Abstract

In order to examine the association between plasma phytoestrogen concentration (genistein, daidzein, equol and enterolactone) and hypertension, we conducted a nested case–control study for 229 hypertension cases including 112 prehypertension and 159 healthy controls derived from the Korean Multi-center Cancer Cohort (KMCC). The concentration of plasma phytoestrogens was measured using time-resolved fluoroimmunoassay. We assessed the association between plasma phytoestrogens and hypertension using logistic regression models using odds ratio (OR) and 95% confidence interval (95%CI). The highest tertile of plasma equol and enterolactone concentration exhibited a significantly decreased risk of hypertension (equol, OR = 0.34, 95%CI 0.20–0.57; enterolactone, OR = 0.32, 95%CI 0.18–0.57), compared with the lowest tertile. Equol and enterolactone showed reduced ORs for prehypertension (the highest tertile relative to the lowest tertile, OR = 0.50, 95%CI 0.26–0.96; OR = 0.38, 95%CI 0.19–0.75, respectively) and hypertension (OR = 0.42, 95%CI 0.22–0.81; OR = 0.28, 95%CI 0.14–0.54, respectively). There was a stronger association in hypertension (the highest tertile relative to the lowest tertile in obesity vs. non-obesity; equol, OR = 0.06 vs. 0.63; enterolactone, OR = 0.07 vs. 0.46; both p-heterogeneity < 0.01). This study suggests that equol and enterolactone may contribute to prevent primarily prehypertension and hypertension, and control cardiovascular disease (CVD) based on the continuum of hypertension and CVD. Further study to assess hypertension risk based on useful biomarkers, including phytoestrogens, may contribute to primary prevention of hypertension.

Highlights

  • IntroductionHypertension has been referred as an epidemic due to its high prevalence worldwide and it has been predicted that 29.5% of the global adult population worldwide will be hypertension patients by 2025 [1]

  • In contrast to prior studies which used relatively inaccurate methods of evaluating dietary exposure, such as estimation based on a questionnaire [30], our study focused on accurate quantitative measurement of the dietary exposure in serum level and detailed analysis for each of the specific types of compounds which make up phytoestrogen

  • There was no difference in mean age; 62.5 (7.5), 63.9 (8.9) in healthy controls and total cases including hypertension and prehypertension, respectively

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Summary

Introduction

Hypertension has been referred as an epidemic due to its high prevalence worldwide and it has been predicted that 29.5% of the global adult population worldwide will be hypertension patients by 2025 [1]. In Korea, the number of people with hypertension has increased steadily, and is over 12.0 million [2,3]. The increase in Koreans eating a Westernized diet containing high-sodium and fattening westernized foods, in addition to traditional Korean salty foods, has been noted as one of the main risk factors contributing to this rise in hypertension [4]. Epidemiological studies on the role of dietary habits on hypertension risk in Korea are limited

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