Nutrients deficiency pattern possible important risk factor for mortality in older adults with hypertension

A recent BMC Public Health study determines the impact of nutrient deficiencies on mortality risk in older adults with hypertension.

Study: Nutrient deficiency patterns and all-cause and cardiovascular mortality in older adults with hypertension: a latent class analysis. Image Credit: Anatoily Cherkas / Shutterstock.com

How can diet affect blood pressure?

In addition to the rapid aging of the global population, a significant increase in the prevalence of hypertension and hypertension-related mortality has been recorded. Although many effective antihypertensive medication therapies are available, millions of people continue to die from hypertension every year.

A healthy diet, in addition to medication, also helps manage hypertension. Previous epidemiological studies have highlighted that specific dietary patterns, food groups, and diet quality reduce mortality rates. These studies emphasize the importance of certain nutrients, including vitamins and minerals, in reducing the risk of mortality.

Dietary vitamins and minerals can reduce the risk of many chronic conditions and mortality. For example, one previous study indicated that an increased intake of dietary fiber reduces the mortality risk in older adults diagnosed with hypertension.

Although humans consume multiple nutrients in a single healthy meal, most studies have only assessed the efficacy of individual nutrients on mortality. Thus, there remains a need for more comprehensive research to evaluate how diverse nutrients interact with each other and affect human health and certain diseases, such as hypertension. These data will support the formulation of targeted nutrition-based interventions to minimize adverse effects in these patients.

About the study

The current study investigated how nutrient deficiency patterns, including those that affect vitamin, fiber, and mineral levels, affect morbidity and mortality in older adults with hypertension.

The latent class analysis (LCA), which is a person-centered statistical technique, was used to identify relatively similar sub-populations with similar characteristics. LCA is a widely accepted approach to formulate rational policies for managing psychology and physical diseases.

All study participants were selected from the National Health and Nutrition Examination Survey (NHANES) conducted in the United States. Relevant data on adults 60 years of age and older with hypertension were obtained from six NHANES cycles between 2003 and 2014. Dietary data were obtained from the NHANES’s Dietary Interview-Total Nutrient Intakes section.

Study findings

Based on eligibility criteria, 6,924 individuals were selected for the study. LCA was conducted using multiple nutrients, such as fiber, folate, and vitamins A, B1, B12, C, D, E, and K, as well as minerals, including selenium, copper, iron, zinc, calcium, and magnesium.

Four distinct dietary nutrient deficiency patterns that affected older adults with hypertension were identified using LCA. These included Class 1 or Adequate Nutrient, Class 2 or Nutrient Deprived, Class 3, which reflected Low Fiber, Magnesium, and Vitamin E, and Class 4, which reflected Inadequate Nutrient. Each pattern was associated with distinct anthropogenic and demographic characteristics with differential mortality risks.

Class 1 was associated with the lowest all-cause and cardiovascular mortality rates, whereas Class 2 was associated with the highest risks. Class 3 closely resembled Class 1; however, when the levels of vitamin E, magnesium, and fiber were low, all-cause and cardiovascular mortality in this pattern were significantly higher than in Class 1.

Consuming less than 10% of the daily recommended amounts of fiber, magnesium, and vitamin E significantly increased the risk of all-cause and cardiovascular mortality among older adults with hypertension. Consistent with these findings, one previous study indicated that consuming less than 20% of recommended dietary fiber and magnesium increases mortality rates.

Completing more than a high school education was a significant protective factor of three nutrient deficiency classes. Furthermore, as compared to men, women were more likely to be nutrient deficient.

Similar to previous reports, overweight and obesity were two important deficiency classes. Ethnicity also significantly impacted nutrient deficiency classification. These differences in nutrient intake could be attributed to variations in socioeconomic status, lifestyle factors, geography, environment, and individual behaviors.

Conclusions

The current study strongly indicated that dietary deficiencies in vitamins, fiber, and minerals, particularly fiber, magnesium, and vitamin E, significantly affect all-cause and cardiovascular mortality risk among older adults with hypertension. Ethnicity, education, age, body mass index, and cardiovascular disease could serve as potential predictors of nutrient deficiency.

A key strength of the current study is the inclusion of a wide range of essential vitamins. This enabled a more accurate assessment of how nutrients and their interactions affect mortality rates in older adults with hypertension.

Taken together, older adults with hypertension could benefit from interventions targeting nutrient deficiency patterns management. Nevertheless, additional studies are needed to validate these findings.