Abstract WE506: The Association of Dairy-Related Metabolites with High Blood Pressure: The Coronary Artery Risk Development in Young Adults Study

Introduction: Hypertension is a major risk factor for cardiovascular disease. Dairy products provide nutrients that may affect blood pressure, but evidence on associations of dairy-related metabolites with high blood pressure is limited. We aimed to identify metabolites related to dairy intake and assess their association with incident high blood pressure. Hypothesis: We hypothesized that higher dairy intake and its related metabolites would be associated with a lower risk of high blood pressure. Methods: We analyzed 2,171 adults (mean age 32 years, 45% female, 58% White) who attended the year 7 Coronary Artery Risk Development in Young Adults (CARDIA) exam (1992-93) and with metabolomics data. High blood pressure was defined as systolic pressure ≥ 130 mmHg and diastolic ≥ 80 mmHg or hypertension medicines use. Cox proportional hazard models assessed the associations of incident high blood pressure by year 15 across quartiles of dairy intake, adjusting for demographics, lifestyle, and diet quality. Multivariable linear regression models were used to identify dairy-related metabolites. A dairy-related metabolites score was derived by principal component analysis (PCA). The first principal component was included as covariate in a Cox model to evaluate their association with incident high blood pressure. Results: Over a median follow-up of 7.5 years (575 incident high blood pressure cases), participants in quartile 4 of dairy intake had significantly lower risk of high blood pressure compared to those in quartile 1 (hazard ratio [HR]: 0.70; 95% CI 0.53, 0.93; P trend = 0.03). Twenty-three serum metabolites were associated with dairy intake (See Heatmap below). The first principal component representing dairy-related metabolites patterns was significantly associated with incident high blood pressure ( Δ -2LL x 2 , df = 4.74, p = 0.03). Participants in quartile 4 of the principal component 1 score had a lower risk of high blood pressure compared with those in quartile 1 (HR = 0.78, 95% CI: 0.62, 0.98, P trend = 0.03). Exploratory enrichment analysis indicated activation of transport pathways for vitamins, nucleosides, bile salts, organic acids, and metal ions (False Discovery Rate < 0.15). Conclusion: We found higher dairy intake was linked to lower high blood pressure risk. Dairy-related metabolites and their patterns were also associated with lower incident high blood pressure. This suggests metabolomics as a tool to clarify diet-blood pressure mechanisms.