Published online before print April 26, 2004, doi: 10.1161/01.HYP.0000128243.06502.bc
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(Hypertension. 2004;43:1332.)
© 2004 American Heart Association, Inc.
Scientific Contributions |
Blood Pressure Differences Between Northern and Southern Chinese: Role of Dietary Factors
The International Study on Macronutrients and Blood Pressure
From the Department of Epidemiology (L.Z., B.Z., Y.W., J.Y.), Fu Wai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; Department of Health Science (H.U.), Shiga University of Medical Science, Otsu, Japan; Department of Preventive Medicine (L.Z., J.S., L.L.Y., K.L., M.L.D.), Feinberg School of Medicine, Northwestern University, Chicago, Ill; Collaborative Studies Coordinating Center (B.H.D.), Department of Biostatistics, University of North Carolina, Chapel Hill; Guangxi Medical University (L.Z.), Nanning, People’s Republic of China; Department of Epidemiology and Public Health (P.E.), Faculty of Medicine, St Mary’s Campus, Imperial College, London, UK; Yu County Hospital (D.G.), Shanxi, People’s Republic of China.
Correspondence to Dr Jeremiah Stamler, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Suite 1102, 680 North Lake Shore Drive, Chicago, IL 60611. E-mail j-stamler{at}northwestern.edu
Blood pressure and prevalence of high blood pressure are greater for northern than southern Chinese. Reasons for these differences are unclear. Relationships of north–south blood pressure differences with multiple dietary factors were investigated in 839 Chinese participants, International Study on Macronutrients and Blood Pressure (INTERMAP), 561 northern, 278 southern, aged 40 to 59 years. Daily nutrient intakes were determined from four 24-hour dietary recalls and 2 timed 24-hour urine collections. Average systolic/diastolic pressure levels were 7.4/6.9 mm Hg higher for northern than southern participants. Southern participants had lower body mass index, sodium intake, sodium/potassium ratio, and higher intake of calcium, magnesium, phosphorus, and vitamins A and C. Considered singly, with control for age and gender, several dietary variables (eg, body mass index, urinary sodium/potassium ratio, urinary sodium, dietary phosphorus, and magnesium) reduced north–south blood pressure differences by 
10%. Controlled for age and gender, nondietary variables had little effect on north–south blood pressure differences. With inclusion in regression models of multiple dietary variables (sodium, potassium, magnesium or phosphorus, body mass index), north–south blood pressure differences became much smaller (systolic –1.1, diastolic 1.6 mm Hg) and statistically nonsignificant. In conclusion, multiple dietary factors accounted importantly for north–south blood pressure differences. Efforts are needed to improve nutrition in China, especially in the north, as well as in other populations including those in the United States, for prevention and control of adverse blood pressure levels and major adult cardiovascular disease.
Key Words: blood pressure • diet • population
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