Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride

Graudal, Niels; Hubeck-Graudal, Thorbjørn; Jürgens, Gesche

doi:10.1002/14651858.cd004022.pub4

Cited by 287 publications

(162 citation statements)

References 227 publications

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“…Although clinical trials have reported a decrease in blood pressure with a reduction in sodium intake,8 many prospective cohort studies have reported a J-shaped association of sodium intake and cardiovascular disease or mortality,10111213141516 with an increased risk emerging at sodium intakes <2.7 g/day and >5 g/day 10. The increased cardiovascular risk associated with high sodium intake seems to be especially in those with hypertension,17 whereas the increased risk associated with low sodium intake might be mediated through activation of physiological systems to conserve sodium (eg, renin-angiotensin-aldosterone system) 18. In contrast, the association of potassium intake with blood pressure and cardiovascular disease is consistent, with a linear reduction in blood pressure and cardiovascular risk with increasing potassium intake reported in most studies 9.…”

Section: Introductionmentioning

confidence: 99%

Joint association of urinary sodium and potassium excretion with cardiovascular events and mortality: prospective cohort study

O’Donnell

Mente

Rangarajan

et al. 2019

BMJ

108

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ObjectiveTo evaluate the joint association of sodium and potassium urinary excretion (as surrogate measures of intake) with cardiovascular events and mortality, in the context of current World Health Organization recommendations for daily intake (<2.0 g sodium, >3.5 g potassium) in adults.DesignInternational prospective cohort study.Setting18 high, middle, and low income countries, sampled from urban and rural communities.Participants103 570 people who provided morning fasting urine samples.Main outcome measuresAssociation of estimated 24 hour urinary sodium and potassium excretion (surrogates for intake) with all cause mortality and major cardiovascular events, using multivariable Cox regression. A six category variable for joint sodium and potassium was generated: sodium excretion (low (<3 g/day), moderate (3-5 g/day), and high (>5 g/day) sodium intakes) by potassium excretion (greater/equal or less than median 2.1 g/day).ResultsMean estimated sodium and potassium urinary excretion were 4.93 g/day and 2.12 g/day, respectively. After a median follow-up of 8.2 years, 7884 (6.1%) participants had died or experienced a major cardiovascular event. Increasing urinary sodium excretion was positively associated with increasing potassium excretion (unadjusted r=0.34), and only 0.002% had a concomitant urinary excretion of <2.0 g/day of sodium and >3.5 g/day of potassium. A J-shaped association was observed of sodium excretion and inverse association of potassium excretion with death and cardiovascular events. For joint sodium and potassium excretion categories, the lowest risk of death and cardiovascular events occurred in the group with moderate sodium excretion (3-5 g/day) and higher potassium excretion (21.9% of cohort). Compared with this reference group, the combinations of low potassium with low sodium excretion (hazard ratio 1.23, 1.11 to 1.37; 7.4% of cohort) and low potassium with high sodium excretion (1.21, 1.11 to 1.32; 13.8% of cohort) were associated with the highest risk, followed by low sodium excretion (1.19, 1.02 to 1.38; 3.3% of cohort) and high sodium excretion (1.10, 1.02 to 1.18; 29.6% of cohort) among those with potassium excretion greater than the median. Higher potassium excretion attenuated the increased cardiovascular risk associated with high sodium excretion (P for interaction=0.007).ConclusionsThese findings suggest that the simultaneous target of low sodium intake (<2 g/day) with high potassium intake (>3.5 g/day) is extremely uncommon. Combined moderate sodium intake (3-5 g/day) with high potassium intake is associated with the lowest risk of mortality and cardiovascular events.

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Section: Introductionmentioning

confidence: 99%

Joint association of urinary sodium and potassium excretion with cardiovascular events and mortality: prospective cohort study

O’Donnell

Mente

Rangarajan

et al. 2019

BMJ

108

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“…A study published by Graudal et al compared the effects of a low and high sodium diet. In the group of individuals on a sodium-controlled diet, a drop in BP (by 3% in hypertensive patients) was accompanied by increased levels of renin, aldosterone, noradrenaline, adrenaline, cholesterol by 2.5% and triglyceride by 7% [33]. Fig.…”

Section: Treatment Of Resistant Hypertensionmentioning

confidence: 87%

Resistant Hypertension

Doroszko¹,

Janus²,

Szahidewicz-Krupska³

et al. 2016

Adv Clin Exp Med

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“…20 A number of possible mechanisms have been proposed for the association, including that lower sodium intake decreases leptin, which reduces abdominal fat cells, resulting in lower adiposity and insulin resistance. 26 A second proposition is that lower intake of dietary sodium modifies the expression of glucose transporter type-4 protein in adipocytes and may therefore improve insulin sensitivity. 27 A final proposed mechanism is that low sodium intake alters the level of angiotensin II, which regulates insulin activity.…”

Section: Discussionmentioning

confidence: 99%

The association between dietary sodium intake and adiposity, inflammation, and hormone markers: A preliminary study

Choi

Heo

2017

J Nutr Health

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Purpose: Excess intake of sodium is a major diet-related risk factor for human diseases including hypertension and cancer as well as obesity and inflammation. However, findings are still controversial, and evidence is lacking in Koreans. Therefore, for better understanding of the role of dietary sodium intake in disease etiology, this study investigated the effects of dietary sodium intake on adiposity, inflammation, and hormones in Koreans. Methods: A total of 80 males and females joined the study. The general characteristics and dietary intake data were investigated by trained interviewers using a questionnaire and 24-h dietary recall, respectively. For the markers of adiposity, body weight, body mass index, percent of body fat, visceral fat area, and waist and hip circumference were measured. For the inflammation and hormone markers, leptin, adiponectin, insulin, tumor necrosis factor-α, and interleukin-6 were also analyzed. Results: Multivariate linear regression analyses suggested that dietary sodium intake was not associated with adiposity. However, dietary sodium showed a significant association with insulin level: Plasma insulin concentration increased with sodium intake independent of other dietary intake or percent of body fat (β = 0.296, adjusted r 2 = 0.276, p < 0.01). Other markers for inflammation and hormonal responses were not associated with dietary sodium intake. Conclusion: Findings suggested that dietary sodium intake may be a critical modifying factor in the level of plasma insulin. However, it showed a limited effect on obesity and other inflammation markers and hormone levels. These findings should be confirmed in larger, well-designed investigations.

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Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride

Cited by 287 publications

References 227 publications

Joint association of urinary sodium and potassium excretion with cardiovascular events and mortality: prospective cohort study

Joint association of urinary sodium and potassium excretion with cardiovascular events and mortality: prospective cohort study

Resistant Hypertension

The association between dietary sodium intake and adiposity, inflammation, and hormone markers: A preliminary study

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