Dietary Phosphorus and Ambulatory Blood Pressure in African Americans: The Jackson Heart Study

Robert E. Olivo, Sarah L. Hale, Clarissa Diamantidis, Nrupen A. Bhavsar, Crystal C. Tyson, Katherine L. Tucker, Teresa C. Carithers, Bryan Kestenbaum, Paul Muntner, Rikki M. Tanner, John N. Booth, Stanford E. Mwasongwe, Jane Pendergast, Leigh Boulware, Julia J. Scialla

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Higher dietary phosphorus is associated with left ventricular hypertrophy and mortality, which are blood pressure (BP)-related outcomes. For this reason, we hypothesized that dietary phosphorus may be associated with adverse clinic and ambulatory BP patterns. METHODS: Our study included 973 African American adults enrolled in the Jackson Heart Study (2000-2004) with 24-hour ambulatory BP monitoring (ABPM) data at baseline. We quantified dietary phosphorus from a validated Food Frequency Questionnaire as follows: (i) absolute daily intake, (ii) ratio of phosphorus-to-protein intake, (iii) phosphorus density, and (iv) energy-adjusted phosphorus intake. Using multivariable linear regression, we determined associations between dietary phosphorus intake and systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure in clinic and over daytime, nighttime, and 24-hour periods from ABPM. Extent of nocturnal BP dipping was also assessed. Using logistic regression, we modeled relationships between dietary phosphorus intake and clinically relevant qualitative BP phenotypes, such as masked, sustained, or white-coat hypertension and normotension. RESULTS: There were no statistically significant associations between phosphorus intake and SBP or pulse pressure in adjusted models. Most metrics of higher phosphorus intake were associated with lower daytime, nighttime, and clinic DBP. Higher phosphorus intake was not associated with clinic or ABPM-defined hypertension overall, but most metrics of higher phosphorus intake were associated with lower odds of sustained hypertension compared to sustained normotension, white-coat hypertension, and masked hypertension. There were no associations between dietary phosphorus and nocturnal BP dipping. CONCLUSIONS: These data do not support a role for higher phosphorus intake and higher BP in African Americans.

Original languageEnglish (US)
Pages (from-to)94-103
Number of pages10
JournalAmerican Journal of Hypertension
Volume32
Issue number1
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

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Dietary Phosphorus
African Americans
Blood Pressure
Phosphorus
White Coat Hypertension
Ambulatory Monitoring
Hypertension
Masked Hypertension
Ambulatory Blood Pressure Monitoring

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Olivo, R. E., Hale, S. L., Diamantidis, C., Bhavsar, N. A., Tyson, C. C., Tucker, K. L., ... Scialla, J. J. (2019). Dietary Phosphorus and Ambulatory Blood Pressure in African Americans: The Jackson Heart Study. American Journal of Hypertension, 32(1), 94-103. https://doi.org/10.1093/ajh/hpy126

Dietary Phosphorus and Ambulatory Blood Pressure in African Americans : The Jackson Heart Study. / Olivo, Robert E.; Hale, Sarah L.; Diamantidis, Clarissa; Bhavsar, Nrupen A.; Tyson, Crystal C.; Tucker, Katherine L.; Carithers, Teresa C.; Kestenbaum, Bryan; Muntner, Paul; Tanner, Rikki M.; Booth, John N.; Mwasongwe, Stanford E.; Pendergast, Jane; Boulware, Leigh; Scialla, Julia J.

In: American Journal of Hypertension, Vol. 32, No. 1, 01.01.2019, p. 94-103.

Research output: Contribution to journalArticle

Olivo, RE, Hale, SL, Diamantidis, C, Bhavsar, NA, Tyson, CC, Tucker, KL, Carithers, TC, Kestenbaum, B, Muntner, P, Tanner, RM, Booth, JN, Mwasongwe, SE, Pendergast, J, Boulware, L & Scialla, JJ 2019, 'Dietary Phosphorus and Ambulatory Blood Pressure in African Americans: The Jackson Heart Study' American Journal of Hypertension, vol. 32, no. 1, pp. 94-103. https://doi.org/10.1093/ajh/hpy126
Olivo, Robert E. ; Hale, Sarah L. ; Diamantidis, Clarissa ; Bhavsar, Nrupen A. ; Tyson, Crystal C. ; Tucker, Katherine L. ; Carithers, Teresa C. ; Kestenbaum, Bryan ; Muntner, Paul ; Tanner, Rikki M. ; Booth, John N. ; Mwasongwe, Stanford E. ; Pendergast, Jane ; Boulware, Leigh ; Scialla, Julia J. / Dietary Phosphorus and Ambulatory Blood Pressure in African Americans : The Jackson Heart Study. In: American Journal of Hypertension. 2019 ; Vol. 32, No. 1. pp. 94-103.
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abstract = "BACKGROUND: Higher dietary phosphorus is associated with left ventricular hypertrophy and mortality, which are blood pressure (BP)-related outcomes. For this reason, we hypothesized that dietary phosphorus may be associated with adverse clinic and ambulatory BP patterns. METHODS: Our study included 973 African American adults enrolled in the Jackson Heart Study (2000-2004) with 24-hour ambulatory BP monitoring (ABPM) data at baseline. We quantified dietary phosphorus from a validated Food Frequency Questionnaire as follows: (i) absolute daily intake, (ii) ratio of phosphorus-to-protein intake, (iii) phosphorus density, and (iv) energy-adjusted phosphorus intake. Using multivariable linear regression, we determined associations between dietary phosphorus intake and systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure in clinic and over daytime, nighttime, and 24-hour periods from ABPM. Extent of nocturnal BP dipping was also assessed. Using logistic regression, we modeled relationships between dietary phosphorus intake and clinically relevant qualitative BP phenotypes, such as masked, sustained, or white-coat hypertension and normotension. RESULTS: There were no statistically significant associations between phosphorus intake and SBP or pulse pressure in adjusted models. Most metrics of higher phosphorus intake were associated with lower daytime, nighttime, and clinic DBP. Higher phosphorus intake was not associated with clinic or ABPM-defined hypertension overall, but most metrics of higher phosphorus intake were associated with lower odds of sustained hypertension compared to sustained normotension, white-coat hypertension, and masked hypertension. There were no associations between dietary phosphorus and nocturnal BP dipping. CONCLUSIONS: These data do not support a role for higher phosphorus intake and higher BP in African Americans.",
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T1 - Dietary Phosphorus and Ambulatory Blood Pressure in African Americans

T2 - The Jackson Heart Study

AU - Olivo, Robert E.

AU - Hale, Sarah L.

AU - Diamantidis, Clarissa

AU - Bhavsar, Nrupen A.

AU - Tyson, Crystal C.

AU - Tucker, Katherine L.

AU - Carithers, Teresa C.

AU - Kestenbaum, Bryan

AU - Muntner, Paul

AU - Tanner, Rikki M.

AU - Booth, John N.

AU - Mwasongwe, Stanford E.

AU - Pendergast, Jane

AU - Boulware, Leigh

AU - Scialla, Julia J.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - BACKGROUND: Higher dietary phosphorus is associated with left ventricular hypertrophy and mortality, which are blood pressure (BP)-related outcomes. For this reason, we hypothesized that dietary phosphorus may be associated with adverse clinic and ambulatory BP patterns. METHODS: Our study included 973 African American adults enrolled in the Jackson Heart Study (2000-2004) with 24-hour ambulatory BP monitoring (ABPM) data at baseline. We quantified dietary phosphorus from a validated Food Frequency Questionnaire as follows: (i) absolute daily intake, (ii) ratio of phosphorus-to-protein intake, (iii) phosphorus density, and (iv) energy-adjusted phosphorus intake. Using multivariable linear regression, we determined associations between dietary phosphorus intake and systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure in clinic and over daytime, nighttime, and 24-hour periods from ABPM. Extent of nocturnal BP dipping was also assessed. Using logistic regression, we modeled relationships between dietary phosphorus intake and clinically relevant qualitative BP phenotypes, such as masked, sustained, or white-coat hypertension and normotension. RESULTS: There were no statistically significant associations between phosphorus intake and SBP or pulse pressure in adjusted models. Most metrics of higher phosphorus intake were associated with lower daytime, nighttime, and clinic DBP. Higher phosphorus intake was not associated with clinic or ABPM-defined hypertension overall, but most metrics of higher phosphorus intake were associated with lower odds of sustained hypertension compared to sustained normotension, white-coat hypertension, and masked hypertension. There were no associations between dietary phosphorus and nocturnal BP dipping. CONCLUSIONS: These data do not support a role for higher phosphorus intake and higher BP in African Americans.

AB - BACKGROUND: Higher dietary phosphorus is associated with left ventricular hypertrophy and mortality, which are blood pressure (BP)-related outcomes. For this reason, we hypothesized that dietary phosphorus may be associated with adverse clinic and ambulatory BP patterns. METHODS: Our study included 973 African American adults enrolled in the Jackson Heart Study (2000-2004) with 24-hour ambulatory BP monitoring (ABPM) data at baseline. We quantified dietary phosphorus from a validated Food Frequency Questionnaire as follows: (i) absolute daily intake, (ii) ratio of phosphorus-to-protein intake, (iii) phosphorus density, and (iv) energy-adjusted phosphorus intake. Using multivariable linear regression, we determined associations between dietary phosphorus intake and systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure in clinic and over daytime, nighttime, and 24-hour periods from ABPM. Extent of nocturnal BP dipping was also assessed. Using logistic regression, we modeled relationships between dietary phosphorus intake and clinically relevant qualitative BP phenotypes, such as masked, sustained, or white-coat hypertension and normotension. RESULTS: There were no statistically significant associations between phosphorus intake and SBP or pulse pressure in adjusted models. Most metrics of higher phosphorus intake were associated with lower daytime, nighttime, and clinic DBP. Higher phosphorus intake was not associated with clinic or ABPM-defined hypertension overall, but most metrics of higher phosphorus intake were associated with lower odds of sustained hypertension compared to sustained normotension, white-coat hypertension, and masked hypertension. There were no associations between dietary phosphorus and nocturnal BP dipping. CONCLUSIONS: These data do not support a role for higher phosphorus intake and higher BP in African Americans.

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DO - 10.1093/ajh/hpy126

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