Impact of Light Salt Substitution for Regular Salt on Blood Pressure of Hypertensive Patients

Overview

Journal Arq Bras Cardiol

Specialty Cardiology & Vascular Diseases

Date 2014 Nov 21

PMID 25409877

Citations 13

Authors

Carolina Lobo de Almeida Barros

Ana Luiza Lima Sousa

Brunella Mendonca Chinem

Rafaela Bernardes Rodrigues

Thiago Souza Veiga Jardim

Sergio Baiocchi Carneiro

Weimar Kunz Sebba Barroso de Souza

Paulo Cesar Brandao Veiga Jardim

Affiliations

Soon will be listed here.

Abstract

Background: Studies have shown sodium restriction to have a beneficial effect on blood pressure (BP) of hypertensive patients.

Objective: To evaluate the impact of light salt substitution for regular salt on BP of hypertensive patients.

Methods: Uncontrolled hypertensive patients of both sexes, 20 to 65 years-old, on stable doses of antihypertensive drugs were randomized into Intervention Group (IG - receiving light salt) and Control Group (CG - receiving regular salt). Systolic BP (SBP) and diastolic BP (DBP) were analyzed by using casual BP measurements and Home Blood Pressure Monitoring (HBPM), and sodium and potassium excretion was assessed on 24-hour urine samples. The patients received 3 g of salt for daily consumption for 4 weeks.

Results: The study evaluated 35 patients (65.7% women), 19 allocated to the IG and 16 to the CG. The mean age was 55.5 ± 7.4 years. Most participants had completed the Brazilian middle school (up to the 8th grade; n = 28; 80.0%), had a family income of up to US$ 600 (n = 17; 48.6%) and practiced regular physical activity (n = 19; 54.3%). Two patients (5.7%) were smokers and 40.0% consumed alcohol regularly (n = 14). The IG showed a significant reduction in both SBP and DBP on the casual measurements and HBPM (p < 0.05) and in sodium excretion (p = 0.016). The CG showed a significant reduction only in casual SBP (p = 0.032).

Conclusions: The light salt substitution for regular salt significantly reduced BP of hypertensive patients.

Citing Articles

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References

Antman E, Appel L, Balentine D, Johnson R, Steffen L, Miller E . Stakeholder discussion to reduce population-wide sodium intake and decrease sodium in the food supply: a conference report from the American Heart Association Sodium Conference 2013 Planning Group. Circulation. 2014; 129(25):e660-79. DOI: 10.1161/CIR.0000000000000051. View

Chang H, Hu Y, Yue C, Wen Y, Yeh W, Hsu L . Effect of potassium-enriched salt on cardiovascular mortality and medical expenses of elderly men. Am J Clin Nutr. 2006; 83(6):1289-96. DOI: 10.1093/ajcn/83.6.1289. View

Whelton P . Urinary sodium and cardiovascular disease risk: informing guidelines for sodium consumption. JAMA. 2011; 306(20):2262-4. DOI: 10.1001/jama.2011.1746. View

Pimenta E, Gaddam K, Oparil S, Aban I, Husain S, DellItalia L . Effects of dietary sodium reduction on blood pressure in subjects with resistant hypertension: results from a randomized trial. Hypertension. 2009; 54(3):475-81. PMC: 2771382. DOI: 10.1161/HYPERTENSIONAHA.109.131235. View

Sarno F, Jaime P, Ferreira S, Monteiro C . [Sodium intake and metabolic syndrome: a systematic review]. Arq Bras Endocrinol Metabol. 2009; 53(5):608-16. DOI: 10.1590/s0004-27302009000500013. View

Sarno F, Claro R, Levy R, Bandoni D, Ferreira S, Monteiro C . [Estimated sodium intake by the Brazilian population, 2002-2003]. Rev Saude Publica. 2009; 43(2):219-25. DOI: 10.1590/s0034-89102009005000002. View

Dosse C, Cesarino C, Martin J, Castedo M . Factors associated to patients' noncompliance with hypertension treatment. Rev Lat Am Enfermagem. 2009; 17(2):201-6. DOI: 10.1590/s0104-11692009000200010. View

Oesch U, Ammann D, Simon W . Ion-selective membrane electrodes for clinical use. Clin Chem. 1986; 32(8):1448-59. View

Ortega R, Lopez-Sobaler A, Ballesteros J, Perez-Farinos N, Rodriguez-Rodriguez E, Aparicio A . Estimation of salt intake by 24 h urinary sodium excretion in a representative sample of Spanish adults. Br J Nutr. 2010; 105(5):787-94. DOI: 10.1017/S000711451000423X. View

10.

Lourenco B, Vieira L, Macedo A, Nakasato M, Marucci M, Bocchi E . Nutritional status and adequacy of energy and nutrient intakes among heart failure patients. Arq Bras Cardiol. 2010; 93(5):541-8. DOI: 10.1590/s0066-782x2009001100016. View

11.

. Diet, nutrition and the prevention of chronic diseases. World Health Organ Tech Rep Ser. 2003; 916:i-viii, 1-149, backcover. View

12.

Van Horn L, McCoin M, Kris-Etherton P, Burke F, Carson J, Champagne C . The evidence for dietary prevention and treatment of cardiovascular disease. J Am Diet Assoc. 2008; 108(2):287-331. DOI: 10.1016/j.jada.2007.10.050. View

13.

Klaus D, Hoyer J, Middeke M . Salt restriction for the prevention of cardiovascular disease. Dtsch Arztebl Int. 2010; 107(26):457-62. PMC: 2905835. DOI: 10.3238/arztebl.2010.0457. View

14.

. [VI Brazilian Guidelines on Hypertension]. Arq Bras Cardiol. 2010; 95(1 Suppl):1-51. View

15.

He F, Marciniak M, Visagie E, Markandu N, Anand V, Dalton R . Effect of modest salt reduction on blood pressure, urinary albumin, and pulse wave velocity in white, black, and Asian mild hypertensives. Hypertension. 2009; 54(3):482-8. DOI: 10.1161/HYPERTENSIONAHA.109.133223. View

16.

Elliott P, Stamler J, Nichols R, Dyer A, STAMLER R, Kesteloot H . Intersalt revisited: further analyses of 24 hour sodium excretion and blood pressure within and across populations. Intersalt Cooperative Research Group. BMJ. 1996; 312(7041):1249-53. PMC: 2351086. DOI: 10.1136/bmj.312.7041.1249. View

17.

Ruzicka M, Hiremath S, Steiner S, Helis E, Szczotka A, Baker P . What is the feasibility of implementing effective sodium reduction strategies to treat hypertension in primary care settings? A systematic review. J Hypertens. 2014; 32(7):1388-94. DOI: 10.1097/HJH.0000000000000182. View

18.

ODonnell M, Yusuf S, Mente A, Gao P, Mann J, Teo K . Urinary sodium and potassium excretion and risk of cardiovascular events. JAMA. 2011; 306(20):2229-38. DOI: 10.1001/jama.2011.1729. View

19.

Taylor R, Ashton K, Moxham T, Hooper L, Ebrahim S . Reduced dietary salt for the prevention of cardiovascular disease: a meta-analysis of randomized controlled trials (Cochrane review). Am J Hypertens. 2011; 24(8):843-53. DOI: 10.1038/ajh.2011.115. View