Is lowering phosphate exposure the key to preventing arterial stiffening with age?

Area of Science:

• Cardiovascular science
• Nephrology
• Nutritional science

Background:

• Cardiovascular disease is the leading global cause of death.
• Arteriosclerosis, characterized by arterial stiffness, contributes significantly to cardiovascular mortality.
• Serum phosphate is an emerging cardiovascular risk factor implicated in arteriosclerosis and arterial calcification.

Purpose of the Study:

• To highlight the overlooked role of arteriosclerotic vascular disease in cardiovascular mortality.
• To explore the link between dietary phosphate, renal function, and arteriosclerosis.
• To propose phosphate reduction as a strategy to mitigate cardiovascular risk.

Main Methods:

• This is a viewpoint article, presenting a hypothesis based on existing literature.
• It reviews the determinants of serum phosphate, including diet and renal function.
• It discusses the impact of phosphate on arterial stiffness and cardiovascular health.

Main Results:

• Diets in affluent populations are high in phosphate due to animal protein and preservatives.
• Ageing populations often have reduced renal function, exacerbating phosphate retention.
• Phosphate-rich diets, combined with declining kidney function, accelerate arteriosclerosis.

Conclusions:

• Phosphate-rich diets, especially in individuals with diminished renal function, accelerate arteriosclerosis and arterial stiffness.
• Reducing dietary phosphate intake is hypothesized to attenuate arterial stiffness progression.
• This intervention may lead to substantial reductions in cardiovascular mortality and morbidity.