Low-sodium DASH reduces oxidative stress and improves vascular function in salt-sensitive humans

Al-Solaiman, Yaser; Jesri, Ammar; Zhang, Yanru; Morrow, Jason D.; Egan, Brent M.

doi:10.1038/jhh.2009.32

Cited by 88 publications

(78 citation statements)

References 57 publications

(67 reference statements)

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“…A reduction in dietary sodium intake has been shown to decrease significantly blood pressure in hypertensive individuals. 25 A lowsodium diet has also been found to decrease oxidative stress and to improve vascular function in salt-sensitive individuals, 26 and a high sodium intake may promote vascular stiffness. 27 Several prospective studies have observed a positive association between processed meat consumption and risk of type 2 diabetes, 4,28,29 which is a risk factor for cerebral infarction.…”

Section: Discussionmentioning

confidence: 99%

Red Meat Consumption and Risk of Stroke in Swedish Women

Larsson

Virtamo

Wolk

2011

Stroke

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Background and Purpose-High red meat consumption has been associated with increased risk of some cancers and may also be a risk factor for cardiovascular diseases. However, epidemiological studies of red meat consumption in relation to risk of stroke are very limited. Our objective was to examine the association between red meat consumption and stroke incidence in the Swedish Mammography Cohort. Methods-We prospectively followed 34 670 women without cardiovascular disease and cancer at baseline. Participants completed a self-administered questionnaire on diet and other risk factors for cardiovascular diseases in 1997. Cox proportional hazards models were used to estimate multivariable-adjusted relative risks (RR) and 95% CI. Results-During a mean follow-up of 10.4 years, we ascertained 1680 incident cases of stroke, comprising 1310 cerebral infarction, 154 intracerebral hemorrhage, 79 subarachnoid hemorrhage, and 137 unspecified stroke. Total red meat and processed meat consumption was associated with a statistically significant increased risk of cerebral infarction, but not of total stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. The multivariable RR of cerebral infarction for the highest versus the lowest quintile of consumption were 1.22 (95% CI, 1.01-1.46) for red meat and 1.24 (95% CI, 1.04 -1.49) for processed meat. Fresh (unprocessed) meat consumption was not associated with total stroke or with any stroke subtype. Conclusion-Findings from this study suggest that red and processed meat consumption may increase the risk of cerebral infarction in women. (Stroke. 2011;42:324-329.)

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Section: Discussionmentioning

confidence: 99%

Red Meat Consumption and Risk of Stroke in Swedish Women

Larsson

Virtamo

Wolk

2011

Stroke

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“…12 In addition, excessive sodium intake is thought to have direct toxic effects on blood vessels through mediating factors such as oxidative stress, inflammation, endothelial cell dysfunction, and vascular stiffness. [13][14][15] The available evidence detailing the effects of sodium restriction in CKD patients is of poor quality, lacks randomization, [16][17][18] a control group, 17 or blinding, 10,11 or does not use gold-standard measurement techniques (e.g., using clinic instead of ambulatory BP). 10,11 Furthermore, several studies failed to either evaluate or adjust for the influence of key confounding factors, such as potassium intake or body weight, 10,11,[19][20][21][22] thereby making it difficult to assess whether the observed results can be solely attributed to dietary sodium.…”

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confidence: 99%

A Randomized Trial of Dietary Sodium Restriction in CKD

McMahon

Bauer

Hawley

et al. 2013

Journal of the American Society of Nephrology

269

203

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There is a paucity of quality evidence regarding the effects of sodium restriction in patients with CKD, particularly in patients with pre-end stage CKD, where controlling modifiable risk factors may be especially important for delaying CKD progression and cardiovascular events. We conducted a doubleblind placebo-controlled randomized crossover trial assessing the effects of high versus low sodium intake on ambulatory BP, 24-hour protein and albumin excretion, fluid status (body composition monitor), renin and aldosterone levels, and arterial stiffness (pulse wave velocity and augmentation index) in 20 adult patients with hypertensive stage 3-4 CKD as phase 1 of the LowSALT CKD study. Overall, salt restriction resulted in statistically significant and clinically important reductions in BP (mean reduction of systolic/diastolic BP, 10/4 mm Hg; 95% confidence interval, 5 to 15 /1 to 6 mm Hg), extracellular fluid volume, albuminuria, and proteinuria in patients with moderate-to-severe CKD. The magnitude of change was more pronounced than the magnitude reported in patients without CKD, suggesting that patients with CKD are particularly salt sensitive. Although studies with longer intervention times and larger sample sizes are needed to confirm these benefits, this study indicates that sodium restriction should be emphasized in the management of patients with CKD as a means to reduce cardiovascular risk and risk for CKD progression.

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“…Third, individuals with hypertension are more likely than their normotensive counterparts to manifest evidence for salt sensitivity, reduced antioxidant capacity, or increased oxidative stress, which is seen in the collectrin knockout mouse model. 7 Fourth, diets, such as DASH (for Dietary Approaches to Stop Hypertension), that are high in antioxidants and minerals attenuates salt sensitivity 9 and oxidative stress responses and vascular dysfunction in obese and salt-sensitive humans 10,11 similar to Tempol in collectrin knockout mice on high salt. Fifth, collectrin affects insulin secretion.…”

Section: Article See P 1770mentioning

confidence: 99%

Collectrin, an X-Linked, Angiotensin Converting Enzyme 2 Homolog, Causes Hypertension in a Rat Strain Through Gene–Gene and Gene–Environment Interactions

Egan

2013

Circulation

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2 However, previous research demonstrated that the collectrin gene is located on a region of the X chromosome with loci linked to hypertension in humans and rats.3,4 Moreover, renal expression of collectrin is upregulated after subtotal nephrectomy and in salt-sensitive hypertension. Article see p 1770With this background, the authors studied the effects of collectrin null mutations on BP in a 129S6 mouse strain that is susceptible to hypertension and salt sensitivity. 5,6 Under standard feeding conditions, the gene-gene interaction in the collectrin knockout/129S6 strain male mice led to a modest 9-mm Hg elevation in BP compared with wild-type control 129S6 mice. The rise in BP was accompanied by increased left ventricular mass. The investigative team then studied the effects of a high-salt diet on BP in these 2 mice strains. With this gene-environment interaction, BP rose a net 7 mm Hg (15 vs 8 mm Hg) more in collectrin knockout/129S6 male mice than 129S6 male controls over a 2-week period. The collectrin knockout/129S6 mice manifest evidence for increased superoxide and oxidative stress with decreased nitric oxide.Based on previous studies documenting an important role for collectrin in amino acid transport, 1 the authors conducted mechanistic studies to elucidate the root cause(s) for the genegene and gene-environment interactions that led to basal and salt-induced differences in BP between the collectrin knockout/129S6 and 129S6 rat strains. The collectrin knockout strain had decreased levels of amino acid transporters in endothelial cells, reduced arginine uptake, and decreased homodimeric nitric oxide synthase, which generates nitric oxide, to monomeric nitric oxide synthase, which generates superoxide. The investigators further documented impaired endothelium-dependent vasodilation and pressure natriuresis, which can be attributed to the documented changes in nitric oxide and superoxide. Tempol, a superoxide scavenger, lowered BP minimally and insignificantly in both mice strains on usual diets and in control 129S6 mice on high-salt diets, which did not suggest a major role for superoxide in BP regulation in these conditions. However, Tempol lowered BP significantly in the collectrin knockout/129S6 mice on a high-salt diet and eliminated the difference in salt-sensitive BP responses between the two strains. These findings suggest a major role for superoxide in the excessive rise of BP during a salt stress in the collectrin knockout/129S6 mice.These original observations are potentially relevant to human hypertension. First, an array of gene-gene and gene-environment interactions, rather than single-gene defects, likely account for the majority of human hypertension.7 Second, the majority of humans with hypertension have comparatively modest elevations of BP in the prehypertensive (120-139/80-89) and Stage 1 hypertensive (140-159/90-99) range, 8 similar to collectrin knockout/129S6 mice. Third, individuals with hypertension are more likely than their normotensive counterparts to manifest evidence for salt...

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Low-sodium DASH reduces oxidative stress and improves vascular function in salt-sensitive humans

Cited by 88 publications

References 57 publications

Red Meat Consumption and Risk of Stroke in Swedish Women

Red Meat Consumption and Risk of Stroke in Swedish Women

A Randomized Trial of Dietary Sodium Restriction in CKD

Collectrin, an X-Linked, Angiotensin Converting Enzyme 2 Homolog, Causes Hypertension in a Rat Strain Through Gene–Gene and Gene–Environment Interactions

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