A low dietary sodium dose is associated with a more pronounced aldosterone response in normotensive than in hypertensive individuals

Abstract

In this comprehensive meta-regression analysis encompassing 79 randomized controlled trials, we observed that in populations assigned to a high sodium intake level exceeding 94 mmol, there was no discernible link between plasma aldosterone levels and sodium intake. However, among populations with normal blood pressure subjected to a lower sodium intake, falling below 111 mmol (N = 1544), the association between sodium intake and plasma aldosterone levels manifested as a decrease of 192 pg/ml per 100 mmol of sodium (95% CI − 303 to − 81). In hypertensive populations (N = 1145), this association was less pronounced, with a reduction of 46 pg/ml per 100 mmol sodium, (95% CI − 112 to 20). Furthermore, in normotensive populations the plasma aldosterone increase associated with a decrease in sodium intake was 70 pg/ml per 100 mmol sodium (95% CI 27 to 113). In hypertensive populations, the observed increase was more modest, at 30 pg/ml per 100 mmol sodium, (95% CI 6.8 to 54). A limitation of this study lies in the absence of individual participant data. Our analysis included adjustments for potential effect-modifiers, encompassing bias estimation, which did not substantially alter these associations. One perspective of the present results may be to prompt a reconsideration of current sodium reduction recommendations.

Sodium, potassium intake, and all-cause mortality: confusion and new findings

“…Our study uncovers a negative association between daily sodium intake and all-cause mortality for individuals over 40, corroborating findings from previous research conducted by Messerli FH et al [ 5 ] and O'Donnell M et al [ 6 ]. While a reduced sodium intake may diminish peak blood pressure and lower the likelihood of hypertension-related cardiovascular events, an exceedingly low intake can potentially stimulate the renin–angiotensin–aldosterone system (RAAS) [ 33 , 34 ], impacting catecholamine and lipid metabolism and consequently raising the mortality risk. On conducting subgroup analyses, we observed a significant interaction between age and daily sodium intake.…”