Preservative food additives associated with more hypertension in a French cohort

Design

Prospective cohort with repeated 24-hour dietary records

Population

112,395 French adults, 78.7% women, mean age 43

Primary outcome

Incident hypertension and cardiovascular disease

Effect

Non-antioxidant preservatives: hypertension HR 1.29 (1.20–1.39); CVD HR 1.16 (1.04–1.29)

NutriNet-Santé followed 112,395 French adults, most of them women, for a median of 7.9 years. Diet was recorded in repeated 24-hour records that captured commercial brands, and additive exposure was estimated from composition databases and laboratory assays.

Higher intake of non-antioxidant preservatives was associated with more incident hypertension (HR 1.29, 95% CI 1.20–1.39) and cardiovascular disease (HR 1.16, 1.04–1.29). Antioxidant preservatives were also associated with hypertension (HR 1.22, 1.13–1.31). Eight of 17 commonly consumed individual preservatives were linked to hypertension after correction for multiple testing.

This is an association. People who eat more preserved industrial food differ in many ways, and preservatives travel with salt, sugar and processing. The authors call for experimental work to test mechanisms. For now it adds weight to existing advice to favour fresh and minimally processed food, rather than creating new advice of its own.

• Ask about packaged and processed food intake when reviewing a patient with new or hard-to-control hypertension.
• Frame advice around fresh, home-prepared food; it covers salt, sugar and additives together.
• Do not tell patients a specific additive causes hypertension; this study cannot show that.
• The cohort was mostly French women; transfer to Indian diets with different processed-food patterns is uncertain.

Why it matters

It points at a part of processed food that salt-focused advice does not reach.

Don't overread it

This was observational — it cannot show that preservatives cause hypertension or that avoiding them lowers blood pressure.

The statistics, in plain English

A hazard ratio of 1.29 means hypertension developed about 29% more often in higher than lower consumers, after adjustment. Adjustment cannot remove confounding by overall diet quality, so the true independent effect of preservatives may be smaller or absent.

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