Dietary acid load and risk of hypertension: the Rotterdam Study.

M.F. Engberink, S.J. Bakker, E.J. Brink, M.A. van Baak, F.J. van Rooij, A. Hofman, J.C. Witteman, J.M. Geleijnse

Research output: Contribution to journalArticleAcademicpeer-review

33 Citations (Scopus)

Abstract

BACKGROUND: Mild metabolic acidosis, which can be caused by diet, may result in elevated blood pressure (BP). OBJECTIVE: The objective was to examine whether dietary acid load was associated with incident hypertension in a cohort of older Dutch adults from the Rotterdam Study. DESIGN: The analyses included 2241 participants aged >/=55 y who were free of hypertension at baseline (1990-1993) and who had complete dietary and BP data. Dietary data were obtained from a 170-item food-frequency questionnaire. We used 2 measures to characterize dietary acid load: 1) potential renal acid load (PRAL) by using an algorithm including protein, phosphorus, potassium, calcium, and magnesium, and 2) estimated net endogenous acid production (NEAP) based on protein and potassium. HRs for 6-y incidence of hypertension were obtained in tertiles of PRAL and NEAP with adjustment for age, sex, BMI, smoking, education, and intakes of alcohol, fiber, and total energy. RESULTS: We identified 1113 incident cases of hypertension during 8707 person-years of follow-up. The median dietary acid load ranged from -14.6 to 19.9 mEq/d across categories of PRAL. Hypertension risk was not significantly associated with dietary acid load. The multivariate HRs (95% CIs) in consecutive tertiles of PRAL were 1.00 (reference), 1.01 (0.87, 1.17), and 1.02 (0.88, 1.18) (P trend = 0.83). The median dietary acid loads were 30.4, 36.7, and 43.7 mEq/d, respectively, in consecutive tertiles of NEAP. Corresponding HRs for NEAP were 1.00 (reference), 0.92 (0.80, 1.07), and 0.94 (0.81, 1.10) (P-trend = 0.46). CONCLUSION: The findings from this prospective cohort study provided no evidence of an association between dietary acid load and risk of hypertension in older adults.
Original languageEnglish
Pages (from-to)1438-1444
Number of pages7
JournalAmerican Journal of Clinical Nutrition
Volume95
Issue number6
DOIs
Publication statusPublished - Jun 2012

Keywords

  • BLOOD-PRESSURE RESPONSE
  • BASE-BALANCE
  • EXCRETION
  • CALCIUM
  • PROTEIN
  • HUMANS
  • POTASSIUM
  • TRIALS
  • METAANALYSIS
  • ASSOCIATION

Cite this

Engberink, M. F., Bakker, S. J., Brink, E. J., van Baak, M. A., van Rooij, F. J., Hofman, A., Witteman, J. C., & Geleijnse, J. M. (2012). Dietary acid load and risk of hypertension: the Rotterdam Study. American Journal of Clinical Nutrition, 95(6), 1438-1444. https://doi.org/10.3945/ajcn.111.022343