Association of urinary salt and you can potassium excretion with systolic blood pressure throughout the Weight loss Ways to End Blood circulation pressure Sodium Demonstration

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 Scruff vs. Grindr + 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.

Introduction

Blood pressure, widely known non-communicable state internationally, is short for a life threatening around the world public ailment. According to research by the 2017 American Cardiovascular system Organization (AHA) guidelines, the new incidence of blood pressure level in our midst people is actually projected getting 46% ; simultaneously,

50% from hypertensive men and women are estimated to-be sodium painful and sensitive (SS) . While the detailed by the National Center for Persistent State Prevention and you can Health Venture declaration

90% away from American grownups eat an excess of dieting sodium (Na + ), which have an average day-after-day practices surpassing 3400 milligrams in mature All of us guys, a regard nearly three times this new every single day use necessary from the AHA while the National Academy from Science, Engineering, and you may Treatments Fat reduction Site Intakes (DRI) . Because the extreme weight-loss Na + consumption, which can push this new salt awareness out of blood pressure while increasing blood pressure level risk, internationally diet Na + consumption are a general public fitness exposure. New perception off weight-loss Na + consumption into the blood pressure might have been investigated within the multiple dieting input samples promoting research one to faster weight loss salt intake in controlled configurations leads to reductions in the blood pressure levels [six,eight,8]. Next, meta-analyses has actually synchronised dieting Na + restrict having decreases within the blood pressure recommending you will find a healthcare work with in normotensive and hypertensive anyone aside from the new sodium susceptibility away from blood circulation pressure [nine, 10].

Relationship away from urinary salt and you will potassium excretion which have systolic hypertension from the Diet Ways to End Blood pressure Salt Trial

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.