Hypertension incidence according to branched-chain amino acid intake in Brazilian adults: a six-year follow-up of the CUME study

Recent studies show that dietary intake of branched-chain amino acids (BCAA) may be associated with chronic diseases, including hypertension. This study aimed to evaluate the association between BCAA intake and the incidence of hypertension. This longitudinal study included 3192 participants (M = 1067, F = 2125; mean age = 34 years) from the Cohort of Universities of Minas Gerais (CUME Study, 2016–2022), Brazil. BCAA intake was assessed using a validated 144-item semi-quantitative food frequency questionnaire. Participants were classified as an incident case of hypertension when they were free of this disease at baseline and had systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or used antihypertensives or received a diagnosis of hypertension by a physician in at least one follow-up. Crude and adjusted Cox regression models were used to evaluate the association between BCAA intake and incidence of hypertension. After a median follow-up time of 2.21 years, 213 new cases of hypertension were identified. A direct association was shown between the second tertile of total BCAA (HR = 1.76; 95% CI 1.06–2.90) and isoleucine (HR = 2.04; 95% CI 1.14–3.62) consumption and the incidence of hypertension in males. A direct association was observed between the second tertile of valine (HR = 1.74; 95% CI 1.01–3.02) and leucine (HR = 1.94; 95% CI 1.10–3.41) intake and hypertension incidence among adults aged 30–39 years. Conversely, among younger participants (18–29 years), leucine intake in the second tertile was inversely associated with hypertension (HR = 0.36; 95% CI 0.14–0.89). The main foods that contributed to BCAA intake were unprocessed chicken (16.56%), dairy (16.33%), unprocessed beef (14.98%), fish (7.85%), and beans/lentils (6.44%). Our findings may provide valuable evidence to support dietary interventions for the primary prevention of hypertension.