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Nutritional Epidemiology

Low Total and Nonheme Iron Intakes Are Associated with a Greater Risk of Hypertension^1,2

³ UMR U557 Inserm, U1125 Inra, Cnam, Université Paris 13, CRNH IdF, F-93017 Bobigny, France ⁴ Department of Epidemiology and Public Health, Imperial College London, St. Mary's Campus, London W2 1PG, UK ⁵ Université Paris-Descartes, Faculté de Médecine; AP-HP; Hôtel-Dieu, Centre de Diagnostic et Thérapeutique, F-75004, Paris, France ⁶ Département de Santé Publique, Hôpital Avicenne, 93017, Bobigny, France

The relationship between iron intake and blood pressure (BP) status has not been well established. Only 1 cross-sectional study has suggested an inverse association of dietary total iron intake and nonheme iron intake with BP. We investigated the relationship between total, heme, and nonheme iron intakes, markers of iron status, 5.4-y changes in BP, and the incidence of hypertension. A total of 2895 participants included in the Supplémentation en Vitamines et Minéraux Antioxydants cohort were followed up for 5.4 y. At least 3 repeated 24-h dietary records were performed at baseline and 5.4 y later. Hemoglobin and serum ferritin concentrations were assessed at baseline. Low nonheme iron intake at baseline was associated with a greater increase in systolic BP (SBP) and pulse pressure over time after adjustment for multiple possible confounding factors (P-trend = 0.002 and 0.0005, respectively). Conversely, participants in the 3rd tertile of nonheme iron intake at baseline had a 37% lower risk of hypertension after 5.4 y of follow-up compared with those in the first tertile (P-trend = 0.04). Heme iron intake was not associated with BP changes or risk of hypertension. Meat intake was positively associated with an increase in SBP (P-trend = 0.04). However, that relation became nonsignificant after adjusting for dietary pattern scores. Baseline hemoglobin and ferritin concentrations were not associated with changes in BP or incidental hypertension. Our data support a possible role of low nonheme iron intake, independent of heme iron intake, in the development of hypertension.

^* To whom correspondence should be addressed. E-mail: p.galan{at}uren.smbh.univ-paris13.fr.

Manuscript received 5 August 2009. Initial review completed 23 August 2009. Revision accepted 28 October 2009.