Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.4)
Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 6, June, p. 797–806

doi: 10.17219/acem/91487

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Polyphenols and dietary antioxidant potential, and their relationship with arterial hypertension: A cross-sectional study of the adult population in Poland (WOBASZ II)

Anna Waśkiewicz1,A,B,C,D,E,F, Małgorzata Elżbieta Zujko2,A,C,E,F, Danuta Szcześniewska1,B,C,F, Andrzej Tykarski3,B,E,F, Magdalena Kwaśniewska4,B,E,F, Wojciech Drygas1,4,B,E,F, Anna Maria Witkowska2,A,C,E,F

1 Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, National Institute of Cardiology, Warszawa, Poland

2 Department of Food Biotechnology, Medical University of Bialystok, Poland

3 Department of Hypertension, Angiology and Internal Medicine, Poznan University of Medical Sciences, Poland

4 Department of Social and Preventive Medicine, Medical University of Lodz, Poland


Background. Oxidative stress plays a key role in the development of most non-communicable diseases, including arterial hypertension (AH). Diet is the major source of exogenous antioxidants, which support the body in the elimination of excessive free radicals.
Objectives. To assess dietary total antioxidant potential (DTAP) and dietary polyphenol intake (DPI), and to determine the relationship between DTAP, DPI and hypertension in the Polish adult population; to indicate dietary sources of DTAP and DPI in participants with and without AH.
Material and Methods. Within the frame of the National Multicenter Health Survey (WOBASZ II), a random sample of the whole Polish population aged 20 years and above was screened during the years 2013–2014. Dietary habits and blood pressure were assessed in 2,554 men and 3,136 women. Dietary total antioxidant potential and DPI were calculated according to the amount of food consumed by the participants combined with the antioxidant potential and polyphenol contents in foods.
Results. The mean DTAP was 12.36 mmol/day in men and 12.27 mmol/day in women, and DPI was 2069 mg/day and 1989 mg/day, respectively. The DTAP and DPI were associated with reduced odds of AH in the Polish population. After adjusting for confounding variables, higher DTAP (by 1 mmol/day) had reduced odds of AH by 1.3% in men and by 1.8% in women and higher DPI (by 100 mg/day) by 1.1% and by 2.2%, respectively. Regardless of sex and AH, the main sources of DTAP and DPI were beverages, especially coffee and tea (over 50%), fruit (12–24%) and vegetables (12–18%).
Conclusion. The intake of food with high antioxidant potential and rich in polyphenols was associated, slightly but independently of other factors, with a lower chance of hypertension in the adult Polish population. Irrespective of sex and AH, coffee and tea were the basic dietary sources of the antioxidants.

Key words

arterial hypertension, polyphenols, Polish population, dietary antioxidant potential

References (38)

  1. Sharma R. Polyphenols in health and disease. Practice and mechanisms of benefits. In: Watson RR, Preedy VR, Zibadi S. eds. Polyphenols in Human Health and Disease. Tokyo, Japan: Elsevier; 2014:757–778.
  2. Medina-Remón A, Tresserra-Rimbau A, Valderas-Martinez P, Estruch R, Lamuela-Raventos RM. Polyphenol consumption and blood pressure. In: Watson RR, Preedy VR, Zibadi S. eds. Polyphenols in Human Health and Disease. Tokyo, Japan: Elsevier; 2014:971–987.
  3. Pandey KB, Rizvi SI. Plant polyphenols as dietary antioxidants in human health and disease. Oxid Med Cell Longev. 2009;2(5):270–278.
  4. Manach C, Mazur A, Scalbert A. Polyphenols and prevention of cardiovascular diseases. Curr Opin Lipidol. 2005;16(1):77–84.
  5. Andriantsitohaina R, Auger C, Chataigneau T, et al. Molecular mechanisms of the cardiovascular protective effects of polyphenols. Br J Nutr. 2012;108(9):1532–1549.
  6. Chong MF, Macdonald R, Lovegrove JA. Fruit polyphenols and CVD risk: A review of human intervention studies. Br J Nutr. 2010;104 (Suppl 3):S28–39.
  7. Rautiainen S, Serafini M, Morgenstern R, Prior RL, Wolk A. The validity and reproducibility of food-frequency questionnaire-based total antioxidant capacity estimates in Swedish women. Am J Clin Nutr. 2008;87(5):1247–1253.
  8. Agudo A, Cabrera L, Amiano P, et al. Fruit and vegetable intakes, dietary antioxidant nutrients, and total mortality in Spanish adults: Findings from the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). Am J Clin Nutr. 2007;85(6):1634–1642.
  9. Dilis V, Trichopoulou A. Antioxidant intakes and food sources in Greek adults. J Nutr. 2010;140(7):1274–1279.
  10. Tresserra-Rimbau A, Medina-Remón A, Pérez-Jiménez J, et al. Dietary intake and major food sources of polyphenols in a Spanish population at high cardiovascular risk: The PREDIMED study. Nutr Metab Cardiovasc Dis. 2013;23(10):953–959.
  11. Ilow R, Regulska-Ilow B, Misiewicz D, Różańska D, Kowalisko A, Biernat J. Całkowity potencjał antyoksydacyjny wybranych produktów spożywanych przez 50-letnich mieszkańców Wrocławia w 2008 roku. Bromat Chem Toksykol. 2012;45(3):989–994.
  12. Taguchi C, Fukushima Y, Kishimoto Y, et al. Estimated dietary polyphenol intake and major food and beverage sources among elderly Japanese. Nutrients 2015:7(12):10269–10281.
  13. Ovaskainen ML, Törrönen R, Koponen JM, et al. Dietary intake and major food sources of polyphenols in Finnish adults. J Nutr. 2008;138(3):562–566.
  14. Ilow R, Regulska-Ilow B, Różańska D, Tangermann S, Grajeta H. Oszacowanie całkowitego potencjału antyoksydacyjnego wybranych produktów spożywanych przez studentów Akademii Medycznej we Wrocławiu w latach 2005–2007. Bromat Chem Toksykol. 2012;45(3):995–1000.
  15. Grosso G, Stepaniak U, Topór-Mądry R, Szafraniec K, Pająk A. Estimated dietary intake and major food sources of polyphenols in the Polish arm of the HAPIEE study. Nutrition 2014;30(11–12):1398–1403.
  16. Miranda AM, Steluti J, Fisberg RM, Marchioni DM. Association between polyphenol intake and hypertension in adults and older adults: A population-based study in Brazil. PLoS One 2016;11(10):e0165791.
  17. Hügel HM, Jackson N, May B, Zhang AL, Xue CC. Polyphenol protection and treatment of hypertension. Phytomedicine 2016;23(2):220–231.
  18. Medina-Remón A, Estruch R, Tresserra-Rimbau A Vallverdú-Queralt A, Lamuela-Raventos RM. The effect of polyphenol consumption on blood pressure. Mini Rev Med Chem. 2013;13(8):1137–1149.
  19. Medina-Remón A, Zamora-Ros R, Rotchés-Ribalta M, et al; PREDIMED Study Investigators. Total polyphenol excretion and blood pressure in subjects at high cardiovascular risk. Nutr Metab Cardiovasc Dis. 2011;21(5):323–331.
  20. Niklas A, Flotyńska A, Puch-Walczak A, et al. Prevalence, awareness, treatment and control of hypertension in the adult Polish population – Multi-center National Population Health Examination Surveys – WOBASZ studies. Arch Med Sci. 2018;14(5):951–961.
  21. Drygas W, Niklas AA, Piwońska A, et al. Multi-center National Population Health Examination Survey (WOBASZ II study): Assumptions, methods and implementation. Kardiol Pol. 2016;74(7):681–690.
  22. Różańska D, Regulska-Ilow B, Ilow R. Wpływ wybranych procesów kulinarnych na potencjał antyoksydacyjny i zawartość polifenoli w żywności. Probl Hig Epidemiol. 2014;95:215–222.
  23. Benzie IF, Strain JJ. The ferric reducing ability of plasma (FRAP) as a measure of “antioxidant power”: The FRAP assay. Anal Biochem. 1996;239(1):70–76.
  24. Singleton VL, Rossi JA. Colorimetry of total phenolics with phosphomolybdic–phosphotungstic acid reagents. Amer J Enol Viticult. 1965;16:144–158.
  25. Carlsen MH, Halvorsen BL, Holte K, et al. The total antioxidant content of more than 3100 foods, beverages, spices, herbs and supplements used worldwide. Nutr J. 2010;9(3):1–11.
  26. Neveu V, Perez-Jiménez J, Vos F, et al. Phenol-Explorer: An online comprehensive database on polyphenol contents in foods. Database (Oxford). 2010; bap024: doi:10.1093/database/bap024
  27. Zujko ME, Witkowska AM, Górska M, Wilk J, Krętowski A. Reduced intake of dietary antioxidants can impair antioxidant status in type 2 diabetes patients. Pol Arch Med Wewn. 2014;124(11):599–607.
  28. Priori RL, Cao JA, Shukitt-Hale B. Can foods forestall aging? Some with high antioxidant activity appear to aid memory. AgResearch Magazine. 1999;47:15–17.
  29. Russnes KM, Möller E, Wilson KM, et al. Total antioxidant intake and prostate cancer in the Cancer of the Prostate in Sweden (CAPS) study: A case control study. BMC Cancer. 2016;16:438.
  30. Perez-Jimenez J, Fezeu L, Touvier M, et al. Dietary intake of 337 polyphenols in French adults. Am J Clin Nutr. 2011;93(6):1220–1228.
  31. Zujko ME, Witkowska AM, Waśkiewicz A, Mirończuk-Chodakowska I. Dietary antioxidant and flavonoid intakes are reduced in the elderly. Oxid Med Cell Longev. 2015;2015:843173.
  32. Beg M, Sharma V, Akhtar N, Guta A, Mohd J. Role of antioxidants in hypertension. JIACM. 2011;12(2):122–127.
  33. Medina-Remón A, Tresserra-Rimbau A, Pons A, et al; PREDIMED Study Investigators. Effects of total dietary polyphenols on plasma nitric oxide and blood pressure in a high cardiovascular risk cohort. The PREDIMED randomized trial. Nutr Metab Cardiovasc Dis. 2015;25(1):60–67.
  34. Di Castelnuovo A, Giuseppe R, Iacoviello L, Gaetano G. Consumption of cocoa, tea and coffee and risk of cardiovascular disease. Eur J Intern Med. 2012;23(1):15–25.
  35. Mesas AE, Leon-Muñoz LM, Rodriguez-Artalejo F, Lopez-Garcia E. The effect of coffee on blood pressure and cardiovascular disease in hypertensive individuals: A systematic review and meta-analysis. Am J Clin Nutr. 2011;94(4):1113–1126.
  36. Grosso G, Stepaniak U, Polak M, et al. Coffee consumption and risk of hypertension in the Polish arm of the HAPIEE cohort study. Eur J Clin Nutr. 2016;70(1):109–115.
  37. Turek I, Kozińska J, Drygas W. Zielona herbata jako czynnik protekcyjny w profilaktyce i leczeniu wybranych chorób serca i naczyń. Kardiol Pol. 2012;70(8):848–852.
  38. Pająk A, Szafraniec K, Polak M, et al. Changes in the prevalence, treatment, and control of hypercholesterolemia and other dyslipidemias over 10 years in Poland: The WOBASZ study. Pol Arch Med Wewn. 2016;126(9):642–652.