Obesity Masks the Relationship Between Dietary Salt Intake and Blood Pressure in People of African Ancestry: the Impact of Obesity on the Relationship Between Sodium and Blood Pressure

Overview

Journal Cardiovasc J Afr

Specialty Cardiology & Vascular Diseases

Date 2018 Feb 15

PMID 29443353

Citations 4

Authors

Muzi Maseko

Mercy Mashao

Abdulraheem Bawa-Allah

Edgar Phukubje

Bongubuhle Mlambo

Thamsanqa Nyundu

Affiliations

Soon will be listed here.

Abstract

Previous studies conducted to investigate the relationship between sodium intake and blood pressure in our African population have yielded contradictory results. With the high prevalence of obesity in this population, it is possible that these contradictory findings are due to the masking effects of obesity on this relationship. We measured 24-hour ambulatory blood pressure and 24-hour urine excretion on 547 South Africans of African ancestry. A multivariate regression analysis revealed no independent relationship between 24-hour sodium excretion and blood pressure in the total population sample, but when participants were stratified according to body mass index (BMI) status, there was a significant association between 24-hour sodium excretion and blood pressure in the normal-BMI participants but not in the overweight/obese participants. We concluded that dietary salt intake, indexed by 24-hour urinary sodium excretion, was associated with increased ambulatory blood pressure but this relationship was masked because of a high proportion of overweight/obese individuals in this population.

Citing Articles

Self-Reported Frequency of Adding Salt to Food and Risk of Incident Chronic Kidney Disease.

Tang R, Kou M, Wang X, Ma H, Li X, Heianza Y JAMA Netw Open. 2023; 6(12):e2349930.

PMID: 38153731 PMC: 10755616. DOI: 10.1001/jamanetworkopen.2023.49930.

A qualitative study of food sociality in three provinces of South China: social functions of food and dietary behavior.

Yan Y, Petersen J, Lin L, Chen J, Li X, Ji G Front Nutr. 2023; 10:1058764.

PMID: 37937253 PMC: 10626536. DOI: 10.3389/fnut.2023.1058764.

Dietary Sodium Intake and Health Indicators: A Systematic Review of Published Literature between January 2015 and December 2019.

Overwyk K, Quader Z, Maalouf J, Bates M, Webster J, George M Adv Nutr. 2020; 11(5):1174-1200.

PMID: 32449929 PMC: 7490163. DOI: 10.1093/advances/nmaa049.

Sodium Intake, Blood Pressure and Cardiovascular Disease.

Rhee M, Jeong Y Korean Circ J. 2020; 50(7):555-571.

PMID: 32281323 PMC: 7321755. DOI: 10.4070/kcj.2020.0042.

References

Gelber R, Gaziano J, Manson J, Buring J, Sesso H . A prospective study of body mass index and the risk of developing hypertension in men. Am J Hypertens. 2007; 20(4):370-7. PMC: 1920107. DOI: 10.1016/j.amjhyper.2006.10.011. View

Correia-Costa L, Cosme D, Nogueira-Silva L, Morato M, Sousa T, Moura C . Gender and obesity modify the impact of salt intake on blood pressure in children. Pediatr Nephrol. 2015; 31(2):279-88. DOI: 10.1007/s00467-015-3210-7. View

Akpan E, Ekrikpo U, Udo A, Bassey B . Prevalence of Hypertension in Akwa Ibom State, South-South Nigeria: Rural versus Urban Communities Study. Int J Hypertens. 2015; 2015:975819. PMC: 4478357. DOI: 10.1155/2015/975819. View

Drenjancevic-Peric I, Jelakovic B, Lombard J, Kunert M, Kibel A, Gros M . High-salt diet and hypertension: focus on the renin-angiotensin system. Kidney Blood Press Res. 2010; 34(1):1-11. PMC: 3214830. DOI: 10.1159/000320387. View

Beltowski J . Leptin and the regulation of endothelial function in physiological and pathological conditions. Clin Exp Pharmacol Physiol. 2011; 39(2):168-78. DOI: 10.1111/j.1440-1681.2011.05623.x. View

Peer N, Steyn K, Lombard C, Gwebushe N, Levitt N . A high burden of hypertension in the urban black population of Cape Town: the cardiovascular risk in Black South Africans (CRIBSA) study. PLoS One. 2013; 8(11):e78567. PMC: 3826752. DOI: 10.1371/journal.pone.0078567. View

Dyer A, Elliott P, Shipley M, STAMLER R, Stamler J . Body mass index and associations of sodium and potassium with blood pressure in INTERSALT. Hypertension. 1994; 23(6 Pt 1):729-36. DOI: 10.1161/01.hyp.23.6.729. View

Michel F, Norton G, Majane O, Badenhorst M, Vengethasamy L, Paiker J . Contribution of circulating angiotensinogen concentrations to variations in aldosterone and blood pressure in a group of African ancestry depends on salt intake. Hypertension. 2011; 59(1):62-9. DOI: 10.1161/HYPERTENSIONAHA.111.181230. View

He F, Markandu N, Sagnella G, de Wardener H, MacGregor G . Plasma sodium: ignored and underestimated. Hypertension. 2004; 45(1):98-102. DOI: 10.1161/01.HYP.0000149431.79450.a2. View

10.

Shiburi C, Staessen J, Maseko M, Wojciechowska W, Thijs L, Van Bortel L . Reference values for SphygmoCor measurements in South Africans of African ancestry. Am J Hypertens. 2006; 19(1):40-6. DOI: 10.1016/j.amjhyper.2005.06.018. View

11.

Mensah G, Roth G, Sampson U, Moran A, Feigin V, Forouzanfar M . Mortality from cardiovascular diseases in sub-Saharan Africa, 1990-2013: a systematic analysis of data from the Global Burden of Disease Study 2013. Cardiovasc J Afr. 2015; 26(2 Suppl 1):S6-10. PMC: 4557490. DOI: 10.5830/CVJA-2015-036. View

12.

Shin J, Xu E, Hyo Lim Y, Choi B, Kim B, Lee Y . Relationship between nocturnal blood pressure and 24-h urinary sodium excretion in a rural population in Korea. Clin Hypertens. 2016; 20:9. PMC: 4763416. DOI: 10.1186/2056-5909-1-3. View

13.

Appel L, Giles T, Black H, Izzo Jr J, Materson B, Oparil S . ASH Position Paper: Dietary approaches to lower blood pressure. J Clin Hypertens (Greenwich). 2009; 11(7):358-68. PMC: 8673392. DOI: 10.1111/j.1751-7176.2009.00136.x. View

14.

Smyth A, ODonnell M, Yusuf S, Clase C, Teo K, Canavan M . Sodium intake and renal outcomes: a systematic review. Am J Hypertens. 2014; 27(10):1277-84. DOI: 10.1093/ajh/hpt294. View

15.

McCarron D, Kazaks A, Geerling J, Stern J, Graudal N . Normal range of human dietary sodium intake: a perspective based on 24-hour urinary sodium excretion worldwide. Am J Hypertens. 2013; 26(10):1218-23. DOI: 10.1093/ajh/hpt139. View

16.

Yan L, Bi Z, Tang J, Wang L, Yang Q, Guo X . Relationships Between Blood Pressure and 24-Hour Urinary Excretion of Sodium and Potassium by Body Mass Index Status in Chinese Adults. J Clin Hypertens (Greenwich). 2015; 17(12):916-25. PMC: 8031527. DOI: 10.1111/jch.12658. View

17.

Redelinghuys M, Norton G, Scott L, Maseko M, Brooksbank R, Majane O . Relationship between urinary salt excretion and pulse pressure and central aortic hemodynamics independent of steady state pressure in the general population. Hypertension. 2010; 56(4):584-90. DOI: 10.1161/HYPERTENSIONAHA.110.156323. View

18.

. Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure. The Trials of Hypertension Prevention, phase II. The Trials of Hypertension Prevention.... Arch Intern Med. 1997; 157(6):657-67. View

19.

Maseko M, Majane H, Milne J, Norton G, Woodiwiss A . Salt intake in an urban, developing South African community. Cardiovasc J S Afr. 2006; 17(4):186-91. View

20.

Yi S, Kansagra S . Associations of sodium intake with obesity, body mass index, waist circumference, and weight. Am J Prev Med. 2014; 46(6):e53-5. DOI: 10.1016/j.amepre.2014.02.005. View