title: Estimated dietary acid load is not associated with blood pressure or hypertension incidence in men who are approximately 70 years old.
abstract: BACKGROUND
  Dietary acid load affects acid-base homeostasis, which may be associated with blood pressure (BP). Previous research on dietary acid load and BP in the community has provided conflicting results, which may be confounded by underlying kidney function with inability to eliminate acid excess.
  
  
  OBJECTIVE
  The objective of this study was to determine whether dietary acid load is associated with blood pressure or the incidence of hypertension in older men taking into account each individual's kidney function.
  
  
  METHODS
  We included 673 men aged 70-71 y and not receiving antihypertensive medication from the Uppsala Longitudinal Study of Adult Men. Of those, 378 men were re-examined after 7 y. Dietary acid load was estimated at baseline by potential renal acid load (PRAL) and net endogenous acid production (NEAP), based on nutrient intake assessed by 7-d food records at baseline. Ambulatory blood pressure monitoring (ABPM) was performed at both visits. Cystatin C-estimated kidney function allowed identification of underlying chronic kidney disease.
  
  
  RESULTS
  Median estimated PRAL and NEAP were 3.3 and 40.7 mEq/d, respectively. In cross-section, PRAL was in general not associated with ABPM measurements (all P > 0.05, except for the 24-h diastolic BP). During follow-up, PRAL did not predict ABPM changes (all P > 0.05). When individuals with baseline hypertension (ABPM ≥ 130/80 mm Hg) or nondippers (with nighttime-to-daytime systolic BP ratio > 0.9) were excluded, PRAL was not a predictor of incident cases (P > 0.30). Kidney function did not modify these null relations. Similar findings were obtained with the use of NEAP as the exposure.
  
  
  CONCLUSIONS
  Our analyses linking estimated dietary acid load with BP outcome measurements both cross-sectionally and after 7 y in community-based older Swedish men of similar age did not reveal an association between dietary acid load and BP.
authors: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, and.
authors: Desiree
authors: D
authors: Luis
authors: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, and Division of Nephrology, Peking University Shenzhen Hospital, Peking University, Shenzhen, China;
authors: Xiaoyan
authors: X
authors: Huang
authors: Clinical Nutrition and Metabolism and.
authors: Ulf
authors: U
authors: Riserus
authors: Clinical Nutrition and Metabolism and.
authors: Per
authors: P
authors: Sjögren
authors: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, and.
authors: Bengt
authors: B
authors: Lindholm
authors: Geriatrics Section, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden; and School of Health and Social Studies, Dalarna University, Falun, Sweden.
authors: Johan
authors: J
authors: Arnlöv
authors: Clinical Nutrition and Metabolism and.
authors: Tommy
authors: T
authors: Cederholm
authors: Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden; juan.jesus.carrero@ki.se.
authors: Juan Jesús
authors: JJ
authors: Carrero
mesh_terms: D000138:Acidosis / Q000150:complications / Q000378:metabolism; D000143:Acids / Q000008:administration & dosage*; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D004032:Diet; D002149:Energy Intake; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D007668:Kidney / Q000503:physiopathology; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology
chemical_list: D000143:Acids; D018977:Micronutrients
keywords: chronic kidney disease; dip; metabolic acidosis; nutritional epidemiology; renal nutrition