOSURES Dietary intake. @@@ MAIN OUTCOMES AND MEASURES The study outcome was new-onset hypertension, defined as systolic blood pressure 140 mm Hg or greater and/or diastolic blood pressure 90 mm Hg or greater, diagnosis by physician, or current antihypertensive treatment during the follow-up. @@@ RESULTS The mean (SD) age of the study population was 41.2 (14.2) years, and 5728 (46.8%) of participants were men. The mean (SD) dietary niacin intake level was 14.8 (4.1) mg/d. A total of 4306 participants developed new-onset hypertension during a median (interquartile range) follow-up duration of 6.1 (3.6-11.3) years. When dietary niacin was assessed in quartiles, the lowest risk of new-onset hypertension was found in participants in quartile 3 (14.3 to <16.7 mg/d; adjusted hazard ratio, 0.83; 95% CI, 0.75-0.90) compared with those in quartile 1 (<12.4 mg/d). Consistently in the threshold analysis, for every 1 mg/d increase in dietary niacin, there was a 2% decrease in new-onset hypertension (adjusted HR, 0.98; 95% CI, 0.96-1.00) in those with dietary niacin intake less than 15.6 mg/d, and a 3% increase in new-onset hypertension (adjusted HR, 1.03; 95% CI, 1.02-1.04) in participants with dietary niacin 15.6 mg/d or greater. Based on these results, there was a J-shaped association between dietary niacin intake and new-onset hypertension in the general population of Chinese adults, with an inflection point at 15.6 mg/d and a minimal risk at 14.3 to 16.7 mg/d (quartile 3) of dietary niacin intake. @@@ CONCLUSIONS AND RELEVANCE The results of this study provide some evidence for maintaining the optimal dietary niacin intake levels for the primary prevention of hypertension. @@@ This cohort study of a large nationwide database of Chinese adults assesses the association between dietary niacin intake and the risk of new-onset hypertension.

• 单位
  安徽医科大学; 南方医科大学