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(Hypertension. 2008;52:408.)
© 2008 American Heart Association, Inc.

Original Articles

Relationship of Dietary Linoleic Acid to Blood Pressure

The International Study of Macro-Micronutrients and Blood Pressure Study

Katsuyuki Miura; Jeremiah Stamler; Hideaki Nakagawa; Paul Elliott; Hirotsugu Ueshima; Queenie Chan; Ian J. Brown; Ioanna Tzoulaki; Shigeyuki Saitoh; Alan R. Dyer; Martha L. Daviglus; Hugo Kesteloot; Akira Okayama; J. David Curb; Beatriz L. Rodriguez; Patricia J. Elmer; Lyn M. Steffen; Claire Robertson; Liancheng Zhao for the International Study of Macro-Micronutrients and Blood Pressure Research Group

From the Department of Health Science (K.M., H.U.), Shiga University of Medical Science, Otsu, Japan; Department of Epidemiology and Public Health (K.M., H.N.), Kanazawa Medical University, Ishikawa, Japan; Department of Preventive Medicine (J.S., A.R.D., M.L.D.), Feinberg School of Medicine, Northwestern University, Chicago, Ill; Department of Epidemiology and Public Health (P.E., Q.C., I.J.B., I.T.), Faculty of Medicine, St Mary’s Campus, Imperial College London, United Kingdom; 2nd Department of Internal Medicine (S.S.), Sapporo Medical University, Sapporo, Japan; Central Laboratory (H.K.), Akademisch Ziekenhuis St Rafael, Leuven, Belgium; First Institute of Health Service (A.O.), Japan Anti-Tuberculosis Association, Tokyo, Japan; John A. Burn’s School of Medicine (J.D.C., B.L.R.), University of Hawaii at Manoa, Honolulu; Kaiser Permanente Northwest (P.J.E.), Portland, Ore; Division of Epidemiology and Community Health (L.M.S.), University of Minnesota School of Public Health, Minneapolis; School of Biosciences (C.R.), University of Westminster, London, United Kingdom; and the Department of Epidemiology (L.Z.), Fu Wai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China.

Correspondence to Katsuyuki Miura, Department of Health Science, Shiga University of Medical Science, Seta-Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan. E-mail miura{at}belle.shiga-med.ac.jp

Findings from observational and interventional studies on the relationship of dietary linoleic acid, the main dietary polyunsaturated fatty acid, with blood pressure have been inconsistent. The International Study of Macro-Micronutrients and Blood Pressure is an international cross-sectional epidemiological study of 4680 men and women ages 40 to 59 years from 17 population samples in China, Japan, United Kingdom, and United States. We report associations of linoleic acid intake of individuals with their blood pressure. Nutrient intake data were based on 4 in-depth multipass 24-hour dietary recalls per person and 2 timed 24-hour urine collections per person. Systolic and diastolic blood pressures were measured 8 times at 4 visits. With several models to control for possible confounders (dietary or other), linear regression analyses showed a nonsignificant inverse relationship of linoleic acid intake (percent kilocalories) to systolic and diastolic blood pressure for all of the participants. When analyzed for 2238 "nonintervened" individuals (not on a special diet, not consuming nutritional supplements, no diagnosed cardiovascular disease or diabetes, and not taking medication for high blood pressure, cardiovascular disease, or diabetes), the relationship was stronger. With adjustment for 14 variables, estimated systolic/diastolic blood pressure differences with 2-SD higher linoleic acid intake (3.77% kcal) were –1.42/–0.91 mm Hg (P<0.05 for both) for nonintervened participants. For total polyunsaturated fatty acid intake, blood pressure differences were –1.42/–0.98 mm Hg (P<0.05 for both) with 2 SD higher intake (4.04% kcal). Dietary linoleic acid intake may contribute to prevention and control of adverse blood pressure levels in general populations.

Key Words: blood pressure • nutrition • linoleic acid • polyunsaturated fatty acid • population study

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