Association of Processed Meat Intake with Hypertension Risk in Hemodialysis Patients: A Cross-Sectional Study

<div><p>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 than140 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, <i>P</i> < .05) and white meats (β = -0. 75, <i>P</i> = .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, <i>P</i> < .05), white meat (β = -0. 62, <i>P</i> < .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.</p></div

Changes in risk of inflammation and hypertension corresponding to substitution of one serving of processed meat with that of other protein foods

<p>* p < 0.05</p><p>† p = 0.05.</p><p>Changes in risk of inflammation and hypertension corresponding to substitution of one serving of processed meat with that of other protein foods</p

Sodium and phosphorus content of the protein foods in HD patients

<p>Na: sodium, P: phosphorus.</p><p>Sodium and phosphorus content of the protein foods in HD patients</p

Descriptive data of all HD patients

<p>SBP: systolic blood pressure, DBP: diastolic blood pressure, nPCR: normalized protein catabolic rate.</p><p>* p < 0.05.</p><p>Descriptive data of all HD patients</p

Flowchart of participants through the study.

<p>Flowchart of participants through the study.</p

Odds ratio of one serving per day of protein foods intake and CVD risk factors¹.

<p>Values presents as odds ratio (95% CI).</p><p>Model 1: adjusted for dietary energy. Model 2 for blood pressure: adjusted for gender, age, HTN medication, and dietary energy, Model 2 for inflammation status: adjusted for gender, age, hemodialysis duration and dietary energy. Model 2 + BMI included adjusting for the interaction between BMI and protein foods. Model 2 + sodium included adjusting for the interaction between sodium contents and protein foods.</p><p>¹The unit for OR was 1 serving size of protein foods.</p><p>Odds ratio of one serving per day of protein foods intake and CVD risk factors<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0141917#t003fn003" target="_blank">¹</a>.</p