Top Institute Food and Nutrition, Wageningen, Netherlands.
Am J Clin Nutr. 2012 Jun;95(6):1438-44. doi: 10.3945/ajcn.111.022343. Epub 2012 May 2.
Mild metabolic acidosis, which can be caused by diet, may result in elevated blood pressure (BP).
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.
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).
The findings from this prospective cohort study provided no evidence of an association between dietary acid load and risk of hypertension in older adults.
饮食等因素引起的轻度代谢性酸中毒可能导致血压升高。
本分析纳入了 2241 名年龄≥55 岁的参与者，他们在基线时（1990-1993 年）无高血压且有完整的饮食和血压数据。饮食数据来自于 170 项食物频率问卷。我们使用 2 种方法来描述饮食酸负荷：（1）通过包括蛋白质、磷、钾、钙和镁的算法来计算潜在肾酸负荷（PRAL）；（2）基于蛋白质和钾来估算净内源性酸产生（NEAP）。采用 PRAL 和 NEAP 的三分位数，通过调整年龄、性别、BMI、吸烟、教育程度以及酒精、纤维和总能量的摄入量来计算每 6 年高血压发病的 HR。
在 8707 人年的随访期间，我们发现了 1113 例高血压新发病例。PRAL 各分类中饮食酸负荷中位数范围为-14.6 至 19.9 mEq/d。饮食酸负荷与高血压风险无显著相关性。PRAL 连续三分位的多变量 HR（95%CI）依次为 1.00（参考）、1.01（0.87，1.17）和 1.02（0.88，1.18）（P 趋势=0.83）。连续三分位的 NEAP 中位数饮食酸负荷分别为 30.4、36.7 和 43.7 mEq/d，相应的 NEAP HR 分别为 1.00（参考）、0.92（0.80，1.07）和 0.94（0.81，1.10）（P 趋势=0.46）。
本前瞻性队列研究的结果未提供饮食酸负荷与老年人高血压风险之间存在关联的证据。
