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Relation of dietary sodium (salt) to blood pressure and Its possible modulation by other dietary factors: the INTERMAP study

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Title: Relation of dietary sodium (salt) to blood pressure and Its possible modulation by other dietary factors: the INTERMAP study
Authors: Stamler, J
Chan, Q
Daviglus, M
Dyer, A
Van Horn, L
Garside, D
Miura, K
Wu, Y
Ueshima, H
Zhao, L
Elliott, P
Item Type: Journal Article
Abstract: Available data indicate that dietary sodium (as salt) relates directly to blood pressure (BP). Most of these findings are from studies lacking dietary data; hence, it is unclear whether this sodium–BP relationship is modulated by other dietary factors. With control for multiple nondietary factors, but not body mass index, there were direct relations to BP of 24-hour urinary sodium excretion and the urinary sodium/potassium ratio among 4680 men and women 40 to 59 years of age (17 population samples in China, Japan, United Kingdom, and United States) in the INTERMAP (International Study on Macro/Micronutrients and Blood Pressure), and among its 2195 American participants, for example, 2 SD higher 24-hour urinary sodium excretion (118.7 mmol) associated with systolic BP 3.7 mm Hg higher. These sodium–BP relations persisted with control for 13 macronutrients, 12 vitamins, 7 minerals, and 18 amino acids, for both sex, older and younger, blacks, Hispanics, whites, and socioeconomic strata. With control for body mass index, sodium–BP—but not sodium/potassium–BP—relations were attenuated. Normal weight and obese participants manifested significant positive relations to BP of urinary sodium; relations were weaker for overweight people. At lower but not higher levels of 24-hour sodium excretion, potassium intake blunted the sodium–BP relation. The adverse association of dietary sodium with BP is minimally attenuated by other dietary constituents; these findings underscore the importance of reducing salt intake for the prevention and control of prehypertension and hypertension.
Issue Date: 5-Mar-2018
Date of Acceptance: 23-Jan-2018
URI: http://hdl.handle.net/10044/1/56427
DOI: https://dx.doi.org/10.1161/HYPERTENSIONAHA.117.09928
ISSN: 0194-911X
Publisher: American Heart Association
Start Page: 631
End Page: 637
Journal / Book Title: Hypertension
Volume: 71
Copyright Statement: © 2018 American Heart Association, Inc.
Sponsor/Funder: National Institutes of Health
National Institutes of Health
Medical Research Council (MRC)
Medical Research Council (MRC)
Imperial College Healthcare NHS Trust- BRC Funding
UK DRI Ltd
Funder's Grant Number: IMTERMAP Subaward No. 60024563
2R01HL084228-05A1
MR/L01632X/1
MR/L01341X/1
RDF03
N/A
Keywords: blood pressure
diet
hypertension
potassium
sodium
1103 Clinical Sciences
1102 Cardiovascular Medicine And Haematology
Cardiovascular System & Hematology
Publication Status: Published
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care



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