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Dietary Polyphenol Intake, Blood Pressure, and Hypertension: A Systematic Review and Meta-Analysis of Observational Studies

Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
NNEdPro Global Centre for Nutrition and Health, St John’s Innovation Centre, Cambridge CB4 0WS, UK
Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy
Department of Nursing Management and Epidemiology Nursing, Faculty of Health Sciences, Jagiellonian University Medical College, 31-501 Krakow, Poland
Wolfson College at the University of Cambridge, Cambridge CB3 9BB, UK
Nutrition Innovation Centre for Food and Health at Ulster University, Coleraine BT52 1SA, UK
Medical Research Council (MRC) Human Nutrition Research Unit, Cambridge CB1 9NL, UK
The Laboratory of Phytochemicals in Physiology, Department of Veterinary Science, University of Parma, 43126 Parma, Italy
Author to whom correspondence should be addressed.
Antioxidants 2019, 8(6), 152;
Received: 12 May 2019 / Revised: 23 May 2019 / Accepted: 24 May 2019 / Published: 31 May 2019
Background: Dietary polyphenols, including flavonoids, have been the focus of major recent attentions due to their wide content in a variety of foods commonly consumed and the findings from numerous studies showing evidence of an association with positive outcomes on human health. Methods: A systematic search using electronic databases PubMed and EMBASE was performed to retrieve English language studies published from the earliest indexing year of each database to April 2019, reporting on the association between dietary flavonoids intake and hypertension. Results: The search strategy resulted in the final selection of 20 studies including 15 cross-sectional investigations and 7 prospective cohorts (1 study reported on 3 prospective cohorts). 5 prospective cohorts, comprising 200,256 individuals and 45,732 cases of hypertension were included in the quantitative analysis. Analysis by extreme quantiles of intake of flavonoid showed a non-significant association with decreased risk of hypertension (RR (risk ratio): 0.96, 95% CI (confidence interval): 0.89, 1.03). Taking into consideration individual flavonoid subclasses, dietary anthocyanins intake was associated with 8% reduction in risk of hypertension, when comparing highest vs. lowest exposure (RR: 0.92, 95% CI: 0.88, 0.97). Conclusions: Further studies are needed to strengthen the retrieved association between anthocyanins consumption and decreased risk of hypertension and clarify whether total flavonoids or rather individual subclasses may exert beneficial effects on blood pressure. View Full-Text
Keywords: flavonoid; anthocyanin; flavones; hypertension; blood pressure; meta-analysis; cohort flavonoid; anthocyanin; flavones; hypertension; blood pressure; meta-analysis; cohort
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Godos, J.; Vitale, M.; Micek, A.; Ray, S.; Martini, D.; Del Rio, D.; Riccardi, G.; Galvano, F.; Grosso, G. Dietary Polyphenol Intake, Blood Pressure, and Hypertension: A Systematic Review and Meta-Analysis of Observational Studies. Antioxidants 2019, 8, 152.

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