Author Identifier

Catherine P. Bondonno

ORCID : 0000-0001-8509-439X

Lauren C. Blekkenhorst

ORCID : 0000-0003-1561-9052

Joshua R. Lewis

ORCID : 0000-0003-1003-8443

Nicola P. Bondonno

ORCID : 0000-0001-5905-444X

Jonathan M. Hodgson

ORCID : 0000-0001-6184-7764

Document Type

Journal Article

Publication Title

European Journal of Epidemiology

Publisher

Springer

School

Institute for Nutrition Research / School of Medical and Health Sciences

RAS ID

35688

Funders

Edith Cowan University - Open Access Support Scheme 2021

Funding information : https://doi.org/10.1007/s10654-021-00747-3

National Health and Medical Research Council

Grant Number

NHMRC Number : 1159914, 1116937, 1172987

Comments

Bondonno, C. P., Dalgaard, F., Blekkenhorst, L. C., Murray, K., Lewis, J. R., Croft, K. D., ... Hodgson, J. M. (2021). Vegetable nitrate intake, blood pressure and incident cardiovascular disease: Danish diet, cancer, and health study. European Journal of Epidemiology. Advance online publication. https://doi.org/10.1007/s10654-021-00747-3

Abstract

Whether the vascular effects of inorganic nitrate, observed in clinical trials, translate to a reduction in cardiovascular disease (CVD) with habitual dietary nitrate intake in prospective studies warrants investigation. We aimed to determine if vegetable nitrate, the major dietary nitrate source, is associated with lower blood pressure (BP) and lower risk of incident CVD. Among 53,150 participants of the Danish Diet, Cancer, and Health Study, without CVD at baseline, vegetable nitrate intake was assessed using a comprehensive vegetable nitrate database. Hazard ratios (HRs) were calculated using restricted cubic splines based on multivariable-adjusted Cox proportional hazards models. During 23 years of follow-up, 14,088 cases of incident CVD were recorded. Participants in the highest vegetable nitrate intake quintile (median, 141 mg/day) had 2.58 mmHg lower baseline systolic BP (95%CI − 3.12, − 2.05) and 1.38 mmHg lower diastolic BP (95%CI − 1.66, − 1.10), compared with participants in the lowest quintile. Vegetable nitrate intake was inversely associated with CVD plateauing at moderate intakes (~ 60 mg/day); this appeared to be mediated by systolic BP (21.9%). Compared to participants in the lowest intake quintile (median, 23 mg/day), a moderate vegetable nitrate intake (median, 59 mg/day) was associated with 15% lower risk of CVD [HR (95% CI) 0.85 (0.82, 0.89)]. Moderate vegetable nitrate intake was associated with 12%, 15%, 17% and 26% lower risk of ischemic heart disease, heart failure, ischemic stroke and peripheral artery disease hospitalizations respectively. Consumption of at least ~ 60 mg/day of vegetable nitrate (~ 1 cup of green leafy vegetables) may mitigate risk of CVD.

DOI

10.1007/s10654-021-00747-3

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

Research Themes

Health

Priority Areas

Prevention, detection and management of cancer and other chronic diseases

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