Selenium, copper, zinc and hypertension: an analysis of the National Health and Nutrition Examination Survey (2011-2016).

BACKGROUND: Hypertension is a major cardiovascular illness worldwide with many underlying causes. The role of trace elements selenium, copper, and zinc in hypertension is uncertain. The objective of this study was to evaluate the role of these trace elements in hypertension. METHOD: Data from 6683 National Health and Nutrition Examination Survey (NHANES) participants from 2011 to 2016 were analyzed using Statistical Analytical System (SAS, version 9.4) software for the role of trace elements in hypertension in age range 8 to 80 years, irrespective of the antihypertensive medication taken. Recent American Heart Association guidelines and pediatric practice guidelines for hypertension were used. RESULTS: Findings showed a significant positive association between serum selenium levels and hypertension but not serum zinc and copper. At optimal levels for transport and distribution, serum selenium levels of 120 µg/L or higher (reference level 70-150 µg/L) were significantly associated with hypertension (OR = 1.46, 95% CI = 1.29-1.66) after adjusting for confounding factors. At serum selenium level greater than 150 µg/L, the association with hypertension strengthened (OR = 1.69, 95% CI = 1.32-2.17). CONCLUSION: A positive association was found between serum selenium and hypertension, irrespective of age or anti-hypertensive medications intake. These findings also suggest that the reference levels of serum levels in healthy individuals may need to be re-determined, if supported by additional studies. If validated, patients with hypertension may also need to be cautioned about selenium intake.

Dietitian services are associated with improved patient outcomes and the MEDFICTS dietary assessment questionnaire is a suitable outcome measure in cardiac rehabilitation.

OBJECTIVE: The purposes of this study were to (a) examine the effectiveness of registered dietitian (RD) education and counseling on diet-related patient outcomes compared with general education provided by the cardiac rehabilitation (CR) staff, and (b) evaluate the effectiveness of the Meats, Eggs, Dairy, Fried foods, In baked goods, Convenience foods, Table fats, Snacks (MEDFICTS) score as an outcome measure in CR. METHODS: Observational study data examined from 426 CR patients discharged between January 1996 and February 2004. Groups were formed based on education source: (a) RD and (b) general education from CR staff. Baseline characteristics were compared between groups; pre/post diet-related outcomes (lipids, waist circumference, body mass index, MEDFICTS score) were compared within groups. Controlling for baseline measures and lipid-lowering medication, associations were examined between (a) RD education and diet-related outcomes and (b) ending MEDFICTS score and diet-related outcomes. RESULTS: Mean age was 62+/-11 years, 30% of patients were female, and 28% were nonwhite. At baseline, the RD group (n=359) had more dyslipidemia (88% vs 76%), more obesity (47% vs 27%), a larger waist (40+/-6 vs 37+/-5 inches), a higher body mass index (calculated as kg/m(2); 30+/-6 vs 27+/-5), a higher diet score (32+/-28 vs 19+/-19), and lower self-reported physical activity (7+/-12 vs 13+/-18 metabolic equivalent hours) (all P<.05) than the general education group (n=67). RD education was associated with improved low-density lipoprotein (r=0.13; P=.04), triglycerides (r=0.48; P=.01), and MEDFICTS score (r=0.18; P=.01). Improvements in MEDFICTS scores were correlated with improved total cholesterol, triglycerides, and waist measurements (all r=0.19; P=.04). CONCLUSIONS: Dietary education by an RD is associated with improved diet-related outcomes. The MEDFICTS score is a suitable outcome measure in CR.