Organization out-of urinary salt and you will potassium removal with systolic blood pressure level from the Diet Solutions to Avoid Hypertension Sodium Trial
The 2019 National Academy of Science, Engineering and Medicine Dietary Reference Intakes (DRI) for Sodium (Na + ) and Potassium (K + ) Report concluded there remains insufficient evidence to establish a K + DRI. This study tested the hypothesis that reduced Na + and increased K + excretion will positively associate with lower blood pressure in salt sensitive (SS) and salt resistant (SR) participants in the Dietary Approaches to Stop Hypertension Sodium Trial (DASH–Sodium). Via the NHLBI BioLINCC we accessed the DASH-Sodium dataset for data on systolic blood pressure (SBP), 24-h urinary Na + and K + excretion at screening (regular patient diet; N = 186, SS N = 222 SR) and post DASH diet (N = 71 SS, N = 119 SR). The relationships between SBP, urinary Na + and K + excretion, and Na + /K + ratio were assessed via linear regression. At screening elevated urinary Na + excretion positively associated with SBP in SS (1 g increase in urinary Na + excretion = +1 0 ± 0.4 mmHg) but not SR participants, and urinary K + excretion of <1 g K + /day was associated with higher SBP in SS and SR participants. Urinary K + excretion ?1 g/day, or a decreases in urinary Na + /K + ratio, was not associated with lower SBP. Post the DASH–sodium diet intervention, SBP was reduced in SS and SR participants. However, no correlation was observed between reduced SBP and urinary K + excretion or the urinary Na + /K + ratio irrespective of the salt sensitivity of blood pressure. Our data support the DRI recommendation not to establish a K + DRI and suggest further evidence is required to support a reduced Na + /K + ratio to lower SBP.
Addition
Hypertension, widely known non-communicable disease in the world, stands for a critical global social health issue. In line with the 2017 Western Cardio Organization (AHA) assistance, brand new frequency off blood circulation pressure in our midst people are projected getting 46% ; at the same time,
50% out-of hypertensive everyone is projected to-be sodium sensitive and painful (SS) . Since indexed from the Federal Cardiovascular system to have Persistent Problem Cures and you may Fitness Campaign statement
90% out of Western people eat an excess of weight loss sodium (Na + ), having the common day-after-day application exceeding 3400 milligrams when you look at the adult You guys, a value nearly three times this new every day consumption required of the AHA additionally the National Academy away from Research, Systems, and you will Medicine Weightloss Resource Intakes (DRI) . Due to the fact too much fat reduction Na + consumption, that push the sodium susceptibility regarding blood circulation pressure while increasing blood pressure chance, in the world losing weight Na + consumption are a general public wellness exposure. The new effect from fat reduction Na + intake into blood circulation pressure has been investigated in numerous diet input examples promoting research that smaller fat loss sodium intake for the controlled setup contributes to decreases from inside the blood pressure [six,7,8]. Then, meta-analyses keeps synchronised dieting Na + restrict with decrease within the blood pressure level suggesting there is a healthcare work with in both normotensive and you can hypertensive somebody no matter the brand new sodium sensitiveness out-of hypertension [nine, 10].
Connection off urinary salt and potassium excretion having systolic blood pressure levels throughout the Weightloss Answers to Stop Blood pressure Sodium Demo
Recent evidence suggests the salt sensitivity of blood pressure may be modulated, in part, by dietary potassium (K + ) intake. Increasing dietary K + intake appears to counteract the effects of dietary Na + intake on increasing blood pressure [11,12,13]. Despite several studies that have documented blood pressure lowering effects of increasing K + intake, the 2019 National Academy of Science, Engineering, and Medicine DRI for sodium and potassium Report did not establish a DRI for K + . This report concluded that more evidence is required to support a DRI of K + with particular reference to a lack of K + dose-response trials limiting the evidence to establish a K + DRI . Several studies have reported that the urinary Na + :K + ratio has a stronger association with blood pressure than Na + or K + independently [14, 15]. Largely based on these data, a urinary Na + to K + molar ratio of <1 has been recommended [16, 17] as a beneficial target to improve long-term blood pressure control. Given the high global dietary Na + intake this would necessitate dietary, or other means, of K + supplementation-for which a DRI has not been established . A leading dietary intervention study was the Dietary Approaches to Stop Hypertension 2 Trial (DASH-Sodium) conducted between 1997 and 2002 . The DASH-Sodium trial was a multicenter, randomized clinical trial that examined the impact of three levels dietary Na + intake in combination with either a control or DASH diet (rich in fruits, vegetables, and low-fat dairy products, and reduced in total fat) on blood pressure. This study demonstrated substantial effects of dietary Na + reduction and the DASH diet on reducing blood pressure, with more significant blood pressure lowering effects with the combination of a DASH diet plus dietary Na + reduction than dietary Na + restriction alone in individuals with higher than optimal blood pressure . Given that the DASH diet intervention elevated dietary K + intake by increasing dietary intake of fruits and vegetables in combination with modifying daily dietary Na + intake, examining the potential interaction between dietary Na + and K + intake on blood pressure in the DASH trial will provide valuable insight into the potential influence of dietary K + on blood pressure.