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Dietary Acid Load and Risk of Hypertension: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies Publisher Pubmed



Parohan M1, 2 ; Sadeghi A2 ; Nasiri M3, 4 ; Maleki V5 ; Khodadost M6, 7 ; Pirouzi A1 ; Sadeghi O8, 9
Authors
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Authors Affiliations
  1. 1. Gerash University of Medical Sciences, Gerash, Iran
  2. 2. Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Operating Room Technology, School of Paramedicine, Qom University of Medical Sciences, Qom, Iran
  4. 4. Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
  5. 5. Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
  6. 6. Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  7. 7. Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
  8. 8. Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
  9. 9. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran

Source: Nutrition# Metabolism and Cardiovascular Diseases Published:2019


Abstract

Background and aim: Previous studies have assessed diet-induced mild metabolic acidosis in relation to blood pressure, however, data are conflicting. Current systematic review and dose-response meta-analysis aimed to summarize earlier findings from observational studies on the association between dietary acid load and hypertension. Methods and results: We searched the online databases for relevant publications up to Feb 2019, using relevant keywords. Overall, 14 studies (3 prospective and 11 cross-sectional studies) that included 306,183 individuals and 62,264 cases of hypertension were included in the current meta-analysis. Combining effect sizes from both prospective and cross-sectional studies revealed no significant non-linear association between dietary acid load (based on net endogenous acid production (NEAP) method) and hypertension. However, stratified analysis based on study design showed a significant non-linear association between dietary acid load and hypertension in prospective studies (P = 0.006), but not cross-sectional ones. According to linear dose-response analysis, no significant association was found between dietary acid load (based on NEAP) and hypertension (combined effect size: 1.01, 95% CI: 0.97–1.06, P = 0.51). In terms of dietary acid load based on potential renal acid load (PRAL) method, no significant non-linear association was seen with hypertension (P = 0.52). However, in linear dose-response analysis, a-20 unit increase in PRAL values was associated with 3% increased risk of hypertension (combined effect size: 1.03, 95% CI: 1.00–1.06, P = 0.03). Conclusion: We found a significant positive association between dietary acid load and hypertension. Further studies, particularly those with prospective nature, are needed to confirm our findings. © 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University
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