Nutritional Biomarker Analyses for Hypertension-Related Risk Assessment and Control


A simple method to collect 24-hour urine (24U) by sampling 2.5% of the voided urine each time was developed for analyzing the biomarkers of the intakes of salt (NaCl), vegetables and grains (K, Mg), soys (isoflavones), sea-foods (taurine), protein (urea nitrogen) etc. This method was applied to WHO-coordinated CARDIAC (Cardiovascular Diseases and Alimentary Comparison) study covering 61 populations in 25 countries, and revealed significant positive associations of Na or Na/K with blood pressure (BP) and stroke mortality and significant inverse associations of isoflavones or taurine with coronary heart disease (CHD) mortality, indicating the adverse effect of salt intake on BP and stroke and beneficial effect of soy or sea food intakes on CHD. Furthermore, higher urinary taurine and/or Mg excretions were associated with significantly lower risks of metabolic syndromes such as obesity, hypertension and hypercholestelomia. 24U collections were useful to prove nutritional improvement by intervention studies for observing soy intake effect on BP and atherogenic index in Japanese immigrants living in Brazil, and in Australian Aboriginals, for observing taurine effect on BP in Tibetans and for confirming soy and fish effects on the risks of metabolic syndromes in Japanese businessmen. 24U collection was utilized for population strategy to reduce salt and to increase soy intake in 5.6 million people of Hyogo Prefecture. A simple method for 24U collection has enabled us to utilize nutritional biomarkers for hypertension-related disease risk analyses, and to apply objective nutritional intake estimation to intervention studies as well as to population strategy for nutritional improvement, and therefore, the methodology will contribute to hypertension-related disease prevention and global health promotion.

Share and Cite:

Mori, M. , Mori, H. and Yamori, Y. (2014) Nutritional Biomarker Analyses for Hypertension-Related Risk Assessment and Control. World Journal of Cardiovascular Diseases, 4, 268-276. doi: 10.4236/wjcd.2014.45035.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Yamori, Y. (1984) The Stroke-Prone Spontaneously Hypertensive Rat: Contribution to Risk Factor Analysis and Prevention of Hypertensive Diseases. In: de Yong, W., Ed., Handbook of Hypertension Vol. 4: Experimental and Genetic Models of Hypertension, Elsevier, Amsterdam, 240-255.
[2] Yamori, Y., Nara, Y., Kihara, M., Mano, M. and Horie, R. (1984) Simple Method for Sampling Consecutive 24-Hour Urine for Epidemiological and Clinical Studies. Clinical and Experimental Hypertension, A6, 1160-1967.
[3] Yamori, Y. and Lenfent, C. (1987) Prevention of Cardiovascular Diseases: An Approach to Active Long Life. Elsevier, Amsterdam.
[4] Yamori, Y., Nara, Y., Mizushima, S., Mano, M., Sawamura, M., Kihara, M., Horie, R. and Hatano, S. (1990) International Cooperative Study on the Relationship between Dietary Factors and Blood Pressure: A Report from the Cardiovascular Diseases and Alimentary Comparison Study. Journal of Cardiovascular Pharmacology, 16, S43-S47.
[5] Yamori, Y., Liu, L., Mizushima, S., Ikeda, K. and Nara, Y. (2006) Male Cardiovascular Mortality and Dietary Markers in 25 Population Samples of 16 Countries. Journal of Hypertension, 24, 1499-1505.
[6] Yamori, Y. (2006) Food Factors for Atherosclerosis Prevention: Asian Perspective Derived from Analyses of Worldwide Dietary Biomarkers. Experimental & Clinical Cardiology, 11, 94-98.
[7] Yamori, Y., Mizushima, S., Sawamura, M. and Nara, Y. (1994) Nutritional Factors for Hypertension and Major Cardiovascular Diseases: International Cooperative Studies for Dietary Prevention (in Japanese). Deutsche Medizinische Wochenschrift, 15, 1825-1841.
[8] Yamori, Y., Liu, L., Mori, M., Sagara, M., Murakami, S., Nara, Y. and Mizushima, S. (2009) Taurine as the Nutritional Factor for the Longevity of the Japanese Revealed by a Worldwide Epidemiological Survey. Advances in Experimental Medicine and Biology, 643, 13-25.
[9] Yamori, Y., Taguchi, T., Mori, H. and Mori, M. (2010) Low Cardiovascular Risks in the Middle Aged Males and Females Excreting Greater 24U Taurine and Magnesium in 41 WHO-CARDIAC Study Populations in the World. Journal of Biomedical Science, 17, S21.
[10] Yamori, Y. (2006) Soy for “Health for All”: Message from WHO-CARDIAC Study and Dietary Intervention Studies. In: Sugano, M., Ed., Soy in Health and Diseases Prevention, Taylor & Francis, Florida, 107-121.
[11] Mori, H., Mori, M. and Yamori, Y. (2009) Preventive Food for Risk Reduction of Lifestyle-Related Diseases: The Benefit Proven by “A Well-Balanced Meal a Day Project”. Proceedings of the International Symposium: Food Culture: Development and Education/Building Food Culture and Education for Longevity, 20-Year CARDIAC Study Symposium Supported by UNESCO, Nonprofit Organization World Health Frontier Institute, 105-109.
[12] Mori, M. and Thorpe, M. (2009) Australian Aboriginals with Highest Risks and a New Attempt for Their Nutritional Improvement. Proceedings of the International Symposium: Food Culture: Development and Education/Building Food Culture and Education for Longevity, 20-Year CARDIAC Study Symposium Supported by UNESCO, Nonprofit Organization World Health Frontier Institute, 97-101.
[13] Mori, M., Sagara, M., Ohnishi, C., Imai, K. and Yamori, Y. (2007) Effect of Population Strategy on Hypertension (in Japanese). Therapeutic Research, 28, 1788-1791.
[14] Yamori, Y., Liu, L., Ikeda, K., Mizushima, S., Nara, Y. and Simpson, O. (2001) Different Associations of Blood Pressure with 24-Hour Urinary Sodium Excretion among Pre- and Post-Menopausal Women. Journal of Hypertension, 19, 535-538.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.