Salt restriction may not improve BP variability in the white general population
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Researchers observed no association between urinary sodium excretion and salt intake and BP variability in a white general population, according to an analysis of two studies.
Tan Lai Zhou, MD, PhD, of the department of internal medicine at Maastricht University Medical Center and the Cardiovascular Research Institute Maastricht, at Maastricht University, the Netherlands, and colleagues hypothesized that salt restriction may not be an effective intervention to improve BP variability (BPV) in this population.
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The study was published in the Journal of the American Heart Association.
“Greater BPV is associated with an increased risk of cardiovascular disease, but effective intervention to lower BPV is lacking; we investigated whether salt restriction could be an effective intervention,” the researchers wrote. “In a population-based study, we found that urinary sodium excretion was not independently associated with 24-hour BPV. In an intervention study, that is, a crossover trial with a low- and high-salt diet, we did not find a statistically significant difference in 24-hour BPV during a low- or high-salt diet.”
To better understand the relationship between urinary sodium and salt intake and BPV, researchers evaluated BP data from two studies: the cross-sectional population-based Maastricht study and a randomized crossover trial comparing low- and high-salt diets.
In the Maastricht study, researchers measured 24-hour urinary sodium and BPV among 2,652 white participants (mean age, 60 years; 52% men).
In the randomized crossover trial, researchers observed 24-hour BPV among 40 participants (mean age, 49 years; 33% men) who adhered to a 7-day low-salt diet (50 mmol sodium chloride [NaCl] per day) and high-salt diet intervention (250 mmol NaCl per day) followed by a 14-day washout period.
After adjusting for age, sex, mean BP, lifestyle and CV risk factors, researchers observed that 24-hour urinary sodium was not associated with 24-hour systolic or diastolic BPV among Maastricht study participants (beta per 1 g of 24-hour urinary sodium = 0.05 mm Hg systolic; 95% CI, –0.02 to 0.11; beta per 1 g of 24 hour urinary sodium = 0.04 mm Hg diastolic; 95% CI, –0.01 to 0.09).
In addition, mean difference in 24-hour systolic and diastolic BPV between the low-salt and high-salt diets was found to be similar in the randomized crossover trial (difference in systolic BP, 0.62 mm Hg; 95% CI, –0.1 to 1.35; P for interaction = .96; difference in diastolic BP, 0.04 mm Hg; 95% CI, –0.54 to 0.63; P for interaction = .94).
“Our study showed that urinary sodium excretion and salt intake are not associated with 24-hour BPV in both a large white population-based cohort study and in an intervention study,” the researchers wrote. “Therefore, our results do not indicate that salt restriction would be an effective strategy to lower BPV, at least not in a white population-based setting with relatively healthy individuals.”
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