| Background&Objective:The substantial threat to human health posed by hypertension has spread to be a global public health issue.Chronic hypertension can cause the development of heart and brain disorders and possibly result in death.A person’s nutrition,which is a crucial component of lifestyle,has a significant impact on hypertension.There are many risk factors for hypertension.Being rich in a variety of nutrients,nuts are beneficial in controlling and enhancing blood pressure when consumed as part of a healthy diet.Studies on nuts and hypertension in the Chinese population are currently being conducted,however,the results are mixed,and further research is needed to determine whether eating nuts contribute to the development of hypertension.Also,it is unknown how different nut varieties compare in terms of their impact on blood pressure intervention.To investigate the connection between nuts and hypertension,this study used a prospective study design to analyze the impact of nut intake on the risk of developing hypertension.To compare the intervention effects of various nuts and to clarify the impact that different nut types have on blood pressure.Methods:Two sections make up this study.A prospective analysis was presented in the first section.The 2014 follow-up data from the Kailuan cohort study were used as baseline data,and information on new-onset hypertension was collected between2015-2016 and 2017-2018.The Cox proportional risk regression model was used to examine the impact of nut consumption and frequency on the emergence of hypertension.SPSS 26.0 statistical analysis software was used for the analysis.In the second section,network Meta-analysis was performed to rank the effects of pecans,peanuts,pistachios,almonds,walnuts,cashews,and hazelnuts on systolic and diastolic blood pressure.Stata 14.0 statistical analysis software was used to carry out network evidence mapping and network Meta-analysis.Results:1.Prospective study results（1）The risk of hypertension was not significantly different in occasional（HR=0.970,95%CI:0.908,1.036;P=0.21）and sometimes eaters（HR=0.986,95%CI:0.907,1.071;P=0.17）compared to non-nut eaters,but significantly increased in daily nut eaters compared to non-nut eaters 53.6%（HR=1.536,95%CI:1.393,1.649;P<0.001）.Compared with those who consumed less than 50g of nuts per day,the risk of developing hypertension was increased by 16.4%（95%CI:1.056,1.284;P<0.001）and 23.6%（95%CI=1.113,1.373;P<0.001）for those who consumed 50-100g and more than 100g per day,respectively.That is,high frequency and high dose of nut intake are risk factors for the development of hypertension.（2）Excluding patients with new-onset hypertension that occurred during follow-up,sensitivity analyses showed a protective effect of low-frequency nut intake on the development of hypertension（relative to not eating,HR=0.888,95%CI:0.799,0.987;P<0.001）.The protective effect of nuts on hypertension was more apparent in specific populations:In the male group,occasional nut eating significantly decreased the incidence of hypertension（HR=0.734,95%CI:0.656,0.821;P<0.001）.Those under the age of 60 who occasionally ate nuts had a significantly lower risk of getting hypertension(HR 40 years=0.854,95%CI:0.743,0.983;P<0.001;HR 40-60 years=0.908,95%CI:0.831,0.993;P<0.001).In obese individuals,occasional nut eating reduced hypertension（HR=0.802,95%CI:0.688,0.935;P<0.001）.In the low physical activity group,the risk of hypertension was significantly reduced by 13%（95%CI:0.778,0.964;P<0.001）,while in the high physical activity group with occasional nut consumption,it was reduced by 35%（95%CI:0.511,0.828;P<0.001）.2.Network meta-analysis results（1）The network Meta-analysis’s findings revealed that the nut intervention decreased diastolic blood pressure overall,with pecans,peanuts,pistachios,almonds,walnuts,and hazelnuts all lowering it more than the control group.On the other hand,there was no obvious impact on systolic blood pressure.Also,it was found that consumption of nuts such as hazelnuts（4.00 mm Hg,95%CI:3.68,4.32）,cashews（7.40 mm Hg,95%CI:0.56,14.24）,and almonds（3.92 mm Hg,1.37,6.48）significantly raised systolic blood pressure in the obese population.Even when the study’s parameters were restricted to unsalted nuts,a daily control diet,and an intervention period of less than 24 weeks,a substantial reduction in diastolic blood pressure was still observed.（2）The area under the cumulative（SUCRA）ranking probability curve was used to rank the intervention’s effects.Peanuts had the highest likelihood of being the best intervention for lowering diastolic blood pressure,with an SUCRA of 89.0%.Conclusions:The results of the prospective analysis demonstrated that high-frequency,high-dose nut consumption was associated with an increased risk of developing hypertension.Low-frequency nut intake has a protective effect against the development of hypertension,especially in men,people under the age of 60,obese and highly physically active.According to the pooled results of the Network meta-analysis,nuts had a substantial influence on diastolic blood pressure decrease but no effect on systolic blood pressure reduction.Peanuts had the most potential to be the most effective strategy for decreasing diastolic blood pressure.Consumption of nuts in obese people increases systolic blood pressure and has no effect on diastolic blood pressure. |
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