Diet-dependent net acid load and risk of incident hypertension in United States women.
Animal and human studies suggest a potential link between acid-base status and blood pressure. Contemporary Western diets yield a daily systemic acid load of varying amounts, yet the association with hypertension has never been explored. We prospectively examined the association between the diet-dependent net acid load (also known as the estimated net endogenous acid production) and the risk of incident hypertension among 87 293 women without a history of hypertension in the Nurses' Health Study II. We also used the ratio of animal protein intake to potassium intake as an alternative evaluation of diet-dependent net acid load. We identified 15 385 incident cases of hypertension during 995 239 person-years of follow-up. After adjusting for potential confounders, women in the top decile of estimated diet-dependent net acid load had an increased risk of hypertension (relative risk: 1.14; 95% CI: 1.05 to 1.24; P for trend=0.01) compared with women in the bottom decile. To test whether the association between estimated diet-dependent net acid load and hypertension is independent of its individual components, an additional adjustment for intakes of protein and potassium was made and resulted in a relative risk of 1.23 (95% CI: 1.08 to 1.41; P for trend=0.003) for the top decile of estimated diet-dependent net acid load. Results of the ratio of animal protein intake to potassium intake were similar with those of estimated diet-depend net acid load. In conclusion, a high diet-dependent net acid load is independently associated with a higher risk of incident hypertension.
Zhang
Luxia
L
Channing Laboratory/Renal Division, Brigham and Women's Hospital, 181 Longwood Ave., Boston, MA 02115, USA. nhlzh@channing.harvard.edu
Curhan
Gary C
GC
Forman
John P
JP
D000137:Acid-Base Imbalance / Q000150:complications* / Q000378:metabolism*; D000143:Acids / Q000378:metabolism; D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D015331:Cohort Studies; D004044:Dietary Proteins / Q000009:adverse effects* / Q000378:metabolism / Q000494:pharmacology; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000378:metabolism*; D015994:Incidence; D017419:Potassium, Dietary / Q000009:adverse effects* / Q000378:metabolism / Q000494:pharmacology; D011446:Prospective Studies; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
D000143:Acids; D004044:Dietary Proteins; D017419:Potassium, Dietary