Salt and high blood pressure

2009 ◽  
Vol 117 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Sailesh Mohan ◽  
Norm R. C. Campbell
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
High Blood Pressure ◽  
Intervention Studies ◽  
Salt Intake ◽  
Dietary Sodium ◽  
World Health ◽  
Dietary Salt ◽  
Salt Reduction ◽  
The World

HBP (high blood pressure) is the leading risk of death in the world. Unfortunately around the world, blood pressure levels are predicted to become even higher, especially in developing countries. High dietary salt is an important contributor to increased blood pressure. The present review evaluates the association between excess dietary salt intake and the importance of a population-based strategy to lower dietary salt, and also highlights some salt-reduction strategies from selected countries. Evidence from diverse sources spanning animal, epidemiology and human intervention studies demonstrate the association between salt intake and HBP. Furthermore, animal studies indicate that short-term interventions in humans may underestimate the health risks associated with high dietary sodium. Recent intervention studies have found decreases in cardiovascular events following reductions in dietary sodium. Salt intake is high in most countries and, therefore, strategies to lower salt intake could be an effective means to reduce the increasing burden of HBP and the associated cardiovascular disease. Effective collaborative partnerships between governments, the food industry, scientific organizations and healthcare organizations are essential to achieve the WHO (World Health Organization)-recommended population-wide decrease in salt consumption to less than 5 g/day. In the milieu of increasing cardiovascular disease worldwide, particularly in resource-constrained low- and middle-income countries, salt reduction is one of the most cost-effective strategies to combat the epidemic of HBP, associated cardiovascular disease and improve population health.

Sodium and potassium intake, blood pressure, and cardiovascular prevention

ESC CardioMed ◽  
2018 ◽  
pp. 2431-2444
Author(s):  
Francesco P. Cappuccio
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
World Health Organization ◽  
Salt Intake ◽  
World Health ◽  
Salt Reduction ◽  
Potassium Intake ◽  
Salt Consumption ◽  
The World ◽  
Health Organization

Salt consumption is now much greater than needed for survival. High salt intake increases blood pressure in both animals and humans. Conversely, a reduction in salt intake causes a dose-dependent reduction in blood pressure in men and women of all ages and ethnic groups, and in patients already on medication. The risk of strokes and heart attacks rises with increasing blood pressure, but can be decreased by antihypertensive drugs. However, most cardiovascular disease events occur in individuals with ‘normal’ blood pressure levels. Non-pharmacological prevention is therefore the only option to reduce such events. Reduction in population salt intake reduces the number of vascular events. It is one of the most important public health measures to reduce the global cardiovascular burden. Salt reduction policies are powerful, rapid, equitable, and cost saving. The World Health Organization recommends reducing salt consumption below 5 g per day aiming at a global 30% reduction by 2025. A high potassium intake lowers blood pressure in people with and without hypertension. Its beneficial effects extend beyond blood pressure, and may include a reduction in the risk of stroke (independent of blood pressure changes). Potassium intake in the Western world is relatively low, and a lower potassium intake is associated with increased risks of cardiovascular disease, especially stroke. A moderate increase in potassium intake, either as supplement or with diet, reduces blood pressure, and the World Health Organization has issued global recommendations for a target dietary potassium intake of at least 90 mmol/day (≥3510 mg/day) for adults.

scholarly journals The Salt Swap intervention to reduce salt intake in people with high blood pressure: protocol for a feasibility randomised controlled trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Sarah Payne Riches ◽  
Carmen Piernas ◽  
Paul Aveyard ◽  
James P. Sheppard ◽  
Mike Rayner ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Randomised Controlled Trial ◽  
High Blood Pressure ◽  
Salt Intake ◽  
Controlled Trial ◽  
Behavioural Change ◽  
Dietary Salt ◽  
Salt Reduction ◽  
Dietary Salt Intake ◽  
Randomised Controlled

Abstract Background High salt intake is a risk factor for hypertension and cardiovascular disease. Reducing salt intake has been shown to reduce blood pressure. Despite population-level interventions, including product reformulation and public awareness campaigns, adult salt consumption in the UK still exceeds recommendations; this is primarily due to salt consumed in processed and pre-packaged foods. Moderate or high-intensity dietary advice to encourage individuals to reduce their salt intake has been shown to be effective at reducing blood pressure, but evidence of the effectiveness of interventions that are suitable for delivery at scale in routine primary care is scarce. This feasibility trial investigates a complex behavioural change intervention to reduce dietary salt intake and blood pressure by encouraging individuals to purchase lower-salt foods when grocery shopping. Methods This randomised controlled trial will test the feasibility of a novel intervention to reduce salt intake, and the trial procedures to assess its effectiveness. We will recruit participants through UK general practices and randomise 40 participants with high blood pressure, in a 2:1 allocation to receive either the Salt Swap intervention or a control information leaflet. The primary outcomes relate to the criteria for progression to a large-scale trial. These include follow-up rates at 6 weeks, fidelity of intervention delivery and use of the intervention mobile app. Secondary outcomes include the effect of the intervention on the salt content of purchased foods (grams per 100 g), urinary sodium excretion assessed through 24-hour urine samples and blood pressure. Trial process measures will be collected and qualitative assessment will provide insights into participant engagement with the intervention content and perceived barriers to and facilitators of salt reduction dietary behavioural change. Discussion If the outcomes indicate the trial is feasible and there is evidence that behavioural change may result in salt reduction, we will proceed to a definitive trial to test the effectiveness of the intervention to lower blood pressure. If successful, this intervention approach could be applied not only to people with high blood pressure, but also to the wider population with normal blood pressure in whom dietary salt intake exceeds recommendations. Trial registration ISRCTN, 20910962. Registered on 5 April 2017.

scholarly journals Salt: Should I Cut Back?

EDIS ◽  
2018 ◽  
Vol 2018 (4) ◽  
Author(s):  
Asmaa Fatani ◽  
Nancy J. Gal ◽  
Wendy Dahl
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Health Effects ◽  
Blood Volume ◽  
High Blood Pressure ◽  
Fluid Balance ◽  
Sodium Intake ◽  
Good Health ◽  
Dietary Sodium ◽  
Dietary Salt

Dietary salt is made up of sodium and chloride, two essential minerals necessary for good health. Sodium is very important for our body to maintain fluid balance, blood volume, and blood pressure. However, many people consume more dietary sodium (from salt) than needed. Decreasing dietary sodium has received a lot of attention in recent years due to its association with high blood pressure (hypertension) and cardiovascular disease (Kloss, Meyer, Graeve, & Vetter, 2015). This publication explore ways to decrease sodium intake and the health effects of inadequate and excessive sodium intakes.

scholarly journals Salt and cardiovascular disease in PURE: A large sample size cannot make up for erroneous estimations

2018 ◽  
Vol 19 (4) ◽  
pp. 147032031881001 ◽  
Author(s):  
Monique Tan ◽  
Feng J He ◽  
Graham A MacGregor
Keyword(s):  
Cardiovascular Disease ◽  
Salt Intake ◽  
Total Mortality ◽  
World Health ◽  
Large Sample Size ◽  
Salt Reduction ◽  
Spot Urine ◽  
Urban Rural ◽  
Methodological Problems

The latest Prospective Urban Rural Epidemiology (PURE) study claims that salt reduction should be confined to settings where its intake exceeds 12.7 g/day and that eating less than 11.1 g/day of salt could increase cardiovascular risk. More specifically, Mente et al. suggested that (a) salt intake was positively associated with stroke only when it exceeded 12.7 g/day, (b) salt intake was inversely associated with myocardial infarction and total mortality, and (c) these associations were largely independent of blood pressure. These provocative findings challenge the robust evidence on the role of salt reduction in the prevention of cardiovascular disease and call into question the World Health Organization’s global recommendation to reduce salt intake to less than 5 g/day. However, Mente et al.’s re-analysis of the PURE data has several severe methodological problems, including erroneous estimations of salt intake from a single spot urine using the problematic Kawasaki formula. As such, these implausible results cannot be used to refute the strong evidence supporting the benefits of salt reduction for the general population worldwide.

scholarly journals Sodium Intake and Hypertension

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1970 ◽  
Author(s):  
Grillo ◽  
Salvi ◽  
Coruzzi ◽  
Salvi ◽  
Parati
Keyword(s):  
Blood Pressure ◽  
Salt Intake ◽  
Sodium Intake ◽  
Peripheral Resistance ◽  
Dietary Sodium ◽  
Dietary Salt ◽  
High Sodium ◽  
Close Relationship ◽  
And Function ◽  
Modest Reduction

The close relationship between hypertension and dietary sodium intake is widely recognized and supported by several studies. A reduction in dietary sodium not only decreases the blood pressure and the incidence of hypertension, but is also associated with a reduction in morbidity and mortality from cardiovascular diseases. Prolonged modest reduction in salt intake induces a relevant fall in blood pressure in both hypertensive and normotensive individuals, irrespective of sex and ethnic group, with larger falls in systolic blood pressure for larger reductions in dietary salt. The high sodium intake and the increase in blood pressure levels are related to water retention, increase in systemic peripheral resistance, alterations in the endothelial function, changes in the structure and function of large elastic arteries, modification in sympathetic activity, and in the autonomic neuronal modulation of the cardiovascular system. In this review, we have focused on the effects of sodium intake on vascular hemodynamics and their implication in the pathogenesis of hypertension.

scholarly journals Salt and potassium intake among adult Ghanaians: WHO-SAGE Ghana Wave 3

BMC Nutrition ◽  
2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Elias K. Menyanu ◽  
Barbara Corso ◽  
Nadia Minicuci ◽  
Ilaria Rocco ◽  
Joanna Russell ◽  
...  
Keyword(s):  
Salt Intake ◽  
Population Based ◽  
Dietary Sodium ◽  
World Health ◽  
Adult Health ◽  
Salt Reduction ◽  
Hypertension Prevalence ◽  
Salt Consumption ◽  
Consumption Data

Abstract Though Ghana has high hypertension prevalence, the country lacks current national salt consumption data required to build and enhance advocacy for salt reduction. We explored the characteristics of a randomly selected sub sample that had valid urine collection, along with matched survey, anthropometric and BP data (n = 839, mean age = 60y), from the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE), Ghana Wave 3, n = 3053). We also investigated the relationship between salt intake and blood pressure (BP) among the cohort. BP was measured in triplicate and 24 h urine was collected for the determination of urinary sodium (Na), potassium (K), creatinine (Cr) and iodine levels. Hypertension prevalence was 44.3%. Median salt intake was 8.3 g/day, higher in women compared to men (8.6, interquartile range (IQR) 7.5 g/day vs 7.5, IQR 7.4 g/day, p <  0.01), younger participants (18–49 y) compared to older ones (50+ y) (9.7, IQR 7.9 g/day vs 8.1, IQR 7.1 g/day, p <  0.01) and those with higher Body Mass Index (BMI) (> 30 kg/m2) compared to a healthy BMI (18.5–24.9 kg/m2) (10.04, IQR 5.1 g/day vs 6.2, IQR 5.6 g/day, p <  0.01). More than three quarters (77%, n = 647) of participants had salt intakes above the WHO maximum recommendation of 5 g/d, and nearly two thirds (65%, n = 548) had daily K intakes below the recommended level of 90 mmol. Dietary sodium to potassium (Na: K) ratios above 2 mmol/mmol were positively associated with increasing BP with age. Population-based interventions to reduce salt intake and increase K consumption are needed.

P1691Impact of dose and duration of dietary salt reduction on blood pressure levels: systematic review and meta-analysis of randomised trials

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Huang ◽  
K Trieu ◽  
S Yoshimura ◽  
M Woodward ◽  
N Campbell ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Sodium Excretion ◽  
Salt Intake ◽  
Meta Analysis ◽  
Dietary Salt ◽  
Baseline Blood Pressure ◽  
Salt Reduction ◽  
The Impact

Abstract Background Authoritative medical and public health agencies in most countries advise to reduce population dietary salt intake to under 5–6 g/day as a strategy for preventing high blood pressure and cardiovascular disease. However, there is still dispute about whether salt reduction should be adopted by all populations. In addition, the effect of duration of dietary salt reduction has not been sufficiently investigated. Purpose To understand the effect of dietary salt reduction on blood pressure and the impact of intervention duration. Methods A systematic review and meta-analysis was conducted. Randomized controlled trials that allocated participants to low and high salt intake, without confounding from unequal concomitant interventions, were included. We excluded studies done in individuals younger than 18 years, pregnant women, individuals with renal disease or heart failure, and studies with sodium excretion estimated from spot urine. Random effect meta-analysis was used to generate pooled estimates of the effect on 24-hour urinary sodium excretion, systolic and diastolic blood pressure. Multivariate meta-regression was used to quantify the dose response effect of dietary salt on blood pressure change and to understand the impact of the intervention duration. Results 125 studies were included with 162 data points extracted. Ninety-nine data points (61%) had interventions under 4 weeks. Overall, 24-hour urinary sodium excretion changed by −141 mmol (95% CI: −156; −126), systolic blood pressure changed by −4.4 mm Hg (95% CI: −5.2; −3.7) and diastolic blood pressure changed by −2.4 mm Hg (95% CI: −2.9; −1.9). Sodium reduction resulted in a significant decrease of systolic blood pressure in all subgroups except in participants with low baseline sodium intake (<109 mmol) (Figure 1). Each 100 mmol reduction of sodium was associated with 2.7 mm Hg (95% CI: 1.0; 4.4; p=0.002) reduction of systolic blood pressure and 1.2 mm Hg (95% CI: 0.0; 2.4; p=0.046) reduction of diastolic blood pressure after adjusting for intervention duration, age, sex, race, baseline blood pressure, baseline sodium intake and interaction between age and baseline blood pressure. For the same amount of salt reduction, a 10 mm Hg higher baseline systolic blood pressure would result in 2.5 mm Hg greater reduction of systolic blood pressure. There is not enough evidence to show the impact of intervention duration. Figure 1 Conclusions Our meta-analysis showed that sodium reduction could reduce blood pressure in all adult populations regardless of age, sex and race. The effect of salt reduction on systolic blood pressure increases with higher baseline blood pressure. Further studies, designed to investigate the impact of intervention duration, are needed to understand the significance of the duration. Acknowledgement/Funding None

scholarly journals Barriers of dietary salt reduction among hypertensive patients: a cross sectional study

2020 ◽  
Vol 7 (9) ◽  
pp. 3459
Author(s):  
Mariyam Khwaja
Keyword(s):  
Blood Pressure ◽  
Salt Intake ◽  
Lifestyle Modification ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Dietary Salt ◽  
Cross Sectional ◽  
Salt Reduction ◽  
Hypertensive Patients ◽  
Dietary Salt Intake

Background: Healthy dietary practice is an important lifestyle modification and one of the key adjuncts to pharmacotherapy in management of hypertension. A modest reduction in salt intake of 5 gm/day lowered blood pressure by 7/4 mmHg diastolic in hypertensive patients. Despite knowledge about the ill consequences, many people continue to consume high levels of salt in their diet. To motivate people to reduce salt in their diet, a solid understanding of barriers encountered by those under salt reduction recommendation is necessary. Hence, this study was conducted with the aim of identifying the barriers to dietary salt reduction among hypertensive patients.Methods: A community based cross sectional study was conducted on a sample of 356 hypertensive patients in field practice areas (urban and rural) in Department of Community Medicine, JNMC, AMU, Aligarh. A pretested semi-structured questionnaire was used for the study. Compliance to dietary salt intake was assessed by calculating average salt intake per person per day. The tenets of health belief model were used to examine the key determinants of human behavior. Analysis was done by using correlation, proportions, chi-square and multiple linear regression.Results: 31.4% of the participants took salt <5 gm per day. A significant association was noticed with area, religion, social class, family size, perceived benefits and perceived susceptibility. A significant positive correlation was seen with total adherence score and family size.Conclusions: A lot of barriers hinder the compliance to dietary salt reduction. Health Education stressing the role of salt reduction in control of blood pressure is recommended.

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