Dietary Acid Load and Potassium Intake Associate with Blood Pressure and Hypertension Prevalence in a Representative Sample of the German Adult Population.

Danika Krupp,Thomas Remer,Michael Thamm,Stefanie Klenow,Jonas Esche,Gert Mensink

doi:10.3390/nu10010103

Danika Krupp, Thomas Remer + Show 4 more

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https://doi.org/10.3390/nu10010103

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Journal: Nutrients	Publication Date: Jan 19, 2018
Citations: 31	License type: CC BY 4.0

Affiliation: University of Bonn, Robert Koch Institute

Abstract

Diets rich in fruits and vegetables, like the Dietary Approaches to Stop Hypertension (DASH)-diet, are usually characterized by high potassium intake and reduced dietary acid load, and have been shown to reduce blood pressure (BP). However, the relevance of potential renal acid load (PRAL) for BP has not been compared with the relevance to BP of urinary biomarker (K-urine)- and dietary food frequency questionnaire (K-FFQ)-based estimates of potassium intake in a general adult population sample. For 6788 participants (aged 18–79 years) of the representative German Health-Interview and Examination Survey for Adults (DEGS1), associations of PRAL, K-urine, and K-FFQ with BP and hypertension prevalence were cross-sectionally examined in multivariable linear and logistic regression models. PRAL was significantly associated with higher systolic BP (p = 0.0002) and higher hypertension prevalence (Odds ratio [OR] high vs. low PRAL = 1.45, p = 0.0004) in models adjusted for age, sex, body mass index (BMI), estimated sodium intake, kidney function, relevant medication, and further important covariates. Higher estimates of K-FFQ and K-urine were related to lower systolic BP (p = 0.04 and p < 0.0001) and lower hypertension prevalence (OR = 0.82, p = 0.04 and OR = 0.77, p = 0.02) as well as a lower diastolic BP (p = 0.03 and p = 0.0003). Our results show, for the first time in a comparative analysis of a large representative population sample, significant relationships of BP and hypertension prevalence with questionnaire- and biomarker-based estimates of potassium intake and with an estimate of dietary acid load.

Highlights

Current guidelines on the management of arterial hypertension recommend lifestyle changes including dietary measures to prevent the development of high blood pressure (BP) and to assist in reducing BP as well as cardiovascular disease (CVD) risk in hypertensives [1]
Regarding age and body mass index (BMI), lowest values were observed in the highest potential renal acid load (PRAL) quintile, while no clear trend was discernible for systolic and diastolic BP
Mean values of serum cholesterol were lowest and eGFR was highest in participants with the highest PRAL

Summary

Introduction

Current guidelines on the management of arterial hypertension recommend lifestyle changes including dietary measures to prevent the development of high blood pressure (BP) and to assist in reducing BP as well as cardiovascular disease (CVD) risk in hypertensives [1]. Apart from a reduction in salt and alcohol intake, increases in the consumption of fruits and vegetables, and vegetarian diets as well as Dietary Approaches to Stop Hypertension (DASH)-type diets have been shown to reduce. Nutrients 2018, 10, 103 low-sodium diets), the DASH-type diet may be the most effective [4]. Apart from increased intakes of several minerals including potassium, for which substantial evidence for a BP-reducing effect exists [5,6], a lowered nutritive proton load is a common characteristic of diets rich in fruits and vegetables, including DASH-type diets. Main determinants of the daily dietary acid load include high intakes of protein as well as phosphorus as acid-producing components, whereas high intakes of fruits, vegetables, and potatoes reduce the daily proton load.

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