Relation of choline intake with blood pressure in the National Health and Nutrition Examination Survey 2007-2010

Am J Clin Nutr. 2019 Mar 1;109(3):648-655. doi: 10.1093/ajcn/nqy330.

Abstract

Background: Dietary choline is a precursor of trimethylamine N-oxide (TMAO), a metabolite that has been associated with an increased risk of cardiovascular disease. The mechanism underlying this association is unknown, but may include TMAO effects on blood pressure (BP).

Objectives: This study assessed the association of choline intake with hypertension and BP in US adults through the use of NHANES 2007-2010 data.

Methods: This cross-sectional study was conducted in nonpregnant individuals aged ≥20 y. Choline intake was assessed with the use of two 24-h recalls. Outcomes were BP and hypertension status, which was assessed through the use of questionnaires and BP measurements. Modifying factors (e.g., sex, race/ethnicity) and dietary compared with supplemental sources of choline intake were also investigated.

Results: The associations of total (dietary + supplemental) and dietary choline intake with the prevalence odds of hypertension differed by sex (n = 9227; P-interaction = 0.04 and 0.03, respectively). In women, both total and dietary choline intake tended to be inversely associated with hypertension (n = 4748; prevalence OR per 100 mg of choline intake: 0.89; 95% CI: 0.77, 1.02; P < 0.10 for both total and dietary choline). No association was observed in men (n = 4479; P = 0.54 and 0.49 for total choline and dietary choline, respectively). Use of choline supplements was inversely associated with hypertension in both sexes (user compared with nonuser; OR: 0.68; 95% CI: 0.49, 0.92; P = 0.01). There was little to no association of total, dietary, or supplemental choline intake with systolic or diastolic BP (n = 6,554; the mean ± SEM change in BP associated with a 100-mg difference in total choline was -0.26 ± 0.22 mm Hg for systolic BP and -0.29 ± 0.19 mm Hg for diastolic BP).

Conclusions: Cross-sectional NHANES data do not support the hypothesis of a positive association between choline intake and BP.

Keywords: NHANES; blood pressure; choline; hypertension; trimethylamine N-oxide.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Pressure*
  • Choline / metabolism*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension / epidemiology
  • Hypertension / metabolism
  • Hypertension / physiopathology*
  • Male
  • Methylamines / metabolism
  • Middle Aged
  • Nutrition Surveys
  • Sex Factors
  • United States / epidemiology
  • Young Adult

Substances

  • Methylamines
  • trimethyloxamine
  • Choline