Hypertension is the leading cause of preventable mortality worldwide, contributing to over 9 million deaths per annum, predominantly owing to cardiovascular disease. The association of obesity, physical inactivity and alcohol with elevated blood pressure (BP) is firmly established. Weight loss or other dietary strategies, such as the Dietary Approaches to Stop Hypertension (DASH) diet, have been shown to be effective in lowering BP. Additionally, specific nutrients are recognised to contribute to BP, with higher sodium intake linked with an increased risk of hypertension, while potassium is associated with a reduced risk of hypertension. Of note, emerging evidence has identified a novel role for one-carbon metabolism and the related B vitamins, particularly riboflavin, in BP. Specifically in adults genetically at risk of developing hypertension, owing to the common C677T polymorphism in MTHFR, supplemental riboflavin (co-factor for MTHFR) was shown in randomised trials to lower systolic BP by up to 13 mmHg. A BP response to intervention of this magnitude could have important clinical impacts, given that a reduction in systolic BP of 10 mmHg is estimated to decrease stroke risk by 40%. This review aims to explore the factors contributing to hypertension across the lifecycle and to critically evaluate the evidence supporting a role for nutrition, particularly folate-related B vitamins, in BP and risk of hypertension. In addition, gaps in our current knowledge that warrant future research in this area, will be identified.

中文翻译：

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在生命周期中对营养，血压和高血压风险的严格评论：B维生素是否起作用？

高血压是全世界可预防的死亡的主要原因，每年导致超过900万人死亡，主要是由于心血管疾病。肥胖，缺乏运动和酒精与血压升高（BP）的关联已得到牢固确立。减肥或其他饮食策略，如停止高血压的饮食方法（DASH）饮食，已被证明可有效降低血压。此外，公认的特定营养素有助于BP，钠摄入量增加与高血压风险增加相关，而钾与高血压风险降低相关。值得注意的是，新的证据已经确定了BP中一碳代谢和相关的B族维生素（尤其是核黄素）的新作用。特别是在遗传上有患高血压风险的成年人中，由于MTHFR中常见的C677T多态性，随机试验显示补充核黄素（MTHFR的辅助因子）可使收缩压降低13 mmHg。鉴于收缩压降低10 mmHg估计可将中风风险降低40％，因此对这种程度的干预进行的BP反应可能会产生重要的临床影响。这篇综述旨在探讨在整个生命周期中导致高血压的因素，并严格评估支持营养（尤其是叶酸相关的B族维生素）在BP和高血压风险中的作用的证据。此外，还将确定我们当前知识中有待在该领域进行未来研究的空白。鉴于收缩压降低10 mmHg估计可将中风风险降低40％，因此对这种程度的干预进行的BP反应可能会产生重要的临床影响。这篇综述旨在探讨在整个生命周期中导致高血压的因素，并严格评估支持营养（尤其是叶酸相关的B族维生素）在BP和高血压风险中的作用的证据。此外，还将确定我们当前知识中有待在该领域进行未来研究的空白。鉴于收缩压降低10 mmHg估计可将中风风险降低40％，因此对这种程度的干预进行的BP反应可能会产生重要的临床影响。这篇综述旨在探讨在整个生命周期中导致高血压的因素，并严格评估支持营养（尤其是叶酸相关的B族维生素）在BP和高血压风险中的作用的证据。此外，还将确定我们当前知识中有待在该领域进行未来研究的空白。特别是叶酸相关的B族维生素，血压升高和高血压风险。此外，将确定我们当前知识中需要在该领域进行未来研究的差距。特别是叶酸相关的B族维生素，血压升高和高血压风险。此外，将确定我们当前知识中需要在该领域进行未来研究的差距。