Recommending Salt Intake Reduction to the Hypertensive Patient

Strazzullo, Pasquale; D’Elia, Lanfranco; Cairella, Giulia; Scalfi, Luca; Cola, Michele Schiano di

doi:10.1007/bf03262455

Cited by 5 publications

(4 citation statements)

References 34 publications

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“… Assessment for the presence of target organ damage. Assessment of cardiovascular risk, including an oral glucose tolerance test. Education regarding increased cardiovascular and diabetes risk, with particular emphasis on maintaining and/or losing weight. Education regarding limiting salt intake, in particular processed foods Monitoring weight. Monitoring for conversion to sustained hypertension (1–2 yearly ABPM) and/or regular home BP monitoring. Monitoring for the development of diabetes, particularly in WCHT with weight gain. …”

Section: Overall Message For Treating Cliniciansmentioning

confidence: 99%

White-coat hypertension

Martin

McGrath

2013

Clin Exp Pharmacol Physiol

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1. Numerous studies have examined whether white-coat hypertension (WCHT) is associated with increased cardiovascular risk, but with definitions of WCHT that were not sufficiently robust, results have been inconsistent. The aim of the present review was to standardize the evidence by only including studies that used a definition of WCHT consistent with international guidelines. 2. Published studies were reviewed for data on vascular dysfunction, target organ damage, risk of future sustained hypertension and cardiovascular events. 3. White-coat hypertension has a population prevalence of approximately 15% and is associated with non-smoking and slightly elevated clinic blood pressure. Compared with normotensives, subjects with WCHT are at increased cardiovascular risk due to a higher prevalence of glucose dysregulation, increased left ventricular mass index and increased risk of future diabetes and hypertension. 4. In conclusion, management of a patient with WCHT should focus on cardiovascular risk factors, particularly glucose intolerance, not blood pressure alone.

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Section: Overall Message For Treating Cliniciansmentioning

confidence: 99%

White-coat hypertension

Martin

McGrath

2013

Clin Exp Pharmacol Physiol

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“…Unfortunately, the average salt intake for Americans greatly exceeds their physiological need. The ideal treatment for patients with salt sensitivity would be decreasing salt intake, but this remains an inefficient solution due to patient non-compliance and reluctance to change lifestyles and habits [30]. The increase in salt sensitivity after uninephrectomy was associated with blunted increase in RBF and greater increase in afferent arteriolar resistance (figure 2).…”

Section: Responses To Uninephrectomymentioning

confidence: 99%

Section: Responses To Uninephrectomymentioning

confidence: 99%

Simulating a virtual population's sensitivity to salt and uninephrectomy

2017

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Salt sensitivity, with or without concomitant hypertension, is associated with increased mortality. Reduced functional renal mass plays an important role in causing salt-sensitive hypertension for many individuals. Factors that are important in the condition of decreased renal mass and how they affect blood pressure (BP) or salt sensitivity are unclear. We used HumMod, an integrative mathematical model of human physiology, to create a heterogeneous population of 1000 virtual patients by randomly varying physiological parameters. We examined potential physiological mechanisms responsible for the change in BP in response to high-salt diet (8× change in salt intake for three weeks) with full kidney mass and again after the removal of one kidney in the same group of virtual patients. We used topological data analysis (TDA), a clustering algorithm tool, to analyse the large dataset and separate patient subpopulations. TDA distinguished five unique clusters of salt-sensitive individuals (more than 15 mmHg change in BP with increased salt). While these clusters had similar BP responses to salt, different collections of variables were responsible for their salt sensitivity, e.g. greater reductions in glomerular filtration rate (GFR) or impairments in the renin-angiotensin system. After simulating uninephrectomy in these virtual patients, the three most salt-sensitive clusters were associated with a blunted increase in renal blood flow (RBF) and higher increase in loop and distal sodium reabsorption when compared with the salt-resistant population. These data suggest that the suppression of sodium reabsorption and renin-angiotensin system is key for salt resistance, and RBF in addition to GFR may be an important factor when considering criteria for kidney donors. Here, we show that in our model of human physiology, different derangements result in the same phenotype. While these concepts are known in the experimental community, they were derived here by considering only the data obtained from our virtual experiments. These methodologies could potentially be used to discover patterns in patient sensitivity to dietary change or interventions and could be a revolutionary tool in personalizing medicine.

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“…Reducing sodium intake effectively controls hypertension. 1 , 2 The World Health Organization (WHO) recommends a daily sodium intake of less than 2000 mg. 3 In Hong Kong, sodium intake in the general population has been found to exceed the recommended level. 4 – 6 Therefore, reducing salt intake is a high-priority goal in the effort to halt the increasing trend of hypertension.…”

Section: Introductionmentioning

confidence: 99%

Low awareness of high sodium intake among older Chinese people

et al. 2021

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Awareness is one of the first steps in a lifestyle modification process. Since older adults are at a higher risk of hypertension, maintaining low sodium intake is of utmost importance. Yet, it is uncertain if older adults have an awareness of their sodium intake. This study aimed to explore self-perceived sodium intake among older Chinese people and compare it with various measures of sodium intake. A cross-sectional study was conducted in Hong Kong in 2015. Data were collected from 24-h urinary sodium excretion (UNa24) measurements, dietary sodium intake by 24-h diet recalls and self-perceived salt intake levels among the older Hong Kong population. Kappa statistics and a paired t-test were used to compare the different measures. Fifty-nine participants provided complete 24-h urine samples. The mean (±SD) UNa24 of participants was 2846 ± 1253 mg, of which 74.6% exceeded the recommended daily sodium intake. About 87.8% of participants with UNa24 values >2000 mg perceived their sodium intake as too little or just right. The kappa statistic between UNa24 and self-perception was insignificantly different from zero (κ = −0.003, p-value = 0.909). The UNa24 estimates were significantly higher than those estimated from the 24-h diet recalls by 1203 mg ( p-value <0.001). The findings imply that the low awareness of excessive sodium intake should be raised among older people to promote a healthy intake of sodium.

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Recommending Salt Intake Reduction to the Hypertensive Patient

Cited by 5 publications

References 34 publications

White-coat hypertension

White-coat hypertension

Simulating a virtual population's sensitivity to salt and uninephrectomy

Low awareness of high sodium intake among older Chinese people

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