Vegetable nitrate intake, blood pressure and incident cardiovascular disease: Danish Diet, Cancer, and Health Study
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Vegetable nitrate intake, blood pressure and incident cardiovascular disease : Danish Diet, Cancer, and Health Study. / Bondonno, Catherine P.; Dalgaard, Frederik; Blekkenhorst, Lauren C.; Murray, Kevin; Lewis, Joshua R.; Croft, Kevin D.; Kyro, Cecilie; Torp-Pedersen, Christian; Gislason, Gunnar; Tjonneland, Anne; Overvad, Kim; Bondonno, Nicola P.; Hodgson, Jonathan M.
In: European Journal of Epidemiology, Vol. 36, 2021, p. 813–825.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Vegetable nitrate intake, blood pressure and incident cardiovascular disease
T2 - Danish Diet, Cancer, and Health Study
AU - Bondonno, Catherine P.
AU - Dalgaard, Frederik
AU - Blekkenhorst, Lauren C.
AU - Murray, Kevin
AU - Lewis, Joshua R.
AU - Croft, Kevin D.
AU - Kyro, Cecilie
AU - Torp-Pedersen, Christian
AU - Gislason, Gunnar
AU - Tjonneland, Anne
AU - Overvad, Kim
AU - Bondonno, Nicola P.
AU - Hodgson, Jonathan M.
PY - 2021
Y1 - 2021
N2 - 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 (similar to 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 similar to 60 mg/day of vegetable nitrate (similar to 1 cup of green leafy vegetables) may mitigate risk of CVD.
AB - 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 (similar to 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 similar to 60 mg/day of vegetable nitrate (similar to 1 cup of green leafy vegetables) may mitigate risk of CVD.
KW - Vegetables
KW - Nitrate
KW - Nitric oxide
KW - Blood pressure
KW - Cardiovascular disease
KW - INORGANIC NITRATE
KW - PREDICTIVE-VALUE
KW - BEETROOT JUICE
KW - ALL-CAUSE
KW - ASSOCIATION
KW - MORTALITY
KW - DIAGNOSES
KW - RISK
KW - VALIDITY
KW - ALCOHOL
U2 - 10.1007/s10654-021-00747-3
DO - 10.1007/s10654-021-00747-3
M3 - Journal article
C2 - 33884541
VL - 36
SP - 813
EP - 825
JO - European Journal of Epidemiology
JF - European Journal of Epidemiology
SN - 0393-2990
ER -
ID: 271753428