Abstract
The relationship of dietary niacin intake with the risk of hypertension remains unknown. To determine the prospective association between dietary niacin intake and new-onset hypertension, and examine factors that may modify the association among Chinese adults. 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. Dietary intake. 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. 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. The results of this study provide some evidence for maintaining the optimal dietary niacin intake levels for the primary prevention of hypertension.
Highlights
Hypertension is a leading cause of noncommunicable diseases, mortality, and disability worldwide.[1,2,3] Approximately one-third of the adult population, or more than 300 million people, had hypertension in China between 2014 and 2015.4,5 there is an urgent need to identify high-risk individuals and develop effective primary prevention strategies to reverse the rapidly rising trend of hypertension.Niacin, known as nicotinic acid or vitamin B3, is a vitamin precursor of nicotinamide adenine dinucleotide and is essential for energy metabolism and redox reactions.[6]
When dietary niacin was assessed in quartiles, the lowest risk of new-onset hypertension was found in participants in quartile 3 (14.3 to
The results of this study provide some evidence for maintaining the optimal dietary niacin intake levels for the primary prevention of hypertension
Summary
Known as nicotinic acid or vitamin B3, is a vitamin precursor of nicotinamide adenine dinucleotide and is essential for energy metabolism and redox reactions.[6] Studies have shown that niacin supplementation may regulate abnormal lipid metabolism, improve endothelial function, and have antioxidant and anti-inflammatory properties.[7] excessive niacin is engaged in numerous pathologies, including insulin resistance and elevated homocysteine (HCY) levels.[8,9] Several randomized clinical trials have assessed the effect of niacin supplementation on blood pressure (BP), but the results were inconsistent.[10,11,12,13,14,15] Of note, these trials mainly examined the effects of relatively high niacin supplementation in high-risk populations rather than the effects of dietary niacin derived from foods in general populations. The dietary sources of niacin mainly include cereals and cereal products, meat and meat products, and vegetables.[16] to date, research on the association between dietary niacin intake and hypertension is limited, and the prospective association between dietary niacin intake and incident hypertension risk remains unknown in the general population
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