Sodium intake is positively associated with hypertension risk; however, it is not clear whether there is an association between the intake of fermented soy products, a major source of salt, and blood pressure (BP). This study aimed to investigate the hypothesis that hypertension risk and BP were negatively associated with the intake of fermented soy products but not with the intake of sodium from fermented soy products. This cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey (2013–2018). In total, 11,566 men and postmenopausal women aged ≥50 years were divided according to quintiles of sodium or fermented soy product intake. The intake of fermented soy products was negatively associated with hypertension risk (odds ratio: 0.81, 95% confidence interval: 0.66–0.98; p-trend = 0.023) and systolic BP (SBP; p-trend = 0.043) in postmenopausal women. Mediation analysis showed that the intake of fermented soy products had total and direct effects on SBP; however, there was no indirect effect because soy nutrients, such as protein, fiber, calcium, and potassium, had no significant effects on SBP. Among men, fermented soy product intake was not associated with hypertension risk and BP. Additionally, the intake of sodium from fermented soy products was not significantly associated with hypertension risk and BP in both postmenopausal women and men. This study suggests that hypertension risk and BP were not associated with the intake of sodium from fermented soy products; further, hypertension risk and BP were inversely associated with fermented soy product intake in postmenopausal women. Further clinical studies are needed to confirm the effect of fermented soy product intake on hypertension risk and BP.

Objectives Sodium is known to positively relate with hypertension risk; however, the association of fermented soy products, a major source of salt in Korea, with hypertension risk and blood pressure (BP) has not been reported. The present study aimed to investigate the hypothesis that hypertension risk and BP were inversely associated with the intake of fermented soy products but not with the intake of sodium from fermented soy products. Methods This cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey (2013–2018). In total, 11,566 men and postmenopausal women aged ≥50 years were divided according to quintiles of sodium or fermented soy product intake. Results In multivariable adjusted models, the intake of fermented soy products was negatively associated with hypertension risk (odds ratio: 0.81, 95% confidence interval: 0.66–0.98; p-trend = 0.023) and systolic BP (SBP; p-trend = 0.043) in postmenopausal women. Mediation analysis showed significant total and direct effects between the intake of fermented soy products and SBP; however, there was no indirect effect because soy nutrients, such as protein, fiber, calcium, and potassium, had no significant effects on SBP. Among men, fermented soy product intake was not associated with hypertension risk and BP. Additionally, the intake of sodium from fermented soy products was not significantly associated with hypertension risk and BP in both postmenopausal women and men. Conclusions This study suggested that hypertension risk and BP were not associated with the intake of sodium from fermented soy products; further, hypertension risk and BP were inversely associated with fermented soy product intake in postmenopausal women. Further clinical studies are needed to confirm the effect of fermented soy product intake on hypertension risk and BP. Funding Sources This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT).