Reducing consumption of sugar-sweetened beverages is associated with reduced blood pressure: a prospective study among United States adults

Abstract

Background: Increased consumption of sugar-sweetened beverages (SSBs) has been associated with an elevated risk of obesity, metabolic syndrome, and type II diabetes mellitus. However, the effects of SSB consumption on blood pressure (BP) are uncertain. The objective of this study was to determine the relationship between changes in SSB consumption and changes in BP among adults.

Methods and results: This was a prospective analysis of 810 adults who participated in the PREMIER Study (an 18-month behavioral intervention trial). BP and dietary intake (by two 24-hour recalls) were measured at baseline and at 6 and 18 months. Mixed-effects models were applied to estimate the changes in BP in responding to changes in SSB consumption. At baseline, mean SSB intake was 0.9+/-1.0 servings per day (10.5+/-11.9 fl oz/d), and mean systolic BP/diastolic BP was 134.9+/-9.6/84.8+/-4.2 mm Hg. After potential confounders were controlled for, a reduction in SSB of 1 serving per day was associated with a 1.8-mm Hg (95% confidence interval, 1.2 to 2.4) reduction in systolic BP and 1.1-mm Hg (95% confidence interval, 0.7 to 1.4) reduction in diastolic BP over 18 months. After additional adjustment for weight change over the same period, a reduction in SSB intake was still significantly associated with reductions in systolic and diastolic BPs (P<0.05). Reduced intake of sugars was also significantly associated with reduced BP. No association was found for diet beverage consumption or caffeine intake and BP. These findings suggest that sugars may be the nutrients that contribute to the observed association between SSB and BP.

Conclusions: Reduced consumption of SSB and sugars was significantly associated with reduced BP. Reducing SSB and sugar consumption may be an important dietary strategy to lower BP.

Clinical trial registration: URL: http://clinicaltrials.gov. Unique identifier: NCT00000616.

Figure 1

Model adjusted mean blood pressure changes (Panel A: SBP; Panel B: DBP) and proportion of participants (%) who moved from hypertensive at baseline to non-hypertensive at 18 months (Panel C) by tertiles of change in sugar-sweetened beverage (SSB) consumption (fl oz/day) from baseline to 18 months (18-mo – baseline). The mean change in SSB consumption across the tertiles was 9.5 ± 7.4, −0.9 ± 1.6, and −15.3 ± 9.9 fl oz/day (persons in the 3^rd tertile had the greatest reduction in SSB). Covariates in the model included gender, race, family history of hypertension, randomization assignment, site, baseline age, alcohol drinking, and BMI, baseline SSB intake, baseline fitness and change in fitness, baseline physical activity and change in physical activity, baseline urinary sodium excretion and change in urinary sodium excretion, baseline DASH Index and change in DASH Index, and change in body weight from baseline to 18 months.