Intersalt revisited: further analyses of 24 hour sodium excretion and blood pressure within and across populations

Elliott, Paul; Stamler, Jeremiah; Nichols, R; Dyer, Alan R.; Stamler, Rose; Kesteloot, Hugo; Marmot, Michael

doi:10.1136/bmj.312.7041.1249

Cited by 761 publications

(445 citation statements)

References 31 publications

(48 reference statements)

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“…We did not find an urban-rural difference in hypertension prevalence, but what is considered urban in The Gambia might well be considered rural in other sub-Saharan countries with more urbanized communities. The influence of urbanization may be mediated by increased stress and by changes in diet, in particular a higher salt intake when more processed foods are consumed (Poulter et al 1990;Elliott et al 1996;Antonios & MacGregor 1996). These factors were not assessed in the present study, but are possibly less variable in The Gambia than elsewhere.…”

Section: Hypertensionmentioning

confidence: 84%

Nationwide prevalence study of hypertension and related non‐communicable diseases in The Gambia

Sande

Bailey

Faal³

et al. 1997

Tropical Med Int Health

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SummaryThe prevalence of hypertension, diabetes and obesity in The Gambia was assessed in a 1% population sample of 6048 adults over 15 years of age. 572 (9.5%) subjects were hypertensive according to WHO criteria (a diastolic blood pressure (DBP) of 95 mmHg or above and/or a systolic blood pressure (SBP) of 160 mmHg or above); 325 (5.4%) had a DBP of 95 mmHg or above, and 39 (2.3%) a DBP of 105 mmHg or above; 428 (7.1%) had a SBP of 160 mmHg or above. By less conservative criteria (a DBP of 90 mmHg or above and/or SBP of 140 mmHg or above), 24.2% of subjects were hypertensive. The prevalence of hypertension was similar in the major ethnic groups and in urban and rural communities. Age and obesity were risk factors for hypertension; female sex was an additional risk factor for diastolic hypertension. Several communities had a prevalence of diastolic hypertension double the national rate, and significant community clustering of diastolic hypertension (P Ͻ 0.01) was confirmed by Monte Carlo methods. Genetic and/or localized environmental factors (such as diet or Schistosoma haematobium infection), may be involved. 140 (2.3%) subjects were obese. Obesity was associated with female sex, increasing age, urban environment, non-manual work and diastolic hypertension. Only 14 (0.3%) subjects were found to be diabetic. Hypertension appears to be very prevalent in The Gambia, with a substantial population at risk of developing target organ damage. Further studies to delineate this risk and appropriate interventions to reduce it are needed.

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Section: Hypertensionmentioning

confidence: 84%

Nationwide prevalence study of hypertension and related non‐communicable diseases in The Gambia

Sande

Bailey

Faal³

et al. 1997

Tropical Med Int Health

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“…Sodium intake contributes to differences in blood pressure between populations and to the increase in BP with age. 11 Meta-analyses from controlled trials have consistently shown that blood pressure decreases with sodium restriction, although estimates of the size of the fall vary. [12][13][14] In the TONE study, 15 a decrease in sodium intake of about 40 mmol/day reduced requirements for antihypertensive drugs, with further improvement when weight loss and sodium restriction were combined.…”

Section: Discussionmentioning

confidence: 99%

Prevalence, awareness, treatment, and control of hypertension in the Czech Republic. Results of two nationwide cross-sectional surveys in 1997/1998 and 2000/2001, Czech Post-MONICA Study

et al. 2004

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Hypertension is an easily diagnosed and eminently modifiable risk factor for the development of all clinical manifestations of atherosclerosis. Despite the availability of a simple, non-invasive, and rather accurate method of measuring blood pressure (BP), and overwhelming evidence that reducing BP effectively prevents cardiovascular events, hypertension at the population level is not managed optimally. In 1997/ 1998 and 2000/2001, two surveys for cardiovascular risk factors were conducted in nine districts of the Czech Republic, involving a 1% population random sample aged 25-64 years in each district. In concordance with the MONICA Project, the present study confirms a high prevalence of hypertension in the Czech population, detecting an increase in prevalence for the male population over a period of 3 years (males from 38.8 in

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“…[31][32][33][34] The estimates of the association with BP appeared to be strongly influenced by the inclusion of body mass index in multiple regression models. 33,34 Third, the use of anti-hypertensive medication may have modified the distribution of BP in the population and may have led to biased estimates of the magnesium-BP relationship, especially as hypertensive persons may have changed their dietary intake as a consequence of the diagnosis of high BP. 35 Only three reports addressed this issue by considering subgroups according to BP status (normotensive/hypertensive) 21a or anti-hypertensive medication (including/excluding those who were on anti-hypertensive medication).…”

Section: Discussionmentioning

confidence: 99%

Dietary magnesium intake and blood pressure: a qualitative overview of the observational studies

Mizushima

Cappuccio

Nichols³

et al. 1998

J Hum Hypertens

122

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Published reports of 30 separate sets of analyses from 29 observational studies relating dietary intake of magnesium to blood pressure (BP) were identified through a comprehensive search using MEDLINE and BIDS-EMBASE. Three studies were prospective, 24 crosssectional (25 reports), of which four also contained a longitudinal component, and two were obtained from baseline data in a trial. Various dietary methodologies were used: 24-h dietary recall (n = 12), food-frequency questionnaire (8), food record (7), and duplicate diet (2). Twelve reports compared magnesium intake or BP level between subgroups. Seven showed a negative association between magnesium intake and BP level, and five reported no association. From 18 of the 30 sets of analyses either a regression estimate or a Pearson correlation coefficient was reported. Many reports also allowed identification of subgroups by sex, age and race. Ninety population samples and subgroups could

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Intersalt revisited: further analyses of 24 hour sodium excretion and blood pressure within and across populations

Cited by 761 publications

References 31 publications

Nationwide prevalence study of hypertension and related non‐communicable diseases in The Gambia

Nationwide prevalence study of hypertension and related non‐communicable diseases in The Gambia

Prevalence, awareness, treatment, and control of hypertension in the Czech Republic. Results of two nationwide cross-sectional surveys in 1997/1998 and 2000/2001, Czech Post-MONICA Study

Dietary magnesium intake and blood pressure: a qualitative overview of the observational studies

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