| Objective:Current evidence on the association between dietary fiber intake and the risk of hypertension is inconsistent.This study aimed to explore the association between dietary fiber intake and hypertension risk using 2017 American College of Cardiology/American Heart Association Blood Pressure Guidelines.Methods:Data from the National Health and Nutrition Examination Survey 2007–2014were used in this cross-sectional study.NHANES aims to assess the health and nutritional status of the U.S.population and adopts a complex multi-stage probabilistic sampling design to select representative samples of the civilian non-institutional U.S.population.NHANES participants were first interviewed in their homes and then completed the health examination in a mobile examination center?MEC?.Dietary fiber data were obtained through two 24-h dietary recall interviews.Hypertension was defined as systolic blood pressure?SBP??130 mmHg or diastolic blood pressure?DBP??80 mmHg or treatment with hypertensive medications.Student's t-tests were used to compare the mean values between participants with and without hypertension.Chi-square tests were used to compare the percentages of categorical variables between individuals with and without hypertension.Binary logistic regression models were used to analyze the association between hypertension and intakes of total,cereal,vegetable,and fruit fiber.Furthermore,stratified analyses were performed based on age?18-44 years,45-64 years,and?65 years?and gender?male and female?to evaluate the relationships between total,cereal,vegetable,and fruit fiber intake and hypertension.The dose-response relationship was assessed by binary logistic regression model with the use of restricted cubic spline function with three knots located at the 5th,50th,and 95th percentiles of the exposure distribution.Subgroup analysis was performed after excluding those previously diagnosed with hypertension,univariate and multivariate bivariate logistic regression analyses were used again to explore the associations between total dietary fiber and fiber intake from different food sources and hypertension in new cases.In the new case analysis,the hypertensive group was further divided into stage?hypertension group?130 mmHg?SBP?139 mmHg and/or 80 mmHg?DBP?89 mmHg?and stage?hypertension group?SBP?140 mmHg and/or DBP?90mmHg?.Univariate and multivariate multi-class logistic regression analyses were used to explore the associations between total dietary fiber,cereal fiber,vegetable fiber and fruit fiber intake and various degrees of hypertension.Advantage analysis explored the importance of total dietary fiber to hypertension.Results:A total of 18,433 participants aged 18 years or older were included in the analyses.The weighted prevalence of hypertension was 44.93%.Binary logistic regression analysis of total dietary fiber and hypertension showed that increased total dietary fiber intake was associated with a lower risk of hypertension.In multivariate model 2,the corresponding odds ratios?ORs?and 95%confidence intervals?CIs?of hypertension was0.65?0.43-0.69?.The stratified analysis by age and gender showed that total dietary fiber intake was inversely associated with hypertension in groups 18-44 years,45-64 years,male and female,and the corresponding ORs?95%CIs?of hypertension were 0.41?0.28-0.59?,0.61?0.44-0.87?,0.58?0.42-0.79?,and 0.50?0.37-0.68?,respectively.Binary logistic regression of case newly diagnosed with hypertension yielded the same results as above.The dose-response relationship showed a statistically negative correlation between total dietary fiber intake and risk of hypertension(P nonlinear<0.01).Disordered multinomial logistic regression analysis showed that the increase in total dietary fiber intake was associated with a lower risk of stage I hypertension and stage II hypertension,corresponding ORs?95%Cis?were 0.50?0.36-0.69?and 0.55?0.32-0.96?.The results of the advantage analysis showed that in the ranking of the relative importance of factors affecting hypertension,total fiber was third,accounting for 3.08%of all factors.Binary logistic regression analysis of fiber from cereals,vegetables,fruits and hypertension showed that increased intakes of cereal fiber,vegetable fiber and fruit fiber were associated with a lower risk of hypertension.In multivariate model 2,the corresponding ORs and?95%CIs?of hypertension were 0.70?0.56-0.86?,0.69?0.64-0.98?,and 0.77?0.63-0.95?,respectively.The stratified analysis showed that cereal fiber intake was inversely associated with hypertension in groups 18-44 years,45-64 years,65 years or older,male and female,and the corresponding ORs?95%CIs?of hypertension were 0.64?0.45-0.92?,0.63?0.52-0.76?,0.66?0.47-0.93?,and 0.59?0.45-0.78?,respectively.Vegetable fiber intake was inversely associated with hypertension in groups 18-44 years and female,and the corresponding ORs?95%CIs?were 0.65?0.50-0.86?and 0.67?0.51-0.87?,respectively.Fruit fiber intake was inversely associated with hypertension in groups 18-44years and male,and the corresponding ORs?95%CIs?were 0.65?0.46-0.92?and 0.62?0.46-0.85?,respectively.Binary logistic regression of case newly diagnosed with hypertension yielded the same results as above.Dose-response analyses revealed that the risk of hypertension was associated with cereal and vegetable fiber intake in a linear trend(P nonlinear=0.34,0.12),while the relationships were nonlinear for fruit fiber(P nonlinear=0.04).Disordered multinomial logistic regression analysis showed that the increase in cereal fiber intake was associated with a lower risk of stage I hypertension and stage II hypertension,corresponding ORs?95%CIs?were 0.57?0.42-0.79?and 0.65?0.41-0.79?.The increase of vegetable and fruit fiber intakes were associated with a lower risk of stage I hypertension,corresponding ORs?95%CIs?were 0.80?0.63-0.99?and 0.69?0.53-0.91?.Conclusions:Our results suggested that the intakes of total,cereal,vegetable fiber and fruit fiber were associated with a decreased risk of hypertension in the U.S.adults.The risk of hypertension was associated with cereal and vegetable fiber intake in a linear trend,while the relationships were nonlinear for total and fruit fiber.Increased dietary fiber and dietary fiber intake may be associated with a lower risk of stage I hypertension and stage II hypertension.Increased intake of vegetable and fruit fiber may be associated with a reduced risk of stage I hypertension.Further prospective studies and experimental studies are needed to confirm our findings. |
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