{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T20:50:12Z","timestamp":1770497412838,"version":"3.49.0"},"reference-count":51,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T00:00:00Z","timestamp":1711065600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>We aimed to investigate how dietary fructose and sodium impact blood pressure and risk of hypertensive target organ damage 10 years later. Data from n = 3116 individuals were obtained from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Four groups were identified based on the four possible combinations of the lower and upper 50th percentile for sodium (in mg) and fructose (expressed as percent of total daily calories). Differences among groups were ascertained and logistic regression analyses were used to assess the risk of hypertensive target organ damage (diastolic dysfunction, coronary calcification and albuminuria). Individuals in the low-fructose + low-sodium group were found to have lower SBP compared to those in the low-fructose + high-sodium and high-fructose + high-sodium groups (p &lt; 0.05). The highest risk for hypertensive target organ damage was found for albuminuria only in the high-fructose + high-sodium group (OR = 3.328, p = 0.006) while female sex was protective across all groups against coronary calcification. Our findings highlight that sodium alone may not be the culprit for hypertension and hypertensive target organ damage, but rather when combined with an increased intake of dietary fructose, especially in middle-aged individuals.<\/jats:p>","DOI":"10.3390\/nu16070913","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T10:58:02Z","timestamp":1711105082000},"page":"913","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Dietary Fructose and Sodium Consumed during Early Mid-Life Are Associated with Hypertensive End-Organ Damage by Late Mid-Life in the CARDIA Cohort"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8855-4291","authenticated-orcid":false,"given":"Dragana","family":"Komnenov","sequence":"first","affiliation":[{"name":"Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA"},{"name":"John D. Dingell VA Medical Center, Detroit, MI 48201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Al-Hadidi","sequence":"additional","affiliation":[{"name":"Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamza","family":"Ali","sequence":"additional","affiliation":[{"name":"Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Malik","family":"Al-Jamal","sequence":"additional","affiliation":[{"name":"Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kassim","family":"Salami","sequence":"additional","affiliation":[{"name":"Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samy","family":"Shelbaya","sequence":"additional","affiliation":[{"name":"Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kareem","family":"Tayeb","sequence":"additional","affiliation":[{"name":"Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Domin","sequence":"additional","affiliation":[{"name":"Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rana","family":"Elhamzawy","sequence":"additional","affiliation":[{"name":"Physiology and Internal Medicine, Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI 48201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,22]]},"reference":[{"key":"ref_1","unstructured":"CDC (2023, January 16). Leading Causes of Death, Available online: https:\/\/www.cdc.gov\/nchs\/fastats\/leading-causes-of-death.htm."},{"key":"ref_2","unstructured":"AHA (2023, January 16). Life\u2019s Essential 8. Available online: https:\/\/www.heart.org\/en\/healthy-living\/healthy-lifestyle\/lifes-essential-8."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"100452","DOI":"10.1016\/j.ajpc.2022.100452","article-title":"AHA Life\u2019s essential 8 and ideal cardiovascular health among young adults","volume":"13","author":"Shetty","year":"2023","journal-title":"Am. J. Prev. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1016\/j.amjcard.2014.07.002","article-title":"An Unsavory Truth: Sugar, More than Salt, Predisposes to Hypertension and Chronic Disease","volume":"114","author":"DiNicolantonio","year":"2014","journal-title":"Am. J. Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1016\/j.nut.2014.04.003","article-title":"Fructose content in popular beverages made with and without high-fructose corn syrup","volume":"30","author":"Walker","year":"2014","journal-title":"Nutrition"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"R529","DOI":"10.1152\/ajpregu.00020.2018","article-title":"Bilateral renal cryodenervation decreases arterial pressure and improves insulin sensitivity in fructose-fed Sprague-Dawley rats","volume":"315","author":"Soncrant","year":"2018","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Komnenov, D., Levanovich, P.E., and Rossi, N.F. (2019). Hypertension Associated with Fructose and High Salt: Renal and Sympathetic Mechanisms. Nutrients, 11.","DOI":"10.3390\/nu11030569"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"111","DOI":"10.2147\/IBPC.S257205","article-title":"Aortic Stiffness and Diastolic Dysfunction in Sprague Dawley Rats Consuming Short-Term Fructose Plus High Salt Diet","volume":"13","author":"Komnenov","year":"2020","journal-title":"Integr. Blood Press Control"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Levanovich, P.E., Chung, C.S., Komnenov, D., and Rossi, N.F. (2021). Fructose plus High-Salt Diet in Early Life Results in Salt-Sensitive Cardiovascular Changes in Mature Male Sprague Dawley Rats. Nutrients, 13.","DOI":"10.3390\/nu13093129"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e15456","DOI":"10.14814\/phy2.15456","article-title":"Dietary fructose and high salt in young male Sprague Dawley rats induces salt-sensitive changes in renal function in later life","volume":"10","author":"Levanovich","year":"2022","journal-title":"Physiol. Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1172\/JCI96702","article-title":"Fructose metabolism and metabolic disease","volume":"128","author":"Hannou","year":"2018","journal-title":"J. Clin. Investig."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Osborne, M., Bernard, A., Falkowski, E., Peterson, D., Vavilikolanu, A., and Komnenov, D. (2023). Longitudinal Associations of Dietary Fructose, Sodium, and Potassium and Psychological Stress with Vascular Aging Index and Incident Cardiovascular Disease in the CARDIA Cohort. Nutrients, 16.","DOI":"10.1101\/2023.10.03.23296515"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1093\/ajcn\/nqz323","article-title":"Fructose-induced alterations of glucose and lipid homeostasis: Progressive organ dysfunction leading to metabolic diseases or mere adaptive changes?","volume":"111","author":"Tappy","year":"2020","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_14","first-page":"3218275","article-title":"Prediabetes Induced by Fructose-Enriched Diet Influences Cardiac Lipidome and Proteome and Leads to Deterioration of Cardiac Function prior to the Development of Excessive Oxidative Stress and Cell Damage","volume":"2019","author":"Bruszel","year":"2019","journal-title":"Oxid. Med. Cell Longev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1038\/s41387-021-00150-7","article-title":"Elevated myocardial fructose and sorbitol levels are associated with diastolic dysfunction in diabetic patients, and cardiomyocyte lipid inclusions in vitro","volume":"11","author":"Daniels","year":"2021","journal-title":"Nutr. Diabetes"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"353","DOI":"10.2337\/diacare.25.2.353","article-title":"Increased fructose concentrations in blood and urine in patients with diabetes","volume":"25","author":"Kawasaki","year":"2002","journal-title":"Diabetes Care"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1007\/s00592-014-0611-1","article-title":"Serum uric acid predicts vascular complications in adults with type 1 diabetes: The coronary artery calcification in type 1 diabetes study","volume":"51","author":"Bjornstad","year":"2014","journal-title":"Acta Diabetol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"135","DOI":"10.3389\/fcvm.2018.00135","article-title":"Cardiovascular Effects and Benefits of Exercise","volume":"5","author":"Nystoriak","year":"2018","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1159\/000329929","article-title":"Physical Activity in the Prevention of Chronic Kidney Disease","volume":"1","author":"Stump","year":"2011","journal-title":"Cardiorenal Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1161\/ATVBAHA.120.314838","article-title":"Low-Carbohydrate Diet Score and Coronary Artery Calcium Progression: Results From the CARDIA Study","volume":"41","author":"Gao","year":"2021","journal-title":"Arter. Thromb. Vasc. Biol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1016\/0895-4356(88)90080-7","article-title":"CARDIA: Study design, recruitment, and some characteristics of the examined subjects","volume":"41","author":"Friedman","year":"1988","journal-title":"J. Clin. Epidemiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1016\/S0002-8223(21)01299-2","article-title":"The CARDIA dietary history: Development, implementation, and evaluation","volume":"91","author":"Jacobs","year":"1991","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1161\/HYPERTENSIONAHA.111.184101","article-title":"Rate of decline of forced vital capacity predicts future arterial hypertension: The Coronary Artery Risk Development in Young Adults Study","volume":"59","author":"Jacobs","year":"2012","journal-title":"Hypertension"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1001\/jamacardio.2018.0005","article-title":"The 2017 American College of Cardiology\/American Heart Association clinical practice guideline for high blood pressure in adults","volume":"3","author":"Whelton","year":"2018","journal-title":"JAMA Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2679","DOI":"10.1016\/j.jacc.2015.04.042","article-title":"Cumulative Blood Pressure in Early Adulthood and Cardiac Dysfunction in Middle Age: The CARDIA Study","volume":"65","author":"Kishi","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1148\/radiol.2341040439","article-title":"Calcified coronary artery plaque measurement with cardiac CT in population-based studies: Standardized protocol of Multi-Ethnic Study of Atherosclerosis (MESA) and Coronary Artery Risk Development in Young Adults (CARDIA) study","volume":"234","author":"Carr","year":"2005","journal-title":"Radiology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/0735-1097(90)90282-T","article-title":"Quantification of coronary artery calcium using ultrafast computed tomography","volume":"15","author":"Agatston","year":"1990","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/aje\/kwg208","article-title":"Correlates of urinary albumin excretion in young adult blacks and whites: The Coronary Artery Risk Development in Young Adults Study","volume":"158","author":"Murtaugh","year":"2003","journal-title":"Am. J. Epidemiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1097\/00008483-198911000-00003","article-title":"Validity and reliability of short physical activity history: CARDIA and the Minnesota Heart Health Program","volume":"9","author":"Jacobs","year":"1989","journal-title":"J. Cardiopulm. Rehabil. Prev."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/j.ijcard.2017.07.078","article-title":"Adding markers of organ damage to risk score models improves cardiovascular risk assessment: Prospective analysis of a large cohort of adult outpatients","volume":"248","author":"Tocci","year":"2017","journal-title":"Int. J. Cardiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1001\/jama.289.2.194","article-title":"Burden of systolic and diastolic ventricular dysfunction in the community: Appreciating the scope of the heart failure epidemic","volume":"289","author":"Redfield","year":"2003","journal-title":"JAMA"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1016\/j.jacc.2014.01.017","article-title":"Coronary artery calcification: Pathogenesis and prognostic implications","volume":"63","author":"Madhavan","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1097\/HJH.0b013e328336ed09","article-title":"Combined effect of albuminuria and estimated glomerular filtration rate on cardiovascular events and all-cause mortality in uncomplicated hypertensive patients","volume":"28","author":"Viazzi","year":"2010","journal-title":"J. Hypertens."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/ehjci\/jev014","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"16","author":"Lang","year":"2015","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1056\/NEJMoa072100","article-title":"Coronary calcium as a predictor of coronary events in four racial or ethnic groups","volume":"358","author":"Detrano","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1001\/jama.286.4.421","article-title":"Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals","volume":"286","author":"Gerstein","year":"2001","journal-title":"JAMA"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"DeChristopher, L.R., Auerbach, B.J., and Tucker, K.L. (2020). High fructose corn syrup, excess-free-fructose, and risk of coronary heart disease among African Americans\u2014The Jackson Heart Study. BMC Nutr., 6.","DOI":"10.1186\/s40795-020-00396-x"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1016\/j.jada.2009.05.002","article-title":"Interrelationships of added sugars intake, socioeconomic status, and race\/ethnicity in adults in the United States: National Health Interview Survey, 2005","volume":"109","author":"Thompson","year":"2009","journal-title":"J. Am. Diet Assoc."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.jand.2021.06.012","article-title":"Sodium and Potassium Intake, the Sodium to Potassium Ratio, and Associated Characteristics in Older Adults, NHANES 2011\u20132016","volume":"122","author":"Vaudin","year":"2022","journal-title":"J. Acad. Nutr. Diet"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"128","DOI":"10.5694\/j.1326-5377.2011.tb03239.x","article-title":"Relationship of urinary sodium and sodium-to-potassium ratio to blood pressure in older adults in Australia","volume":"195","author":"Huggins","year":"2011","journal-title":"Med. J. Aust."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1007\/s00394-018-1712-3","article-title":"High sodium intake and sodium to potassium ratio may be linked to subsequent increase in vascular damage in adults aged 40 years and older: The Korean multi-rural communities cohort (MRCohort)","volume":"58","author":"Jung","year":"2019","journal-title":"Eur. J. Nutr."},{"key":"ref_42","first-page":"l772","article-title":"Joint association of urinary sodium and potassium excretion with cardiovascular events and mortality: Prospective cohort study","volume":"364","author":"Mente","year":"2019","journal-title":"BMJ"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1056\/NEJMoa1311889","article-title":"Urinary sodium and potassium excretion, mortality, and cardiovascular events","volume":"371","author":"Mente","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Iwahori, T., Miura, K., and Ueshima, H. (2017). Time to Consider Use of the Sodium-to-Potassium Ratio for Practical Sodium Reduction and Potassium Increase. Nutrients, 9.","DOI":"10.3390\/nu9070700"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1016\/S0140-6736(22)00369-5","article-title":"Reduction of dietary sodium to less than 100 mmol in heart failure (SODIUM-HF): An international, open-label, randomised, controlled trial","volume":"399","author":"Ezekowitz","year":"2022","journal-title":"Lancet"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1097\/RTI.0000000000000566","article-title":"Cardiovascular Risk Factors and Coronary Calcification in a Middle-aged Dutch Population: The ImaLife Study","volume":"36","author":"Xia","year":"2021","journal-title":"J. Thorac. Imaging"},{"key":"ref_47","first-page":"3337","article-title":"Prevalence, severity, characteristics and coronary calcified score of coronary artery plaques are different in women than men with suspected coronary artery disease","volume":"95","author":"Sun","year":"2015","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1007\/s12471-019-1234-5","article-title":"Sex differences in coronary artery plaque composition detected by coronary computed tomography: Quantitative and qualitative analysis","volume":"27","author":"Plank","year":"2019","journal-title":"Neth. Heart J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1161\/HYPERTENSIONAHA.119.13069","article-title":"Early Onset Hypertension Is Associated With Hypertensive End-Organ Damage Already by MidLife","volume":"74","author":"Suvila","year":"2019","journal-title":"Hypertension"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1016\/j.jacc.2022.05.031","article-title":"Cardiorespiratory Fitness and Mortality Risk Across the Spectra of Age, Race, and Sex","volume":"80","author":"Kokkinos","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"e13137","DOI":"10.1111\/obr.13137","article-title":"What exercise prescription is optimal to improve body composition and cardiorespiratory fitness in adults living with obesity? A network meta-analysis","volume":"22","author":"Blake","year":"2021","journal-title":"Obes. Rev."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/7\/913\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:17:53Z","timestamp":1760105873000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/16\/7\/913"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,22]]},"references-count":51,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["nu16070913"],"URL":"https:\/\/doi.org\/10.3390\/nu16070913","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,22]]}}}