Further evidence that methods based on spot urine samples should not be used to examine sodium‐disease relationships from the Science of Salt: A regularly updated systematic review of salt and health outcomes (November 2018 to August 2019)

Petersen, Kristina S.; Malta, Daniela; Rae, Sarah; Dash, Sarah; Webster, Jacqui; McLean, Rachael; Thout, Sudhir Raj; Campbell, Norm R.C.; Arcand, JoAnne

doi:10.1111/jch.13958

Cited by 5 publications

(5 citation statements)

References 61 publications

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“…Consistent with previous Science of Salt reviews, we found that most RCTs were short-term (≤1month) and assessed intermediate health outcomes (BP) [ 72 – 80 ]. Here, there were no long-term RCTs examining Category I (Mortality) or Category II (Morbidity) outcomes which are considered as being more important to patients.…”

Section: Discussionsupporting

confidence: 82%

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The World Hypertension League Science of Salt: a regularly updated systematic review of salt and health outcomes studies (Sept 2019 to Dec 2020)

et al. 2022

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The World Hypertension League Science of Salt health outcomes review series highlights high-quality publications relating to salt intake and health outcomes. This review uses a standardised method, outlined in previous reviews and based on methods developed by WHO, to identify and critically appraise published articles on dietary salt intake and health outcomes. We identified 41 articles published between September 2019 to December 2020. Amongst these, two studies met the pre-specified methodological quality criteria for critical appraisal. They were prospective cohort studies and examined physical performance and composite renal outcomes as health outcomes. Both found an association between increased/higher sodium intake and poorer health outcomes. Few studies meet criteria for high-quality methods. This review adds further evidence that dietary salt reduction has health benefits and strengthens evidence relating to health outcomes other than blood pressure and cardiovascular disease. We observe that most studies on dietary sodium do not have adequate methodology to reliably assess sodium intake and its association with health outcomes.

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Section: Discussionsupporting

confidence: 82%

“…In the series of Science of Salt health outcomes reviews [ 72 – 80 ], this is the first to have identified physical performance as a health outcome. This is a valuable addition to the scope of adverse health outcomes relating to high sodium intake as it addresses an important quality of life indicator.…”

Section: Discussionmentioning

confidence: 99%

The World Hypertension League Science of Salt: a regularly updated systematic review of salt and health outcomes studies (Sept 2019 to Dec 2020)

et al. 2022

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“…Estimated 24-h urinary Na was associated with a J-shaped curve for blood pressure and mortality, whereas measured 24-h urinary sodium was linearly associated with mortality. A policy statement from the World Hypertension League issued in 2019 cautions against the use of spot urines and urges rigorous study of spot urines based on systematic review of Na–disease association studies published November 2018–August 2019 ( 40 ).…”

Section: Discussionmentioning

confidence: 99%

Estimating 24-Hour Urinary Excretion of Sodium and Potassium Is More Reliable from 24-Hour Urine Than Spot Urine Sample in a Feeding Study of US Older Postmenopausal Women

Tinker

Huang

Johnson

et al. 2021

Current Developments in Nutrition

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Background Assessing estimated sodium (Na) and potassium (K) intakes derived from 24-h urinary excretions versus a spot urine sample if comparable could reduce participant burden in epidemiologic and clinical studies. Objectives In a two-week controlled feeding study, Na and K excretion from a 24-h urine collection were compared with a first void spot urine sample, applying established algorithms and enhanced models to estimate 24-h excretion. Actual and estimated 24-h excretions were evaluated relative to mean daily Na and K intakes in the feeding study. Methods 153 older postmenopausal women ages 75.4 ± 3.5 years participated in a 2-week controlled feeding study with a 4-day repeating menu cycle based on their usual intake (ClinicalTrials.gov Identifier: NCT00000611). Of the 150 participants who provided both a first void spot urine sample and a 24-h urine collection on the penultimate study day, statistical methods included Pearson correlations for Na and K between intake, 24-h collections and the 24-h estimated excretions using four established algorithms; enhanced biomarker models by regressing ln-transformed intakes on ln-transformed 24-h excretions or ln-transformed 24-h estimated excretions plus participant characteristics; and sensitivity analyses for factors potentially influencing Na or K excretion, e.g., possible kidney disease estimated eGFR < 60 mL/min/1.73m). Results Pearson correlation coefficients between Na and K intakes and actual 24-h excretions were 0.57 and 0.38–0.44 for estimated 24-h excretions, depending on electrolyte and algorithm used. Enhanced biomarker model cross-validated R2 (CVR2s) for 24-h excretions were 38.5% (Na), 40.2% (K) and 42.0% (Na/K). After excluding participants with possible kidney disease, the CVR2s were 43.2% (Na), 40.2% (K) and 38.1% (Na/K). Conclusions 24-h urine excretion measurement performs better than estimated 24-h excretion from a spot urine as a biomarker for Na and K intake among a sample of primarily white postmenopausal women. Summary 24-h urine excretion measurement performs better than estimated 24-h excretion from a spot urine as a biomarker for Na and K intake among a sample of primarily white postmenopausal women.

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“…The first line of HTN prevention and treatment is lifestyle/nonpharmacological interventions: weight loss, healthy dietary patterns (Dietary Approaches to Stop HTN and Mediterranean diets), sodium reduction, increased potassium, physical activity, stress reduction, smoke avoidance, and limiting indoor air pollution [8–12].…”

Section: Therapeutic Lifestyle/nonpharmacological Interventionsmentioning

confidence: 99%

Global interventions in hypertension: new and emerging concepts

Ferdinand

Reddy²,

Vo³

2021

Current Opinion in Cardiology

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Purpose of reviewHypertension (HTN) is the most prevalent risk factor for cardiovascular disease (CVD) worldwide, affecting 1.39 billion people. This review discusses recent literature regarding the global burden of HTN and emerging concepts in prevalence, treatment, and control in different regions around the globe. Recent findingsCommunity-based interventions and telemedicine may be useful in increasing access to care and identifying/assisting patients with HTN, especially in populations with geographical and economic barriers to healthcare. Home blood pressure monitoring is beneficial for HTN control in diverse regions. Polypills have proven benefits to decrease HTN and CVD risk. Continuation of treatment with angiotensin-convertingenzyme inhibitors and angiotensin-receptor blockers in high risk COVID-19 patients appears appropriate. SummaryExtensive research demonstrates that early screening/treatment, lifestyle modification, and pharmacotherapy are essential to control HTN worldwide. This review highlights recent research and novel concepts on effective interventions being used globally.

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Further evidence that methods based on spot urine samples should not be used to examine sodium‐disease relationships from the Science of Salt: A regularly updated systematic review of salt and health outcomes (November 2018 to August 2019)

Cited by 5 publications

References 61 publications

The World Hypertension League Science of Salt: a regularly updated systematic review of salt and health outcomes studies (Sept 2019 to Dec 2020)

The World Hypertension League Science of Salt: a regularly updated systematic review of salt and health outcomes studies (Sept 2019 to Dec 2020)

Estimating 24-Hour Urinary Excretion of Sodium and Potassium Is More Reliable from 24-Hour Urine Than Spot Urine Sample in a Feeding Study of US Older Postmenopausal Women

Global interventions in hypertension: new and emerging concepts

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