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In the current study, using data from the DASH–Sodium trial, during screening when participants are consuming their normal dietary intake, we report a slope increment of an elevation in SBP of approximately 3 mmHg across the urinary Na + excretion range of 2–5 g/day in SS, but not SR participants. However, when assessed across the full range of observed urinary Na + excretion values we did not observe a positive correlation between SBP and urinary Na + excretion in either SS or SR participants. Significantly, despite urinary K + excretion of <1 g K + /day associating with higher SBP in SS and SR participants further increments in urinary K + excretion did not correlate with a reduction in SBP in either participant group. Furthermore, at baseline screening we did not observe a correlation between the urinary Na + :K + excretion ratio irrespective of the salt sensitivity of blood pressure. As such our data, from the DASH–Sodium Trial, in US participants at both baseline screening and following a highly controlled dietary intervention does not support the hypothesis that a reduced urinary Na + :K + ratio will be beneficial in population level blood pressure reduction or support the proposal for a urinary Na + :K + molar ratio of <1 to lower blood pressure.
Pursuing the Dash diet intervention i seen no correlation between a good urinary Na + :K + proportion and SBP in both SS or SR people
Weighed against the latest Natural , INTERSALT , and you can INTERMAP education, you to definitely created a population level self-confident organization anywhere between urinary Na + excretion and you can hypertension, the fresh new Dashboard–Sodium Trial enables the business of one’s sodium susceptibility of online dating reviews blood pressure in trial players. In contrast, inside the SS participants i noticed a hill increment regarding a growth when you look at the SBP of just one.step three mmHg for every single step 1 g increase in urinary Na + removal along the excretion range of 3–5 grams Na + /go out that is within normal mediocre directory of daily Na + consumption in america . However, when assessed over the entire list of observed urinary Na + removal, i seen no association ranging from urinary Na + removal and you will SBP in a choice of SS otherwise SR members. We imagine this discrepancy anywhere between a positive dating anywhere between SBP and you may urinary Na + excretion inside expected variety of fat reduction Na + excretion regarding step three–5 g/big date no organization along the over directory of beliefs reflects the fresh perception of numerous players from the Dashboard–Sodium study exhibiting high quantities of urinary Na + excretion, higher than 5 g/go out, and you will relatively lower hypertension. Significantly, the benefits received in this study for a boost in SBP within this step three–5 grams/big date Na + removal is comparable to one received regarding the Absolute studies hence claimed an optimistic hill increment out of a 1.7 mmHg escalation in SBP for every single step 1 g escalation in urinary Na + removal along the same range of Na + excretion thinking . The essential difference between the newest seen upsurge in SBP in reaction so you can elevated urinary Na + removal anywhere between Dash-Salt and you may Sheer ple size and racial experiences of your own professionals and (2) the possibility variations in methods to evaluate urine content regarding twenty four-h urine range versus an estimate from a single morning location pee test from the Dashboard-Sodium as opposed to Sheer Research respectively. Our very own research support assistance so you can maximum slimming down Na + intake [5, 24] and advise that quicker weightloss salt consumption might only lower SBP into the SS customers.
The influence of K + intake on blood pressure remains controversial, with conflicting data emerging from multiple clinical studies . In a randomized controlled trial conducted in free living non-dietary regulated participants with a mean SBP of 132 mmHg and not taking blood pressure lowering medication, K + intake was increased by dietary intake (via fruit and vegetable intake) or direct K + supplements. In this study increased K + intake up to 40 mmol/day had no impact on blood pressure [22, 26]. A separate randomized placebo-controlled crossover trial was conducted in participants who have never received antihypertensive medication with mildly elevated blood pressure . Participants were maintained on their normal diet and received K + at 64 mmol/day for a 4-week period as either potassium chloride or bicarbonate-in this study there was no effect of K + supplementation on office blood pressure . In contrast in a randomized placebo-controlled, crossover study, in which untreated patients with a mean SBP of 145 mmHg blood pressure received 4 weeks of supplemental K + at 3 g/day and a diet relatively low in Na + reported a reduction in SBP of 3.9 mmHg. Beyond the highly controlled trials discussed above the PURE study reports that for each increment of 1 g/day of urinary K + excretion there is a reduction of 0.75 mmHg in SBP across the excretion range of <1.25 to 3 g K + /day . In the DASH–Sodium data, we observed an elevation in SBP in both SS and SR participants when urinary K + excretion was below 1 g/day. However, we did not observe any correlation between urinary K + excretion and SBP or an impact of urinary K + excretion on SBP over the range of <1 to >3 g K + excretion per day. We speculate that discrepancy between the PURE study data and our own analysis of the DASH-Sodium data may reflect the difference in SBP response to urinary K + excretion reported in PURE between Chinese and non-Chinese participants. Chinese participants exhibited a large reduction in SBP with increased urinary K + excretion versus a smaller SBP effect in participants from the rest of the world. As the DASH-Sodium trial did not contain Chinese participants this may have influenced the outcome.