Abstract
In this cross-sectional study, we hypothesized that hemodialysis patients consuming greater processed meat is associated with hypertension risk, which can be partly explained by the high sodium content in processed meat. From September 2013 to May 2014, one hundred and four patients requiring chronic hemodialysis treatment were recruited from hemodialysis centers. Data on systolic blood pressure and diastolic blood pressure before receiving dialysis, and 3-day dietary records of the recruited patients were collected. HD patients with systolic and diastolic blood pressures greater than 140 mmHg and higher than 90 mmHg, respectively, were considered hypertension risk. Protein foods were divided into 4 categories: red meat, white meat, soybeans, and processed meat (e.g., sausage and ham). In a model adjusted for energy intake and hypertension history, additional servings of processed meats was positively associated to systolic blood pressure >140 mmHg (odds ratio [95% confidence interval]: 2.1 [1.0–4.3]), and diastolic blood pressure > 90 mmHg (odds ratio: 2.5 [1.2–5.5]). After adjustment for dietary sodium contents or body mass index (BMI), most associations were substantially attenuated and were no longer significant. In systolic blood pressure greater than140 mmHg, one serving per day of red meats (β = -1.22, P < .05) and white meats (β = -0. 75, P = .05) was associated with a reduced risk compared with one serving per day of processed meats. Similarly, compared with one serving per day of processed meat, a reduced risk of diastolic blood pressure higher than 90 mmHg was associated with one serving per day of red meat (β = -1. 59, P < .05), white meat (β = -0. 62, P < .05). Thus, in these hemodialysis patients, intake of processed meat is significantly positively associated with higher blood pressure risk, and both sodium contents in processed meat and BMI significantly contributes to this association.
Generated Summary
This cross-sectional study investigated the association between processed meat intake and hypertension risk in hemodialysis (HD) patients, hypothesizing that higher processed meat consumption correlates with increased hypertension risk, potentially due to the high sodium content in processed meats. The study recruited 104 patients undergoing chronic hemodialysis, collecting data on blood pressure, 3-day dietary records, and other relevant clinical information. Hypertension risk was defined by systolic and diastolic blood pressures exceeding 140 mmHg and 90 mmHg, respectively. The study analyzed the association of various protein foods, including processed meats, red meat, white meat, and soybeans, with hypertension risk. Statistical analysis included multiple logistic regression models to determine odds ratios for hypertension and inflammation, adjusting for factors such as dietary energy, gender, age, and medication use. The researchers aimed to determine if substituting processed meat with other protein sources could attenuate the positive association between processed meat and the risk of CVD risk factors in HD patients.
Key Findings & Statistics
- The study included 104 participants with a mean age of 62.3 ± 1.5 years.
- The median HD duration was 6.5 years.
- 52% of participants had hypertension and 49% had CVD.
- Mean SBP was 144.5 ± 2.4 mmHg, DBP was 76.6 ± 1.4 mmHg, and serum CRP level was 5.0 ± 0.8 mg/L.
- Patients consumed an average of 1.3 ± 0.2 servings of processed meat, 1.0 ± 0.1 servings of red meat, 2.4 ± 0.2 servings of white meat, and 0.5 ± 0.1 servings of soybeans.
- The sodium content in processed meat was 1.6–45.7 times higher than in red meats, 2.6–37.1 times higher than in white meats, and 1.5-815.3 times higher than soybeans.
- After adjusting for gender, age, HTN medication, and dietary energy intake, each additional serving of processed meat was positively associated with the risk of hypertension (SBP >140 mmHg: OR = 2.10, 95% CI: 1.03 to 4.30; DBP >90 mmHg: OR = 2.51, 95% CI: 1.15 to 5.47).
- Substituting one serving of processed meat with red meat or white meat was negatively associated with HTN risk.
- After adjustment for sodium contents or BMI, the associations with SBP >140 mmHg and DBP >90 mmHg attenuated and were no longer significant.
- The substitution effects were estimated according to exchanging one serving of processed meat intake with another protein food containing equal protein.
- Substituted one serving of processed meat with one serving of red meat or white meat was negatively associated with risk of SBP >140 mmHg and DBP >90 mmHg in HD patients (Table 4).
Other Important Findings
- The study found that greater intake of processed meat, but not unprocessed red meat, was associated with a higher risk of hypertension in HD patients.
- After adjustment for sodium contents or BMI, these associations with SBP >140 mmHg and DBP >90 mmHg attenuated and were no longer significant.
- The study also observed that the amount of sodium from processed meat was 1.5–815.3 times higher than other protein foods.
- The effects of substituting processed meat with red and white meat were not significant after adjustment for dietary sodium contents.
Limitations Noted in the Document
- The study’s sample size was relatively small.
- Selection bias might have existed during enrollment.
- The average serum CRP concentration was lower than that reported by a previous study.
- The study was cross-sectional, making it difficult to determine causal relationships.
- The study did not include all confounding factors for pre-HD blood pressure, such as the concentration of sodium in the dialysis solution.
Conclusion
In conclusion, this study provides evidence suggesting that greater consumption of processed meat is associated with increased hypertension risk in HD patients, which may be partially attributed to the high sodium content and BMI. The findings highlight the need for HD patients to be mindful of their processed meat intake. The study suggests that substituting processed meat with unprocessed red and white meats may offer a protective effect against hypertension risk. The association between processed meat and hypertension risk was significantly attenuated after adjusting for sodium intake, indicating sodium as a major contributor to the observed association. The study emphasizes the importance of dietary modifications in managing hypertension among HD patients. Future research should investigate the long-term effects of processed meat intake and explore potential mechanisms to improve outcomes. Further interventional studies are required to assess the effects of processed meat on this factor in HD patients. The findings support the DASH eating pattern is suggested for lowering blood pressure in the general population. Moreover, the study implies that a higher intake of unprocessed red and white meat may reduce the risk of CVD risk factors, especially in the context of HD patients.