Salt and blood pressure in children and adolescents

Abstract

To study the relationship between salt intake and blood pressure in children and adolescents, we analysed the data of a large cross-sectional study (the National Diet and Nutrition Survey for young people), which was carried out in Great Britain in 1997 in a nationally representative sample of children aged between 4 and 18 years. A total of 1658 participants had both salt intake and blood pressure recorded. Salt intake was assessed by a 7-day dietary record. The average salt intake, which did not include salt added in cooking or at the table, was 4.770.2 g/day at the age of 4 years. With increasing age, there was an increase in salt intake, and by the age of 18 years, salt intake was 6.870.2 g/day. There was a significant association of salt intake with systolic blood pressure as well as with pulse pressure after adjusting for age, sex, body mass index and dietary potassium intake. An increase of 1 g/day in salt intake was related to an increase of 0.4 mm Hg in systolic and 0.6 mm Hg in pulse pressure. The magnitude of the association with systolic blood pressure is very similar to that observed in a recent meta-analysis of controlled trials where salt intake was reduced. The consistent finding of our present analysis of a random sample of free-living individuals with that from controlled salt reduction trials provides further support for a reduction in salt intake in children and adolescents.

Salt intake in 3-year-old Japanese children

“…[1][2][3][4] As in adults, the positive relationship between salt intake and blood pressure has already been reported in children. [14][15][16][17][18][19] A large cross-sectional study in Great Britain that investigated 1658 children and adolescents with a mean age of 11±0.1 years showed a significant association of salt intake with systolic blood pressure (SBP). 14 That study estimated that increasing salt intake by 1 g per day would relate to an SBP increase of 0.4 mm Hg.…”

Salt and blood pressure in children

“…11 Parenthetically, it is interesting to note that in countries where most sodium intake is discretionary, as parts of East Asia, sodium intake is much higher than in Britain, where most sodium is not discretionary, but consumed in our foods! The restricted focus of this report does not detract from the careful analysis and lucid presentation by He et al 5 It does, however, account for my dissent from the call for British youngsters to reduce their sodium intake. Observational data tells us something about associations, and can, when the data are particularly robust, even infer guilt.…”

“…The British Survey of Young People probably includes, in addition to physical and physiological data, information on other social, economic and developmental characteristics whose explanation might well inform our understanding of the relation of blood pressure, diet, health and development in these youngsters. Of note, He et al 5 also provide some other interesting information. For example, they note that 18-year-old British residents, in 1997, were consuming B2.6-g of sodium per day.…”

“…In this issue of the Journal of Human Hypertension, He et al 5 analysed the salt to blood pressure link in a cross-sectional study of a large representative sample of British children. They found that, in children 4-18 years old, sodium, potassium, and energy intake, body mass index, arm circumference and all measures of blood pressure, increase with age.…”

“…Its inclusion in the analysis eliminated the significance of the relationship between sodium and blood pressure in these children. He et al 5 appropriately pointed out the inability to determine whether energy or sodium intake provides the tenuous link to blood pressure.…”