Harmful effects of dietary salt in addition to hypertension

Wardener, H. E. de; MacGregor, Graham A.

doi:10.1038/sj.jhh.1001374

Cited by 159 publications

(102 citation statements)

References 107 publications

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“…[1][2][3][4] In addition, a high-salt diet is reported to have direct harmful effects; for example, it increases the risk of stroke, renal disease and cardiovascular disease, independently of blood pressure elevation. 5,6 Moreover, a relationship between salt intake and stomach cancer has also been suggested. 7,8 Therefore, a reduction in salt intake is an important issue for public health.…”

Section: Introductionmentioning

confidence: 99%

Salt intake in 3-year-old Japanese children

et al. 2011

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Salt restriction is widely recommended for the prevention and management of hypertension. It is very important to reduce salt intake during childhood. This survey was conducted to investigate salt intake in Japanese children. The study subjects, totalling 1424, comprised 3-year-old children who received health checkups conducted by a public health center. Using first-morning urine samples, urinary concentrations of sodium, potassium and creatinine were measured. Additionally, the participants' parents filled out a questionnaire regarding their children's dietary habits. Urinary sodium and potassium concentrations were 140 ± 67 and 67 ± 41 mmol l À1 , respectively. The estimated urinary sodium excretion values had a wide distribution, with a mean value of 75±47 mmol per day (4.4 g per day of salt). Sodium excretion exceeded 100 and 200 mmol per day in 336 (24%) and 32 (2.2%) subjects, respectively. Urinary sodium excretion was significantly higher in children who had older siblings than in firstborn children (78 ± 49 vs. 72 ± 45 mmol per day, Po0.05). The urinary sodium/potassium ratio was also higher in the former group (3.0±2.7 vs. 2.7±2.2, Po0.01). Sodium excretion tended to be higher in children who ate daily snacks than in those who did not (76±48 vs. 71±44 mmol per day, P¼0.07). In contrast, potassium excretion was significantly higher and the sodium/potassium ratio was lower in children who ate fruits daily than those who did not (39 ± 29 vs. 33 ± 23 mmol per day and 2.6 ± 2.0 vs. 3.2 ± 2.7, Po0.01, respectively). These results suggest that excess salt intake occurs in a significant number of 3-year-old Japanese children. The presence of older siblings and dietary habits of eating snacks or fruits influence their sodium and potassium intake.

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Section: Introductionmentioning

confidence: 99%

Salt intake in 3-year-old Japanese children

et al. 2011

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“…This latter point was important because different pressure levels trigger chronic cardiovascular and renal adaptations that can strongly influence the risk of pressure increase and hypertension and it is unclear whether adjustment for initial pressure levels in multivariable models can correct for these adaptations. 12 For this purpose, we chose to perform a nested case-control study that also had the interest of maximizing the statistical power while minimizing the number of hormonal measurements. Our third aim was to analyse the potential modifying effect of habitual dietary sodium and potassium intakes on the ability of plasma aldosterone and renin to predict the risk of pressure increase and hypertension as these dietary factors influence both blood pressure and the plasma levels of these hormones.…”

Section: Introductionmentioning

confidence: 99%

High plasma aldosterone and low renin predict blood pressure increase and hypertension in middle-aged Caucasian populations

et al. 2008

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Plasma aldosterone and renin levels have been associated with blood pressure increase and 3-4 year incidence of hypertension in a middle-aged North American community in Framingham. To confirm these findings in a different population, a nested case-control study was performed in a national sample of 1984 French non-hypertensive volunteers aged 45-64 year and followed for 5 years. Cases and controls (individuals becoming hypertensive or remaining non-hypertensive on follow-up) were individually matched on sex, diastolic and systolic pressures at baseline. Multivariable regression models show that plasma aldosterone and renin are respectively positively and negatively associated with the increase in systolic pressure (P ¼ 0.01 and 0.001) and the risk of hypertension (22% increase and 16% decrease per s.d. increment in the log, P ¼ 0.04 and 0.07). These associations are mostly observed in the lowest tertiles of dietary sodium and potassium intakes where plasma aldosterone is positively associated with the increase in systolic pressure (P ¼ 0.01 and 0.08) and the risk of hypertension (59 and 69% increase per s.d. increment in the log, P ¼ 0.02 and 0.01), whereas plasma renin is negatively associated with the increase in systolic pressure (P ¼ 0.0004 and 0.004) and the risk of hypertension (31 and 28% decrease per s.d. increment in the log, P ¼ 0.03 and 0.05). These results reinforce the hypothesis that high plasma aldosterone and low plasma renin levels precede blood pressure increase and the occurrence of hypertension in middle-aged Caucasian populations.

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“…However, there is evidence that high sodium intake increases cardiovascular risk also through other mechanisms (Safar et al, 2000;Schmieder and Messerli, 2000;Simon, 2003) and could have some direct effects (Perry and Beevers, 1992;Tuomilehto et al, 2001). Besides CVD, high sodium intake may be a risk factor for stomach cancer and have an effect on calcium and bone mineral metabolism; it has also been connected with increased risk of some infections and asthma disorders (Joossens et al, 1996;de Wardener and MacGregor, 2002).…”

Section: Introductionmentioning

confidence: 99%

Sodium in the Finnish diet: 20-year trends in urinary sodium excretion among the adult population

Laatikainen¹,

Pietinen²,

Valsta³

et al. 2006

Eur J Clin Nutr

177

127

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Objective: High sodium intake increases the risk of cardiovascular diseases and may also be associated with higher rates of stomach cancer, asthma disorders and infections. In Finland, cross-sectional population surveys to monitor cardiovascular risk factors have been carried out since the 1970s. The main aim of this paper is to present trends in urinary sodium and potassium excretion from 1979 to 2002. Design: Cross-sectional population surveys on cardiovascular risk factors. Setting: Surveys were carried out in Finland in 1979Finland in , 1982Finland in , 1987Finland in and 2002 in four geographical areas: North Karelia, the Kuopio area, Southwestern Finland and the Helsinki area. Subjects: For each survey a random sample stratified by age and sex was drawn from the population register. In this analysis, participants of urine collection subsamples aged 25-64 years (n ¼ 4648) were included. Interventions: A 24-h urinary collection was carried out in subsamples (n ¼ 2218-2487) in connection with population risk factor surveys. Urinary sodium and potassium concentrations were analyzed in the same laboratory throughout, using a flame photometer in 1979, 1982 and 1987 and an ion-selective electrode in 2002. Results: Between 1979 and 2002 urinary sodium excretion in Finland decreased from over 220 to less than 170 mmol/day among men and from nearly 180 to less than 130 mmol/day among women. Although potassium excretion decreased somewhat as well, the decrease in sodium-potassium molar ratio was also significant. Conclusions: The 24-h urinary sodium excretion in Finland has decreased significantly during the last 20 years. However, excretion levels are still considerably higher than recommendations. A further decrease in sodium intake remains a goal for the Finnish food industry and consumers.

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Harmful effects of dietary salt in addition to hypertension

Cited by 159 publications

References 107 publications

Salt intake in 3-year-old Japanese children

Salt intake in 3-year-old Japanese children

High plasma aldosterone and low renin predict blood pressure increase and hypertension in middle-aged Caucasian populations

Sodium in the Finnish diet: 20-year trends in urinary sodium excretion among the adult population

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