TY - JOUR
T1 - Effect of low vs. high dietary sodium on blood pressure levels in a normotensive Indo-Asian population
AU - Jessani, Saleem
AU - Hatcher, Juanita
AU - Chaturvedi, Nish
AU - Jafar, Tazeen H.
N1 - Funding Information:
Acknowledgments: We thank Sadia Zubair (Nutritionist), Rasool Bux (Sr Data Management Coordinator), and the field team for their contribution to the study. This work was supported by the Wellcome Trust Master’s Research Training Fellowship award (074825/Z/04/Z) to principal investigator: S.J. and supervisor: T.H.J. This work was presented in an abstract form at the 39th Annual meeting of the American Society of Nephrology, 31 October to 5 November 2007, San Francisco, CA, USA, at 7th International Epidemiology Association–Eastern Mediterranean Region Scientific Meeting, Riyadh, Saudi Arabia, November 2007, and at 17th meeting of European Society of Hypertension, Milan, Italy, June 2007.Trial registration ClinicalTrials NCT00330356 (http://www.clinicaltrials.gov).
PY - 2008/11
Y1 - 2008/11
N2 - Background: Hypertension is a major modifiable risk factor, and while sodium restriction in hypertensive patients appears effective, its role in normotensive individuals remains unclear. We assessed the effect of a low vs. high-sodium diet on blood pressure in normotensive Indo-Asian adults. Methods: A randomized, controlled, crossover trial was conducted on 200 normotensive subjects randomly selected from the general population in Karachi, Pakistan. Participants were randomized to either a low (20 mEq/day) or a high-sodium diet (220 mEq/day) for 1 week, followed by 1 week of washout, then the alternate diet for 1 week. The primary outcome was difference in systolic blood pressure (SBP) measured at the end of each phase in the overall population. Results: Mean (95% confidence interval) decline in 24-h urinary sodium excretion was 81.0 (69.6-92.4) mEq/day (P < 0.001), and in SBP was 1 (0-3)mm Hg (P = 0.17) between high and low-sodium phase. A significant interaction was detected (P = 0.001) between dietary sodium and baseline SBP with a greater adjusted mean (95% confidence interval) decline in SBP (6 (2-9)mm Hg) among participants with high-normal SBP (130-139 mm Hg) and no significant change (-1(-2 to1)) in those with normal baseline SBP (<130 mm Hg), respectively. Conclusions: Reducing sodium intake has a beneficial effect on blood pressure in Indo-Asians with high-normal SBP, at least in the short term. Given the ubiquity of high-normal blood pressure (BP), and frank hypertension in this population, we argue that primary prevention strategies, targeted at use of discretionary sodium, should now be designed and evaluated.
AB - Background: Hypertension is a major modifiable risk factor, and while sodium restriction in hypertensive patients appears effective, its role in normotensive individuals remains unclear. We assessed the effect of a low vs. high-sodium diet on blood pressure in normotensive Indo-Asian adults. Methods: A randomized, controlled, crossover trial was conducted on 200 normotensive subjects randomly selected from the general population in Karachi, Pakistan. Participants were randomized to either a low (20 mEq/day) or a high-sodium diet (220 mEq/day) for 1 week, followed by 1 week of washout, then the alternate diet for 1 week. The primary outcome was difference in systolic blood pressure (SBP) measured at the end of each phase in the overall population. Results: Mean (95% confidence interval) decline in 24-h urinary sodium excretion was 81.0 (69.6-92.4) mEq/day (P < 0.001), and in SBP was 1 (0-3)mm Hg (P = 0.17) between high and low-sodium phase. A significant interaction was detected (P = 0.001) between dietary sodium and baseline SBP with a greater adjusted mean (95% confidence interval) decline in SBP (6 (2-9)mm Hg) among participants with high-normal SBP (130-139 mm Hg) and no significant change (-1(-2 to1)) in those with normal baseline SBP (<130 mm Hg), respectively. Conclusions: Reducing sodium intake has a beneficial effect on blood pressure in Indo-Asians with high-normal SBP, at least in the short term. Given the ubiquity of high-normal blood pressure (BP), and frank hypertension in this population, we argue that primary prevention strategies, targeted at use of discretionary sodium, should now be designed and evaluated.
UR - http://www.scopus.com/inward/record.url?scp=54249138533&partnerID=8YFLogxK
U2 - 10.1038/ajh.2008.256
DO - 10.1038/ajh.2008.256
M3 - Article
C2 - 18772855
AN - SCOPUS:54249138533
SN - 0895-7061
VL - 21
SP - 1238
EP - 1244
JO - American Journal of Hypertension
JF - American Journal of Hypertension
IS - 11
ER -