This Article Free upon publication Full Text Full Text (PDF) All Versions of this Article: 54/4/751    most recent HYPERTENSIONAHA.109.135582v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Google Scholar Articles by Zhang, L. Articles by Forman, J. P. PubMed PubMed Citation Articles by Zhang, L. Articles by Forman, J. P. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Dietary Proteins High Blood Pressure Related Collections Other etiology Related Article

(Hypertension. 2009;54:751.)
© 2009 American Heart Association, Inc.

Original Articles

Diet-Dependent Net Acid Load and Risk of Incident Hypertension in United States Women

Luxia Zhang; Gary C. Curhan; John P. Forman

From the Channing Laboratory (L.Z., G.C.C., J.P.F.) and Renal Division (L.Z., G.C.C., J.P.F.), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Mass; Renal Division (L.Z.), Department of Medicine, Peking University First Hospital, Beijing, China.

Correspondence to Luxia Zhang, Channing Laboratory/Renal Division, Brigham and Women’s Hospital, 181 Longwood Ave, Boston, MA 02115. E-mail nhlzh{at}channing.harvard.edu

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.

Key Words: acid-base equilibrium • hypertension • risk factors • epidemiology • human

Related Article:

Optimal Dietary Strategies for Reducing Incident Hypertension

Matthew R. Weir and Cheryl A.M. Anderson
Hypertension 2009 54: 698-699. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				M. R. Weir and C. A.M. Anderson Optimal Dietary Strategies for Reducing Incident Hypertension Hypertension, October 1, 2009; 54(4): 698 - 699. [Full Text] [PDF]