Is a Hypertension Diagnosis Associated With Improved Dietary Outcomes Within 2 to 4 Years? A Fixed-Effects Analysis From the China Health and Nutrition Survey

J Am Heart Assoc. 2019 Nov 5;8(21):e012703. doi: 10.1161/JAHA.119.012703. Epub 2019 Oct 28.

Abstract

Background Evidence shows that dietary factors play an important role in blood pressure. However, there is no clear understanding of whether hypertension diagnosis is associated with dietary modifications. The aim of this study is to estimate the longitudinal association between hypertension diagnosis and subsequent changes (within 2-4 years) in dietary sodium, potassium, and sodium-potassium (Na/K) ratio. Methods and Results We included adults (18-75 years, n=16 264) from up to 9 waves (1991-2015) of the China Health and Nutrition Survey. Diet data were collected using three 24-hour dietary recalls and a household food inventory. We used fixed-effects models to estimate the association between newly self-reported diagnosed hypertension and subsequent within-individual changes in sodium, potassium, and Na/K ratio. We also examined changes among couples and at the household level. Results suggest that on average, men who were diagnosed with hypertension decreased their sodium intake by 251 mg/d and their Na/K ratio by 0.19 within 2 to 4 years after diagnosis (P<0.005). Among spouse pairs, sodium intake and Na/K ratio of women decreased when their husbands were diagnosed (P<0.05). Household average sodium density and Na/K ratio decreased, and household average potassium density increased after a man was diagnosed. In contrast, changes were not statistically significant when women were diagnosed. Conclusions Our findings suggest that hypertension diagnosis for a man may result in modest dietary improvements for him, his wife, and other household members. Yet, diagnosis for a woman does not seem to result in dietary changes for her or her household members.

Keywords: dietary changes; fixed‐effects models; hypertension diagnosis; sodium intake.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • China
  • Female
  • Humans
  • Hypertension / diagnosis
  • Hypertension / diet therapy*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Potassium, Dietary / administration & dosage*
  • Sodium, Dietary / administration & dosage*
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Potassium, Dietary
  • Sodium, Dietary