Dairy products consumption and the risk of hypertension in adults: An updated systematic review and dose-response meta-analysis of prospective cohort studies

Aims: With an increase in the number of published prospective cohort studies, we sought to summarize the relationship between dairy products consumption and the risk of hypertension (HTN). Data synthesis: We searched PubMed, Web of Science, Embase, Science direct, and Scopus. Pooled RRs and 95% CIs were calculated using a random effects model. The certainty of the evidence was assessed by Grading of Recommendations Assessment, Development and Evaluation (GRADE). Sixteen studies were included in the current meta-analysis. We found an inverse association between total dairy products (RR = 0.90; 95% CI: 0.87, 0.94; n = 16), low-fat dairy products (RR = 0.86; 95% CI: 0.77, 0.96; n = 8), milk (RR = 0.94; 95% CI: 0.90, 0.99; n = 11), and fermented dairy (RR = 0.95; 95% CI: 0.91, 0.99; n = 8) consumption and the risk of HTN. However, in subgroup analysis, despite a significant association for total dairy products in women, Americans, longer and larger studies, and self-reported HTN, no associations were found in males, Europeans, or Asians, and studies which followed participants for <10 years or had <3000 participants or measured HTN. Dose-response analysis revealed a non-linear association between total dairy products and milk consumption and the risk of HTN, but a linear association for low-fat dairy products. Conclusions: Higher dairy products consumption was associated with reduced risk of HTN. This association was dependent on sex, geographical region of study, and the stage of HTN. However, the certainty of the evidence was graded either as low or very low. (c) 2021 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.