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Nutrients 2018, 10(1), 103; https://doi.org/10.3390/nu10010103

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

1
DONALD Study Dortmund, Department of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, 44225 Dortmund, Germany
2
Robert Koch-Institute, Department of Epidemiology and Health Monitoring, Robert Koch Institute, 13302 Berlin, Germany
These authors contributed equally to this work as principal investigators (D.K., J.E.) and as senior author (T.R.).
*
Author to whom correspondence should be addressed.
Received: 21 November 2017 / Revised: 10 December 2017 / Accepted: 11 January 2018 / Published: 19 January 2018
(This article belongs to the Special Issue Nutritional Prevention and Acid Base Status)
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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. View Full-Text
Keywords: dietary acid load; PRAL; potassium intake; blood pressure; hypertension; DEGS1 dietary acid load; PRAL; potassium intake; blood pressure; hypertension; DEGS1
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Krupp, D.; Esche, J.; Mensink, G.B.M.; Klenow, S.; Thamm, M.; Remer, T. Dietary Acid Load and Potassium Intake Associate with Blood Pressure and Hypertension Prevalence in a Representative Sample of the German Adult Population. Nutrients 2018, 10, 103.

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