P4540Obesity in patients with heart failure and without diabetes mellitus is associated with longer event-free survival only among those with high dietary sodium intake

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Z Saleh ◽  
T Lennie ◽  
D Moser
Keyword(s):  
Diabetes Mellitus ◽  
Sodium Intake ◽  
Dietary Sodium ◽  
Obese Patients ◽  
Event Free Survival ◽  
Free Survival ◽  
High Sodium ◽  
High Sodium Intake ◽  
Low Sodium ◽  
Patients With Heart Failure

Abstract Background Obesity is paradoxically associated with better short- and long-term outcomes in patients with heart failure (HF) and without diabetes mellitus (DM). While excessive dietary sodium intake is common among obese persons, its impact on the association between obesity and outcomes has not been considered. Aim To determine whether dietary sodium intake levels would affect the association between obesity and better outcomes in patients with HF and without DM. Method A sample of 129 patients (age 60±12.4 years; 30% female) provided a single 24-hour urine collection sample to estimate dietary sodium intake. Patients were divided into 4 groups based on body mass index (BMI) and the sodium intake recommendation for HF of 3g/day (obese with high sodium intake [n=41; 32%], obese with low sodium intake [n=16; 12%], non-obese with high sodium intake [n=35; 27%], and non-obese with low sodium intake [n=37; 29%]). Patients were followed-up during an average period of 395 days to determine time to first event of all-cause hospitalization or death. Cox regression was used to determine the association between obesity and outcomes in the context of sodium intake after controlling for age, gender, NYHA class (I II vs. III IV) and LVEF. Results There were 41 patients (31.8%) who had an event of all-cause hospitalization or death. Obese patients with high sodium intake had 61% lower risk for events than those non-obese with low dietary sodium intake (figure). There were no differences in the event-free survival among other groups. Conclusion These data suggest that dietary sodium intake may be particularly important for obese patients with HF and without DM.

Abstract 4607: Lycopene Intake Predicts Event-Free Survival in Patients with Heart Failure

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Martha J Biddle ◽  
Seongkum Heo ◽  
Eun Kyeung Song ◽  
Terry A Lennie ◽  
Sandi Dunbar ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cox Regression ◽  
Sodium Intake ◽  
Dietary Sodium ◽  
Event Free Survival ◽  
Nutrient Analysis ◽  
Substantial Impact ◽  
Free Survival ◽  
High Sodium ◽  
Positive Effects

Background: Higher intake of the dietary carotenoid lycopene may be beneficial for heart disease. A main source of lycopene is processed tomato products, which are high in sodium. Increased dietary sodium intake is a primary reason for heart failure (HF) exacerbation and may counter the positive effects of lycopene. Purpose: To determine whether lycopene intake stratified by sodium intake predicts event-free survival. Methods: Detailed 4-day food diaries were kept by 149 HF pts (age 60 ± 12, 38% female). A registered dietitian reviewed the diaries with pt to verify serving sizes and preparation methods. Nutrient analysis was performed using Nutrition Data System software ™ . Pts were stratified into 2 groups by sodium intake based on the median of 2913 mg. Outcomes were then compared in these strata by 2 groups of lycopene intake formed by the median intake of the sample (2624 mcg). Kaplan Meier and Cox regression survival techniques were used to detect differences in event-free survival (survival free of HF or cardiac hospitalization) between lycopene groups in the 2 sodium strata. Results: High lycopene compared to low lycopene intake was associated with greater event free survival. (p=.012, figure ). This finding held in both sodium strata, although the best event-free survival was in the high lycopene group with the low sodium intake (p=.019). High lycopene intake was a predictor of event-free survival after controlling for age, gender, NYHA and EF (p=.014). Conclusion: These findings suggest the naturally occurring antioxidant lycopene has the potential for substantial impact on event free survival rates in HF pts, but its positive effect is attenuated by high sodium intake.

Dietary sodium affects systemic and renal hemodynamic response to NO inhibition in healthy humans

1998 ◽  
Vol 274 (5) ◽  
pp. F914-F923 ◽  
Author(s):  
J. N. Bech ◽  
C. B. Nielsen ◽  
P. Ivarsen ◽  
K. T. Jensen ◽  
E. B. Pedersen
Keyword(s):  
Sodium Excretion ◽  
Sodium Intake ◽  
Renal Hemodynamics ◽  
Dietary Sodium ◽  
High Sodium ◽  
High Sodium Intake ◽  
Healthy Humans ◽  
Low Sodium ◽  
Arterial Blood ◽  
Relative Decrease

Animal studies have indicated that increased nitric oxide (NO) synthesis plays a significant role in the renal adaptation to increased sodium intake. To investigate the role of NO during increased sodium intake in humans, we studied the effect of acute, systemic injection of N G-monomethyl-l-arginine (l-NMMA) on renal hemodynamics [glomerular filtration rate and renal plasma flow (GFR and RPF, respectively)], urinary sodium excretion (FENa), systemic hemodynamics [mean arterial blood pressure and heart rate (MAP and HR)], and plasma levels of several vasoactive hormones in 12 healthy subjects during high (250 mmol/day) and low (77 mmol/day) sodium intake in a crossover design. The sodium diets were administered for 5 days before the l-NMMA treatments, in randomized order, with a washout period of 9 days between each diet and l-NMMA treatment. GFR and RPF were measured using the renal clearance of51Cr-labeled EDTA and125I-labeled hippuran by the constant infusion technique in clearance periods of 30-min duration. Two baseline periods were obtained, after whichl-NMMA was given (3 mg/kg over 10 min), and the effect of treatment was followed over the next five clearance periods. During high sodium intake,l-NMMA induced a more pronounced relative decrease in RPF ( P = 0.0417, ANOVA), a more pronounced relative decrease in FENa( P = 0.0032, ANOVA), and a more pronounced relative increase in MAP ( P= 0.0231, ANOVA). During low sodium intake, the effect ofl-NMMA on FENa was abolished. During low sodium intake, l-NMMA induced a sustained drop in plasma renin (31 ± 5 vs. 25 ± 5 μU/ml, P < 0.001), which was not seen during high sodium intake. The data indicate that increased production of NO is an important part of the adaptation to increased dietary sodium intake in healthy humans, with respect to renal hemodynamics, sodium excretion, and the secretion of renin.

scholarly journals Kir4.1/Kir5.1 Activity Is Essential for Dietary Sodium Intake–Induced Modulation of Na-Cl Cotransporter

2018 ◽  
Vol 30 (2) ◽  
pp. 216-227 ◽  
Author(s):  
Peng Wu ◽  
Zhong-Xiuzi Gao ◽  
Xiao-Tong Su ◽  
Ming-Xiao Wang ◽  
Wen-Hui Wang ◽  
...  
Keyword(s):  
Potassium Channel ◽  
Knockout Mice ◽  
Sodium Intake ◽  
Dietary Sodium ◽  
Wild Type ◽  
High Sodium ◽  
High Sodium Intake ◽  
Low Sodium ◽  
Inwardly Rectifying Potassium Channel ◽  
Urinary Potassium

BackgroundDietary sodium intake regulates the thiazide-sensitive Na-Cl cotransporter (NCC) in the distal convoluted tubule (DCT). Whether the basolateral, inwardly rectifying potassium channel Kir4.1/Kir5.1 (a heterotetramer of Kir4.1/Kir5.1) in the DCT is essential for mediating the effect of dietary sodium intake on NCC activity is unknown.MethodsWe used electrophysiology, renal clearance techniques, and immunoblotting to examine effects of Kir4.1/Kir5.1 in the DCT and NCC in wild-type and kidney-specific Kir4.1 knockout mice.ResultsLow sodium intake stimulated basolateral Kir4.1/Kir5.1 activity, increased basolateral K+ conductance, and hyperpolarized the membrane. Conversely, high sodium intake inhibited the potassium channel, decreased basolateral K+ currents, and depolarized the membrane. Low sodium intake increased total and phosphorylated NCC expression and augmented hydrochlorothiazide-induced natriuresis; high sodium intake had opposite effects. Thus, elevated NCC activity induced by low sodium intake was associated with upregulation of Kir4.1/Kir5.1 activity in the DCT, whereas inhibition of NCC activity by high sodium intake was associated with diminished Kir4.1/Kir5.1 activity. In contrast, dietary sodium intake did not affect NCC activity in knockout mice. Further, Kir4.1 deletion not only abolished basolateral K+ conductance and depolarized the DCT membrane, but also abrogated the stimulating effects induced by low sodium intake on basolateral K+ conductance and hyperpolarization. Finally, dietary sodium intake did not alter urinary potassium excretion rate in hypokalemic knockout and wild-type mice.ConclusionsStimulation of Kir4.1/Kir5.1 by low intake of dietary sodium is essential for NCC upregulation, and inhibition of Kir4.1/Kir5.1 induced by high sodium intake is a key step for downregulation of NCC.

scholarly journals Dietary Sodium Intake and Risk of Cardiovascular Disease: A Systematic Review and Dose-Response Meta-Analysis

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2934
Author(s):  
Yi-Jie Wang ◽  
Tzu-Lin Yeh ◽  
Ming-Chieh Shih ◽  
Yu-Kang Tu ◽  
Kuo-Liong Chien
Keyword(s):  
Cardiovascular Disease ◽  
Dose Response ◽  
Disease Risk ◽  
Sodium Intake ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Dietary Sodium ◽  
High Sodium ◽  
High Sodium Intake ◽  
Low Sodium

Dietary sodium intake has received considerable attention as a potential risk factor of cardiovascular disease. However, evidence on the dose-response association between dietary sodium intake and cardiovascular disease risk is unclear. Embase and PubMed were searched from their inception to 17 August 2020 and studies that examined the association between sodium intake and cardiovascular disease in adolescents were not included in this review. We conducted a meta-analysis to estimate the effect of high sodium intake using a random effects model. The Newcastle-Ottawa Scale assessment was performed. A random-effects dose-response model was used to estimate the linear and nonlinear dose-response relationships. Subgroup analyses and meta-regression were conducted to explain the observed heterogeneity. We identified 36 reports, which included a total of 616,905 participants, and 20 of these reports were also used for a dose-response meta-analysis. Compared with individuals with low sodium intake, individuals with high sodium intake had a higher adjusted risk of cardiovascular disease (Rate ratio: 1.19, 95% confidence intervals = 1.08–1.30). Our findings suggest that there is a significant linear relationship between dietary sodium intake and cardiovascular disease risk. The risk of cardiovascular disease increased up to 6% for every 1 g increase in dietary sodium intake. A low-sodium diet should be encouraged and education regarding reduced sodium intake should be provided.

scholarly journals Is socio-demographic status, body mass index, and consumption of food away from home associated with high sodium intake among adults in Malaysia?: findings from the Malaysian Community Salt Survey (MyCoSS)

2021 ◽  
Vol 40 (S1) ◽  
Author(s):  
Ruhaya Salleh ◽  
Shubash Shander Ganapathy ◽  
Norazizah Ibrahim Wong ◽  
Siew Man Cheong ◽  
Mohamad Hasnan Ahmad ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Logistic Regression ◽  
Body Mass ◽  
Sodium Intake ◽  
Daily Intake ◽  
Dietary Sodium ◽  
Cooking Methods ◽  
High Sodium ◽  
High Sodium Intake ◽  
Meal Consumption

Abstract Background Studies have shown that having away from home meals contributes to high sodium intake among young people and those who lived in urban areas. This study aimed to determine the association between dietary sodium intake, body mass index, and away from home meal consumption behaviour among Malaysian adults. Methods MyCoSS was a cross-sectional household survey involving 1440 adults age 18 years and above. This study utilized stratified cluster sampling to obtain a nationally representative sample. Data was collected between October 2017 and March 2018. Socio-demographic information, dietary assessment using food frequency questionnaire (FFQ), and away from home meal consumption were assessed through a face-to-face interview by trained health personnel. Descriptive analysis and logistic regression were applied to identify the association of socioeconomic status and away from home meal consumption with dietary sodium intake. Results A total of 1032 participants completed the FFQ, with a mean age of 48.8 + 15.6 years. Based on the FFQ, slightly over half of the participants (52.1%) had high sodium intake. Results showed that 43.6% of participants consumed at least one to two away from home meals per day, while 20.8% of them had their three main meals away from home. Participants aged less than 30 years old were the strongest predictor to consume more sodium (adjusted OR: 3.83; 95%CI: 2.23, 6.58) while those of Indian ethnicity had significantly lower sodium intake. Surprisingly, having three away from home meals per day was not associated with high dietary sodium intake, although a significant association (crude OR; 1.67, 95% CI: 1.19, 2.35) was found in the simple logistic regression. Obese participants were less likely to have high dietary sodium intake compared with the normal BMI participants in the final model. Conclusion Over half of the participants consumed sodium more than the recommended daily intake, especially those who consumed three away from home meals. However, there was no significant association between high sodium intake and having three away from home meals per day. The promotion of healthy cooking methods among the public must continue to be emphasized to reduce the dietary sodium intake among Malaysian adults.

scholarly journals Sodium Sensitivity, Sodium Resistance, and Incidence of Hypertension

Hypertension ◽  
2021 ◽  
Author(s):  
Jiang He ◽  
Jian-Feng Huang ◽  
Changwei Li ◽  
Jing Chen ◽  
Xiangfeng Lu ◽  
...  
Keyword(s):  
Sodium Intake ◽  
Experimental Studies ◽  
Dietary Sodium ◽  
Cross Sectional ◽  
Incident Hypertension ◽  
High Sodium ◽  
Sodium Sensitivity ◽  
Sodium Diet ◽  
Low Sodium ◽  
Increased Risk

Cross-sectional studies have reported that high sodium sensitivity is more common among individuals with hypertension. Experimental studies have also reported various animal models with sodium-resistant hypertension. It is unknown, however, whether sodium sensitivity and resistance precede the development of hypertension. We conducted a feeding study, including a 7-day low-sodium diet (1180 mg/day) followed by a 7-day high-sodium diet (7081 mg/day), among 1718 Chinese adults with blood pressure (BP) <140/90 mm Hg. We longitudinally followed them over an average of 7.4 years. Three BP measurements and 24-hour urinary sodium excretion were obtained on each of 3 days during baseline observation, low-sodium and high-sodium interventions, and 2 follow-up studies. Three trajectories of BP responses to dietary sodium intake were identified using latent trajectory analysis. Mean (SD) changes in systolic BP were −13.7 (5.5), −4.9 (3.0), and 2.4 (3.0) mm Hg during the low-sodium intervention and 11.2 (5.3), 4.4 (4.1), and −0.2 (4.1) mm Hg during the high-sodium intervention ( P <0.001 for group differences) in high sodium-sensitive, moderate sodium-sensitive, and sodium-resistant groups, respectively. Compared with individuals with moderate sodium sensitivity, multiple-adjusted odds ratios (95% CIs) for incident hypertension were 1.43 (1.03–1.98) for those with high sodium sensitivity and 1.43 (1.03–1.99) for those with sodium resistance ( P =0.006 for nonlinear trend). Furthermore, a J-shaped association between systolic BP responses to sodium intake and incident hypertension was identified ( P <0.001). Similar results were observed for diastolic BP. Our study indicates that individuals with either high sodium sensitivity or sodium resistance are at an increased risk for developing hypertension.

scholarly journals Evidence related to sodium restriction in patients with heart failure

2020 ◽  
Vol 73 (4) ◽  
Author(s):  
Mailson Marques de Sousa ◽  
Bernadete de Lourdes André Gouveia ◽  
Taciana da Costa Farias Almeida ◽  
Maria Eliane Moreira Freire ◽  
Francisco de Assis Brito Pereira de Melo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sodium Intake ◽  
Main Tool ◽  
Dietary Sodium ◽  
Protective Measure ◽  
Sodium Restriction ◽  
Low Sodium Diet ◽  
Low Sodium ◽  
Asymptomatic Patients ◽  
Patients With Heart Failure

ABSTRACT Objectives: to analyze the scientific production about sodium restriction in patients with heart failure. Methods: integrative literature review from articles published from 2007 to 2017, located in the CINAHL and Scopus databases. Results: thirteen studies were analyzed. Sodium intake restriction was associated with lower unfavorable clinical outcomes in patients with marked symptomatology. The 24-hour urine sodium dosage was the main tool to assess adherence to the low sodium diet. Conclusions: based on the studies included in this review, in symptomatic patients, dietary sodium restriction should be encouraged in clinical practice as a protective measure for health. However, in asymptomatic patients, it should be well studied.

Abstract MP64: High Sodium Intake is Associated with Short Leukocyte Telomere Length in Overweight and Obese Adolescents

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Haidong Zhu ◽  
Jigar Bhagatwala ◽  
Norman Pollock ◽  
Bernard Gutin ◽  
Jeffrey Thomas ◽  
...  
Keyword(s):  
Physical Activity ◽  
Telomere Length ◽  
Weight Status ◽  
Sodium Intake ◽  
Vigorous Physical Activity ◽  
Cellular Aging ◽  
Dietary Sodium ◽  
Leukocyte Telomere Length ◽  
High Sodium ◽  
High Sodium Intake

Introduction: The aging process in children and adolescents is accelerated resulting in the premature development of “adult” diseases such as hypertension and diabetes. Telomere shortening plays a key role in human aging; identifying factors that regulate this process is important for developing effective lifestyle interventions so as to prevent and treat age-associated diseases. In vitro and in vivo studies demonstrate that high salt content markedly decreases life span, and accelerates cellular aging through increased DNA breakage. However, the effect of high salt diet on telomere length, a marker of biological aging, remains unknown. Therefore, we aimed to test the hypothesis that high dietary sodium intake is inversely associated with leukocyte telomere length, especially in the context of obesity. Methods: Leukocyte telomere length (T/S ratio) was assessed by a quantitative polymerase chain reaction method in 766 adolescents aged 14-18 years (50% female, 49% African Americans). Diet was assessed with three to seven 24-h recalls, and physical activity was determined by accelerometry. Participants were classified according to low vs. high sodium intake (below or above the median), and according to weight status (normal vs. overweight/obese). Analysis of covariance and linear regression analyses were used to determine the effects of sodium intake and weight status on leukocyte telomere length. Results: After controlling for age, sex, race, energy intake, Tanner stage, and vigorous physical activity, a statistically significant sodium intake by weight status interaction was observed, such that leukocyte telomere length was significantly shorter in the high sodium intake vs. low sodium intake subjects from the overweight/obese group (1.24 ± 0.22 vs. 1.32 ± 0.21, p=0.02), but not the normal weight group (1.29 ± 0.24 vs. 1.30 ± 0.24, p=0.69). Consistent with the low vs. high sodium intake group data, multiple linear regression analyses, adjusting for age, sex, race, energy intake, Tanner stage and vigorous physical activity, revealed that higher dietary sodium intake was associated with shorter leukocyte telomere length in the overweight/obese group (β=-0.37, p=.045), but not the normal weight group. Conclusion: High dietary sodium intake is associated with shorter telomere length in overweight and obese adolescents suggesting that high sodium intake and obesity may act synergistically to accelerate cellular aging. Longitudinal studies are warranted to determine the synergistic effect of high sodium intake and obesity on telomere shortening over time.

Dietary sodium intake modulates renal excretory responses to intrarenal angiotensin (1–7) administration in anesthetized rats

2013 ◽  
Vol 304 (3) ◽  
pp. R260-R266 ◽  
Author(s):  
Julie O'Neill ◽  
Alan Corbett ◽  
Edward J. Johns
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Sodium Intake ◽  
Dietary Sodium ◽  
High Sodium ◽  
Sodium Diet ◽  
Low Sodium Diet ◽  
Low Sodium ◽  
Renal Hemodynamic

Angiotensin II at the kidney regulates renal hemodynamic and excretory function, but the actions of an alternative metabolite, angiotensin (1–7), are less clear. This study investigated how manipulation of dietary sodium intake influenced the renal hemodynamic and excretory responses to intrarenal administration of angiotensin (1–7). Renal interstitial infusion of angiotensin (1–7) in anesthetized rats fed a normal salt intake had minimal effects on glomerular filtration rate but caused dose-related increases in urine flow and absolute and fractional sodium excretions ranging from 150 to 200%. In rats maintained for 2 wk on a low-sodium diet angiotensin (1–7) increased glomerular filtration rate by some 45%, but the diuretic and natriuretic responses were enhanced compared with those in rats on a normal sodium intake. By contrast, renal interstitial infusion of angiotensin (1–7) in rats maintained on a high-sodium intake had no effect on glomerular filtration rate, whereas the diuresis and natriuresis was markedly attenuated compared with those in rats fed either a normal or low-sodium diet. Plasma renin and angiotensin (1–7) were highest in the rats on the low-sodium diet and depressed in the rats on a high-sodium diet. These findings demonstrate that the renal hemodynamic and excretory responses to locally administered angiotensin (1–7) is dependent on the level of sodium intake and indirectly on the degree of activation of the renin-angiotensin system. The exact way in which angiotensin (1–7) exerts its effects may be dependent on the prevailing levels of angiotensin II and its receptor expression.

Effects of Sodium Status on the Venous Response to Noradrenaline Infusion in Pre-Ascitic Cirrhosis

1995 ◽  
Vol 88 (5) ◽  
pp. 525-531 ◽  
Author(s):  
Florence Wong ◽  
Arieh Bomzon ◽  
Alexander Logan ◽  
Laurence Blendis
Keyword(s):  
Sodium Intake ◽  
High Sodium ◽  
Sodium Diet ◽  
High Sodium Intake ◽  
Control Subjects ◽  
Low Sodium ◽  
Dorsal Hand ◽  
Hand Vein ◽  
Cirrhotic Patients ◽  
Dorsal Hand Vein

1. This study assesses the effects of sodium status on venous responsiveness to noradrenaline and the neurohumoral profile in pre-ascitic cirrhotic patients. Eight cirrhotic patients and ten control subjects were studied after both a low (20 mmol/day) and a high (200 mmol/day) sodium diet. Venous responsiveness to increasing doses of noradrenaline in a dorsal hand vein and various plasma hormone levels were measured. Maximal response (Rmax.) and the dose of noradrenaline that yielded 50% of Rmax (ED50) were then calculated. 2. A significantly smaller dorsal hand vein diameter was observed in the control subjects on a low sodium (2.23 ± 0.14 mm) compared with a high sodium (2.57 ± 0.15 mm; P = 0.04) diet, but not in the cirrhotic patients. Rmax. was not significantly different in either group on both diets. With low sodium intake, ED50 was similar in the two groups. However, on high sodium intake, control subjects had a significantly higher ED50 (34.4 ± 7.4 ng/min) than the cirrhotic patients (5.03 ± 0.86 ng/min; P < 0.003). Plasma noradrenaline in the control subjects fell significantly with the change from a low (1.29 ± 0.11 nmol/l) to a high (0.68 ± 0.09 nmol/l; P < 0.001) sodium diet, but remained elevated in the cirrhotic patients. Cirrhotic patients had significantly higher atrial natriuretic factor levels and lower plasma renin activity than the control subjects on both diets. 3. In conclusion, pre-ascitic cirrhotic patients show no evidence of venodilatation. Their sympathetic nervous activity is not suppressible by volume expansion. Relative hyper-responsiveness of the peripheral venous circulation to adrenergic stimulation with high sodium intake is present.

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