Luis Desiree, Huang Xiaoyan, Riserus Ulf, Sjögren Per, Lindholm Bengt, Arnlöv Johan, Cederholm Tommy, Carrero Juan Jesús
Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, and.
Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, and Division of Nephrology, Peking University Shenzhen Hospital, Peking University, Shenzhen, China;
J Nutr. 2015 Feb;145(2):315-21. doi: 10.3945/jn.114.197020. Epub 2014 Dec 17.
Dietary acid load affects acid-base homeostasis, which may be associated with blood pressure (BP). Previous research on dietary acid load and BP in the community has provided conflicting results, which may be confounded by underlying kidney function with inability to eliminate acid excess.
The objective of this study was to determine whether dietary acid load is associated with blood pressure or the incidence of hypertension in older men taking into account each individual's kidney function.
We included 673 men aged 70-71 y and not receiving antihypertensive medication from the Uppsala Longitudinal Study of Adult Men. Of those, 378 men were re-examined after 7 y. Dietary acid load was estimated at baseline by potential renal acid load (PRAL) and net endogenous acid production (NEAP), based on nutrient intake assessed by 7-d food records at baseline. Ambulatory blood pressure monitoring (ABPM) was performed at both visits. Cystatin C-estimated kidney function allowed identification of underlying chronic kidney disease.
Median estimated PRAL and NEAP were 3.3 and 40.7 mEq/d, respectively. In cross-section, PRAL was in general not associated with ABPM measurements (all P > 0.05, except for the 24-h diastolic BP). During follow-up, PRAL did not predict ABPM changes (all P > 0.05). When individuals with baseline hypertension (ABPM ≥ 130/80 mm Hg) or nondippers (with nighttime-to-daytime systolic BP ratio > 0.9) were excluded, PRAL was not a predictor of incident cases (P > 0.30). Kidney function did not modify these null relations. Similar findings were obtained with the use of NEAP as the exposure.
Our analyses linking estimated dietary acid load with BP outcome measurements both cross-sectionally and after 7 y in community-based older Swedish men of similar age did not reveal an association between dietary acid load and BP.
饮食酸负荷会影响酸碱平衡，这可能与血压（BP）相关。先前关于社区中饮食酸负荷与血压的研究结果相互矛盾，这可能受到潜在肾功能影响，因为肾功能无法消除过多的酸。
本研究的目的是在考虑个体肾功能的情况下，确定饮食酸负荷是否与老年男性的血压或高血压发病率相关。
我们纳入了来自乌普萨拉成年男性纵向研究的673名年龄在70 - 71岁且未服用抗高血压药物的男性。其中，378名男性在7年后接受了再次检查。基于基线时通过7天食物记录评估的营养摄入量，在基线时通过潜在肾酸负荷（PRAL）和净内源性酸产生量（NEAP）估算饮食酸负荷。两次就诊时均进行了动态血压监测（ABPM）。通过胱抑素C估算的肾功能可识别潜在的慢性肾病。
PRAL和NEAP的估算中位数分别为3.3和40.7 mEq/d。在横断面分析中，PRAL总体上与ABPM测量值无关（除24小时舒张压外，所有P>0.05）。在随访期间，PRAL不能预测ABPM的变化（所有P>0.05）。当排除基线高血压（ABPM≥130/80 mmHg）或非勺型血压者（夜间与白天收缩压比值>0.9）时，PRAL不是新发病例的预测指标（P>0.30）。肾功能并未改变这些无关联关系。使用NEAP作为暴露因素时也得到了类似的结果。
我们对瑞典社区中年龄相近的老年男性进行的横断面分析以及7年后的分析，将估算的饮食酸负荷与血压结果测量值联系起来，未发现饮食酸负荷与血压之间存在关联。
