Relation of choline intake with blood pressure in the National Health and Nutrition Examination Survey 2007–2010

Abstract

Dietary choline is a precursor of trimethylamine N-oxide (TMAO), a metabolite that has been associated with an increased risk of cardiovascular disease. The mechanism underlying this association is unknown, but may include TMAO effects on blood pressure (BP). This study assessed the association of choline intake with hypertension and BP in US adults through the use of NHANES 2007-2010 data. This cross-sectional study was conducted in nonpregnant individuals aged ≥20 y. Choline intake was assessed with the use of two 24-h recalls. Outcomes were BP and hypertension status, which was assessed through the use of questionnaires and BP measurements. Modifying factors (e.g., sex, race/ethnicity) and dietary compared with supplemental sources of choline intake were also investigated. The associations of total (dietary+supplemental) and dietary choline intake with the prevalence odds of hypertension differed by sex (n=9227; P-interaction=0.04 and 0.03, respectively). In women, both total and dietary choline intake tended to be inversely associated with hypertension (n=4748; prevalence OR per 100 mg of choline intake: 0.89; 95% CI: 0.77, 1.02; P<0.10 for both total and dietary choline). No association was observed in men (n=4479; P=0.54 and 0.49 for total choline and dietary choline, respectively). Use of choline supplements was inversely associated with hypertension in both sexes (user compared with nonuser; OR: 0.68; 95% CI: 0.49, 0.92; P=0.01). There was little to no association of total, dietary, or supplemental choline intake with systolic or diastolic BP (n=6,554; the mean±SEM change in BP associated with a 100-mg difference in total choline was -0.26±0.22 mm Hg for systolic BP and -0.29±0.19 mm Hg for diastolic BP). Cross-sectional NHANES data do not support thehypothesis of a positive association between choline intake and BP.