Abstract
Purpose: The relationship between egg and cholesterol intakes, and cardiovascular disease is controversial. Meta-analyses indicate that egg consumption is associated with increased cardiovascular disease and mortality, but reduced incidence of hypertension, a major risk factor for cardiovascular disease. This study aims to investigate the associations between consumption of egg and cholesterol, and hypertension risk in a cohort of French women. Methods: We used data from the E3N cohort study, a French prospective population-based study initiated in 1990. From the women in the study, we included those who completed a detailed diet history questionnaire, and who did not have prevalent hypertension or cardiovascular disease at baseline, resulting in 46,424 women. Hypertension cases were self-reported. Egg and cholesterol intake was estimated from dietary history questionnaires. Cox proportional hazard models with time-updated exposures were used to calculate hazard ratios. Spline regression was used to determine any dose–respondent relationship. Results: During 885,321 person years, 13,161 cases of incident hypertension were identified. Higher cholesterol consumption was associated with an increased risk of hypertension: HRQ1–Q5 = 1.22 [1.14:1.30], with associations similar regarding egg consumption up to seven eggs per week: HR4–7 eggs = 1.14 [1.06:1.18]. Evidence for a non-linear relationship between hypertension and cholesterol intake was observed. Conclusions: Egg and cholesterol intakes were associated with a higher risk of hypertension in French women. These results merit further investigation in other populations.
Highlights
The relationship between cholesterol or egg consumption and the onset of cardiovascular diseases (CVD) is unclear, with observational studies and trials finding inconsistent results [1,2,3,4]
Eggs are a main source of dietary cholesterol, and their consumption has been associated with an increased risk of cardiovascular disease [5], all-cause mortality [6], haemorrhagic stroke [7], and diabetes [8,9]; paradoxically, in meta-analysis eggs are associated with a decreased risk of hypertension [10], which is a major risk-factor for cardiovascular disease [11]
Aside from cholesterol, eggs are a source of essential nutrients, vitamins, and high-quality proteins [21], which may be a reason for the inconsistencies, as overall diet quality may be important in the relationship between eggs and CVD
Summary
The relationship between cholesterol or egg consumption and the onset of cardiovascular diseases (CVD) is unclear, with observational studies and trials finding inconsistent results [1,2,3,4]. Eggs are a main source of dietary cholesterol, and their consumption has been associated with an increased risk of cardiovascular disease [5], all-cause mortality [6], haemorrhagic stroke [7], and diabetes [8,9]; paradoxically, in meta-analysis eggs are associated with a decreased risk of hypertension [10], which is a major risk-factor for cardiovascular disease [11]. High levels of dietary cholesterol have been associated with increased systolic blood pressure in the INTERMAP study [24] conducted in China, Japan, UK and USA, but not in the Finnish Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) [17]
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