Dietary nitrate consumption and risk of coronary heart disease in women from the Nurses’ Health Study

• Published in: British journal of nutrition Vol. 121; no. 7; pp. 831 - 838
• Main Authors: Jackson, Jacklyn K., Zong, Geng, MacDonald-Wicks, Lesley K., Patterson, Amanda J., Willett, Walter C., Rimm, Eric B., Manson, JoAnn E., McEvoy, Mark A.
• Format: Journal Article
• Language: English
• Published: 23.01.2019
• ISSN: 0007-1145; 1475-2662
• DOI: 10.1017/S0007114519000096

The consumption of nitrate-rich vegetables can acutely lower blood pressure, and improve mediators shown to optimise vascular health. However, we do not yet understand the impact of long-term habitual dietary nitrate intake and its association with cardiovascular disease (CVD). Therefore the aim of this investigation was to examine the relationship between habitual dietary nitrate intakes and risk of coronary heart disease (CHD) in women from the Nurses’ Health Study. We prospectively followed 62,535 women who were free from diabetes, CVD and cancer at baseline in 1986. Information on diet was updated every 4 years with validated food frequency questionnaires. The main outcome was CHD, defined by the occurrence of non-fatal myocardial infarction or fatal CHD. Cox proportional hazard regression models were used to estimate relative risks (RR) and 95% confidence intervals (CI). During 26 years of follow-up, 2257 cases of CHD were identified. When comparing the highest quintile of nitrate intake with the lowest quintile, in aged-adjusted analysis there was a protective association for CHD [RR=0.77, (95% CI: 0.68, 0.97); p=0.0002] which dissipated after further adjustment for smoking, physical activity, body mass index and race [RR= 0.91; (95% CI: 0.80, 1.04); P=0.27]. This magnitude of association was further attenuated once we adjusted for the Alternative Healthy Eating Index excluding vegetable and fruit consumption [RR: 1.04 (95% CI: 0.91, 1.20; P=0.34)]. Dietary nitrate intake was not related to risk of CHD after adjustment for other lifestyle and non-vegetable dietary factors in a large group of US women.