Knowledge, attitude and behaviour on salt intake and its association with hypertension in the Malaysian population: findings from MyCoSS (Malaysian Community Salt Survey)

Abstract Background High blood pressure or hypertension has become one of the main health problems, worldwide. A number of studies have proven that an increased intake of salt was related to an increased prevalence of cardiovascular diseases. Of late, its relationship with high salt intake has received a lot of attention. Studies in Malaysia have shown both rising hypertension over time as well as high salt consumption. Actions to reduce salt intake are essential to reduce hypertension and its disease burden. As such, we carried out a study to determine associations between knowledge, attitude and behaviour towards salt intake and hypertension among the Malaysian population. Methods Data obtained from the Malaysian Community Salt Survey (MyCoSS) was used partially for this study. The survey used a cross-sectional two-stage sampling design to select a nationally representative sample of Malaysian adults aged 18 years and above living in non-institutional living quarters (LQ). Face-to-face interviews were done by trained research assistants (RA) to obtain information on sociodemography, medical report, as well as knowledge, attitude and behaviour of the respondents towards salt intake and blood pressure. Results Majority of the respondents have been diagnosed with hypertension (61.4%) as well as knowledge of the effects of high salt intake on blood pressure (58.8%). More than half of the respondents (53.3%) said they controlled their salt intake on a regular basis. Those who knew that a high salt diet could contribute to a serious health problem (OR=0.23) as well as those who controlled their salt intake (OR=0.44) were significantly less likely to have hypertension. Conclusion Awareness of the effects of sodium on human health, as well as the behaviour of controlling salt intake, is essential towards lowering the prevalence of hypertension among Malaysians.

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Knowledge of Salt intake and Blood Pressure Control among Hypertensive Patients in a Tertiary Hospital

Journal of BioMedical Research and Clinical Practice ◽

10.46912/jbrcp.97 ◽

2019 ◽

Vol 2 (1) ◽

pp. 14-18

Author(s):

A O Adeagbo ◽

O E Omosanya ◽

A O Ayodapo ◽

O T Elegbede ◽

O M Shabi

Keyword(s):

Blood Pressure ◽

Blood Pressure Control ◽

Salt Intake ◽

Daily Intake ◽

Pressure Control ◽

High Salt ◽

Dietary Salt ◽

Cross Sectional ◽

Hypertensive Patients ◽

High Salt Intake

As the prevalence of hypertension increases in adult Nigerians, achieving target blood pressure (BP) control has become an important management challenge. High salt intake is an important risk factor for hypertension and its high intake prevents adequate BP control. This study aims to explore the knowledge of salt intake and blood pressure control among hypertensive patients. Data were collected from a cross-sectional sample involving 564 adult hypertensive patients that were followed for at least 3 months prior to recruitment to this study. Data collection comprised interviewer-administered structured questionnaires about demographics, knowledge and practices related to salt, followed by measurement of blood pressure. A majority (92.9%) of the respondents knew that eating too much salt could affect health and less than one-half (40.1%) actually knew that not more than one teaspoon of salt should be consumed daily. Nearly all respondents (516) knew high BP to be a possible consequence of high salt intake. Among those that took a lot of salty food, 87.7% and 78.5% had high systolic BP and diastolic BP respectively. Although the majority of respondents were knowledgeable about the adverse effects of salt, few knew the daily intake recommended value. The higher the dietary salt intake, the higher the chances of having poor BP control. Increased knowledge about recommended salt intake and individual guidance could be important for reducing salt intake in hypertensive patients.

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Estimation of Salt Intake and its Relation to Knowledge and Attitude Regarding the Dangers of High Salt Intake Among an Urban Omani Population

Sultan Qaboos University Medical Journal [SQUMJ] ◽

10.18295/squmj.9.2021.134 ◽

2021 ◽

Author(s):

Muhammad M Shaikh ◽

Ali HZ Alkhayari ◽

Qusay AK Alabdulsalam ◽

Khamis AlHashmi ◽

Sunil K Nadar

Keyword(s):

Urban Population ◽

Salt Intake ◽

High Salt ◽

Dietary Salt ◽

Cross Sectional ◽

Dietary Salt Intake ◽

Attitudes And Practices ◽

Salt Consumption ◽

Knowledge And Attitudes ◽

High Salt Intake

Objectives: High salt consumption is a major risk factor for hypertension. Studies have shown dietary salt intake to be high in many parts of the world. The aim of this study was to assess the daily salt consumption by the urban population in Oman and to assess their knowledge and attitudes towards dietary salt. Methods: This was a cross-sectional questionnaire-based study conducted between September to December 2017 in Muscat. We used previously validated questionnaires to assess salt intake and the knowledge and attitudes to salt intake. Results: 345 responses were received out of 500 distributed questionnaires (response rate 69%) of which 300 responses (27.88 + 7.9 years, 53.3% male) were included for analysis. 94% of the participants agreed that lowering salt in diet is important and nearly half the participants said that they were taking measures to reduce salt intake. However, the median salt intake was high at 10.5(7.3-15.1) gm salt/day. 90% of those questioned consume more than the maximum recommended amount of salt per day. Salt intake was significantly higher in females and older age group (>40 years of age), There did not appear to be any correlation between awareness of the dangers of salt intake and the amount consumed. Conclusion: The salt intake in our sampled population in Oman is high and does not depend on knowledge. Strategies should be designed to reduce salt intake by health education and increasing knowledge about complications of high salt intake among the urban population. Keywords: dietaray sodium chloride; knowledge attitudes and practices.

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Predictors of hypertension among rural people of western Maharashtra: a multivariate analysis

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20193978 ◽

2019 ◽

Vol 6 (9) ◽

pp. 3825

Author(s):

Anup L. Kharde ◽

Rutuja M. Phulambrikar ◽

Jayant D. Deshpande ◽

Varsha N. Mahavarkar ◽

Amruta A. Kharde

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Family History ◽

Salt Intake ◽

Tertiary Care ◽

Sampling Technique ◽

High Salt ◽

Cross Sectional ◽

High Salt Intake ◽

History Of

Background: Hypertension causes morbidity as well as increases mortality either by acting independently or by affecting multiple organ system. Risk factors of hypertension are categorized as modifiable or non-modifiable risk factors. Early identification of these risk factors is not only essential for prediction of hypertension and but also to reduce effect associated with it.Methods: The present descriptive cross-sectional study was carried out at field practice area of tertiary care teaching hospital of western Maharashtra. Total 1537 sample sized was achieved using systematic random sampling technique. All the village individuals, both male and female, over 18 years of age were included in the study whereas, pregnant women, extremely debilitated persons and subjects who were not willing to give informed consent were excluded. A pre-designed and pre-tested questionnaire was used for data collection.Results: In present study the prevalence of hypertension and pre-hypertension was 11.49% (117). On regression analysis risk factors like age, BMI, high salt intake, family history of blood pressure etc., were found to be associated with hypertension.Conclusions: The present study showed a higher prevalence of both hypertension among the rural population and risk factors such as age, obesity, elite social class, high salt intake, family history of blood pressure were the predictors of the hypertension.

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High salt intake: detrimental not only for blood pressure, but also for bone health?

Endocrine ◽

10.1007/s12020-015-0626-6 ◽

2015 ◽

Vol 49 (3) ◽

pp. 580-582 ◽

Cited By ~ 2

Author(s):

Thomas Remer

Keyword(s):

Blood Pressure ◽

Bone Health ◽

Salt Intake ◽

High Salt ◽

High Salt Intake

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Abstract 142: A Fructose-but Not a Glucose-enriched Diet, Induces a Salt-dependent Increase in Blood Pressure and Enhances NKCC2 Phosphorylation in Normal Rats

Hypertension ◽

10.1161/hyp.66.suppl_1.142 ◽

2015 ◽

Vol 66 (suppl_1) ◽

Author(s):

Keyona N King-Medina ◽

Emily Henson ◽

Pablo Ortiz

Keyword(s):

Blood Pressure ◽

Drinking Water ◽

Salt Intake ◽

Caloric Intake ◽

High Salt ◽

Human Consumption ◽

Thick Ascending Limb ◽

Sprague Dawley ◽

High Fructose ◽

High Salt Intake

Human consumption of fructose as a sweetener has increased in the past 30 years. High fructose intake has been implicated in the development of hypertension, diabetes, and obesity. In the US, the upper 10th percentile of the population consumes up to 40% of their caloric intake from added sugars, in which fructose represents half of these. Fructose metabolism is strikingly different from that of glucose. Yet, the effect of a fructose or glucose-enriched diet in salt handling by the kidney, affecting blood pressure, and its interaction with high salt intake has been poorly studied. In genetic models of salt-sensitive hypertension, the activity of the Na + /K + /2Cl - cotransporter (NKCC2) in the thick ascending limb (TAL) is abnormally enhanced. We hypothesized that chronic fructose in drinking water induces a salt-dependent increase in blood pressure and stimulates NKCC2 during high salt intake in normal rats. Sprague-Dawley rats were given 20% fructose or 20% glucose in drinking water for 1 week after which a high salt (HS) diet (4% Na + in chow) was started for 3 weeks. When we measured systolic blood pressure (SBP) by tail cuff plethysmography in fructose-fed and glucose-fed rats on a HS diet, only the fructose-fed rats had an increased SBP from 120±10 to 132±6 mmHg on day 7 of HS (p<0.01). SBP continued to increase up to 144±18 mmHg after 3 weeks (p<0.01 vs glucose). Fructose or glucose alone did not increase SBP after 4 weeks. We then repeated the protocol using radiotelemetry to monitor the blood pressure (BP). In rats fed fructose, by day 5 of HS the SBP increased by 12±3 mmHg (p<0.02) and SBP remained elevated for 3 weeks (delta: 10±2.5 mmHg, n=3). In rats fed glucose, a HS diet did not significantly change SBP for 3 weeks (n=5). Moreover, NKCC2 activity in the TAL is enhanced by phosphorylation at Thr96, 101. We found that NKCC2 phosphorylation was higher in rats fed fructose plus HS (p<0.02) but not in rats fed glucose plus HS for 3 weeks (HS: 100, fructose+HS: 250±40%, glucose+HS: 95±10%). Therefore, we conclude that a high fructose (but not a glucose) diet in normal rats induces a salt-dependent increase in BP independently from caloric intake. Thus, the increase in BP may in part be due to the stimulation of NKCC2 phosphorylation in the TAL by fructose.

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The Relationship Between Urine Uromodulin and Blood Pressure Changes: The DASH-Sodium Trial

American Journal of Hypertension ◽

10.1093/ajh/hpaa140 ◽

2020 ◽

Author(s):

Christine Y Bakhoum ◽

Cheryl A M Anderson ◽

Stephen P Juraschek ◽

Casey M Rebholz ◽

Lawrence J Appel ◽

...

Keyword(s):

Blood Pressure ◽

Salt Intake ◽

Control Diet ◽

Random Order ◽

High Salt ◽

Thick Ascending Limb ◽

Feeding Period ◽

High Sodium ◽

Sodium Diet ◽

High Salt Intake

Abstract BACKGROUND Uromodulin modulates the sodium-potassium-two-chloride transporter in the thick ascending limb of the loop of Henle, and its overexpression in murine models leads to salt-induced hypertension. We hypothesized that individuals with higher baseline levels of urine uromodulin would have a greater increase in systolic blood pressure (SBP) for the same increase in sodium compared with those with lower uromodulin levels. METHODS We used data from 157 subjects randomized to the control diet of the Dietary Approaches to Stop Hypertension (DASH)-Sodium trial who were assigned to 30 days of low (1,500 mg/d), medium (2,400 mg/d), and high salt (3,300 mg/d) diets in random order. Blood pressure was measured prerandomization and then weekly during each feeding period. We evaluated the association of prerandomization urine uromodulin with change in SBP between diets, as measured at the end of each feeding period, using multivariable linear regression. RESULTS Baseline urine uromodulin stratified by tertiles was ≤17.64, 17.65–31.97, and ≥31.98 µg/ml. Across the tertiles, there were no significant differences in SBP at baseline, nor was there a differential effect of sodium diet on SBP across tertiles (low to high, P = 0.81). After adjusting for age, sex, body mass index, and race, uromodulin levels were not significantly associated with SBP change from low to high sodium diet (P = 0.42). CONCLUSIONS In a randomized trial of different levels of salt intake, higher urine uromodulin levels were not associated with a greater increase in blood pressure in response to high salt intake.

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Relationship Between Salt Intake and Blood Pressure in Hypertensive Patients in Beijing

American Journal of Hypertension ◽

10.1093/ajh/hpaa009 ◽

2020 ◽

Vol 33 (4) ◽

pp. 371-371

Author(s):

Hong-yi Wang ◽

Yong-jie He ◽

Wei Li ◽

Fan Yang ◽

Ning-ling Sun

Keyword(s):

Blood Pressure ◽

Ambulatory Blood Pressure ◽

Salt Intake ◽

Blood Pressure Monitoring ◽

Urinary Sodium Excretion ◽

High Salt ◽

Pressure Monitoring ◽

Hypertensive Patients ◽

High Salt Intake ◽

Tertiary Hospitals

Abstract Background To survey the relationship between salt intake and blood pressure in hypertensive patients in Beijing. Methods A cross-sectional survey was used. Essential hypertensive patients were enrolled and divided into three groups (low, medium, and high salt intake) according to their 24 h urinary sodium excretion, which was used to access the salt intake. Blood pressure was measured through office measurement and ambulatory blood pressure monitoring. Results A total of 2,241 patients were enrolled with a mean age of 59.5 ± 13.8 years, mean blood pressure of 141.1 ± 18.5/84.6 ± 12.7 mm Hg, and urinary sodium excretion of 163.9 (95% CI 160.3–167.4) mmol [equal to salt intake 9.59 (9.38–9.79) g/d]. There were 1,544 cases from tertiary hospitals and the other 697 cases from community hospitals. Patients from community hospitals took more salt than patients from tertiary hospitals. Patients with high salt intake were younger than patients with low and medium salt intake. There were more males in high salt intake group than in the other two groups. Ambulatory blood pressure monitoring showed that patients with high salt intake had higher mean blood pressure not only in daytime, but also at night. The diastolic blood pressure in patients with medium salt intake was higher than that in patients with low salt intake. Conclusions Higher salt intake was associated with higher ambulatory blood pressure in hypertensive patients. More effort should be made to lower salt intake to improve blood pressure control rate.

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High Salt Intake Augments Blood Pressure Responses During Submaximal Aerobic Exercise

Journal of the American Heart Association ◽

10.1161/jaha.120.015633 ◽

2020 ◽

Vol 9 (10) ◽

Cited By ~ 1

Author(s):

Matthew C. Babcock ◽

Austin T. Robinson ◽

Kamila U. Migdal ◽

Joseph C. Watso ◽

Christopher R. Martens ◽

...

Keyword(s):

Blood Pressure ◽

Aerobic Exercise ◽

Salt Intake ◽

High Salt ◽

High Salt Intake ◽

Submaximal Aerobic Exercise ◽

Blood Pressure Responses

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High Salt Intake Increases Copeptin but Salt Sensitivity Is Associated with Fluid Induced Reduction of Copeptin in Women

International Journal of Hypertension ◽

10.1155/2014/641587 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Irina Tasevska ◽

Sofia Enhörning ◽

Philippe Burri ◽

Olle Melander

Keyword(s):

Body Weight ◽

Salt Intake ◽

Salt Sensitivity ◽

High Salt ◽

Dietary Salt ◽

Urinary Volume ◽

Salt Consumption ◽

High Salt Intake ◽

Low Salt ◽

Induced Changes

This study investigated if copeptin is affected by high salt intake and whether any salt-induced changes in copeptin are related to the degree of salt sensitivity. The study was performed on 20 men and 19 women. In addition to meals containing 50 mmol NaCl daily, capsules containing 100 mmol NaCl and corresponding placebo capsules were administered during 4 weeks each, in random order. Measurements of 24 h blood pressure, body weight, 24 h urinary volume, and fasting plasma copeptin were performed at high and low salt consumption. Copeptin increased after a high compared to low dietary salt consumption in all subjects 3,59 ± 2,28 versus 3,12 ± 1,95 (P= 0,02). Copeptin correlated inversely with urinary volume, at both low (r= −0,42;P= 0,001) and high (r= −0,60;P< 0,001) salt consumption, as well as with the change in body weight (r= −0,53;P< 0,001). Systolic salt sensitivity was inversely correlated with salt-induced changes of copeptin, only in females (r= −0,58;P= 0,017). As suppression of copeptin on high versus low salt intake was associated with systolic salt sensitivity in women, our data suggest that high fluid intake and fluid retention may contribute to salt sensitivity.

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