Abstract
Blood pressure (BP) control is a key target for interventions to reduce cognitive decline. This cross-sectional study explored associations between objective (24-hour urine excretion) and subjective (food frequency questionnaire [FFQ]) measures of dietary sodium and nitrate intakes with cognitive function and resting BP in the InCHIANTI cohort. Baseline data from 989 participants aged >50 years were included. In fully adjusted models, participants with concurrent high nitrate and low sodium (Odds Ratio (OR)=0.49, 95%CI 0.32–0.76, p = 0.001) and high nitrate and high sodium (OR = 0.49, 95%CI 0.32–0.77, p = 0.002) 24-hour urinary concentrations had lower odds of high BP than participants with low nitrate and high sodium concentrations. We found no significant associations between sodium and nitrate intakes (24-hour urinary concentrations and FFQ) and poor cognitive performance. Urinary nitrate excretion was associated with lower BP and results appeared to be independent of sodium intake. Further analyses in longitudinal studies are required to substantiate these findings.
Highlights
Blood pressure (BP) control has emerged as a key target for long-term, effective interventions to reduce cognitive decline and prevent dementia (Hughes et al 2020)
Hypertension in mid-life has been associated with increased dementia risk (Livingston et al 2020), with a recent clinical trial reporting a lower risk of mild cognitive impairment among individuals randomised to an intensive BP reduction intervention (Williamson et al 2019)
Two independent analyses conducted in the NHANES dataset found that urinary nitrate concentrations in spot samples were associated with a lower prevalence of hypertension, stroke and congestive heart failure (Mendy 2018; Wu et al 2020). These findings are consistent with the results presented here, with significant associations of 24-hour urinary nitrate with systolic BP but this was not seen in analyses with self-reported dietary nitrate derived from the FFQ
Summary
Blood pressure (BP) control has emerged as a key target for long-term, effective interventions to reduce cognitive decline and prevent dementia (Hughes et al 2020). Hypertension in mid-life has been associated with increased dementia risk (Livingston et al 2020), with a recent clinical trial reporting a lower risk of mild cognitive impairment among individuals randomised to an intensive BP reduction intervention (Williamson et al 2019). Epidemiological studies have reported associations of high sodium diets with impaired BP control and increased cardiovascular risk (Strazzullo et al 2009; Mente et al 2018); this evidence has been confirmed in several clinical trials demonstrating the protective effects of salt reduction on cardiovascular health (He et al 2013; He and MacGregor 2018)
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