Sodium, Blood Pressure, and Cardiovascular Disease

Abstract

Abstract-Recent reports of selected observational studies and a meta-analysis have stirred controversy and have become the impetus for calls to abandon recommendations for reduced sodium intake by the US general population. A detailed review of these studies documents substantial methodological concerns that limit the usefulness of these studies in setting, much less reversing, dietary recommendations. Indeed, the evidence base supporting recommendations for reduced sodium intake in the general population remains robust and persuasive. The American Heart Association is committed to improving the health of all Americans through implementation of national goals for health promotion and disease prevention, including its recommendation to reduce dietary sodium intake to Ͻ1500 mg/d. (Circulation. 2012;126:2880-2889.)Key Words: AHA Scientific Statements Ⅲ sodium Ⅲ diet Ⅲ prevention I n almost every country that has established guidelines for the prevention and treatment of cardiovascular disease (CVD) and stroke, national health agencies and professional societies recommend a reduction in dietary sodium as a means to lower blood pressure (BP) and to prevent CVD and stroke. The American Heart Association (AHA) currently recommends a sodium intake Ͻ1500 mg/d for the entire US population. 1 The US Department of Agriculture and US Department of Health and Human Services joint 2010 Dietary Guidelines for Americans calls for no more than 1500 mg/d in AfricanAmericans, people Ͼ51 years of age, and people with hypertension, diabetes mellitus, or chronic kidney disease, and no more than 2300 mg/d in all others. 2 Guideline recommendations far exceed adequate intake for sodium in some age groups, especially in children; the adequate intake for children aged 1 to 3 years is 1000 mg/d, and for children aged 4 to 8 years is 1200 mg/d. 3 The scientific rationale for the AHA recommendation was documented in an AHA presidential advisory published in 2011. 4 The principal basis for the recommendation was the strength of the evidence relating excess sodium intake to high BP, CVD, and stroke and the capacity of reduced intake of sodium to prevent and treat hypertension and to reduce the risk of adverse CVD and stroke events. High BP, both prehypertension and hypertension, is a leading cause of preventable morbidity and mortality worldwide. 5 Excess sodium intake has also been linked to kidney stones, asthma, osteoporosis, and gastric cancer. 3,6 Various local, state, federal, and global initiatives are focused on efforts to meet sodium reduction guidelines. 7 Even a modest reduction in sodium intake is likely to result in substan-The opinions expressed in this article are not necessarily those of the editors. The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Discl...

Estudo de validação das equações de Tanaka e de Kawasaki para estimar a excreção diária de sódio através da coleta da urina casual

“…Our data showed that the salt consumption estimated by the gold-standard is higher in comparison to other populations 9,21,25 , being higher than twice the current recommendation of 5 g of salt a day 29 . The impact of salt consumption on blood pressure of the study participants was described in another publication 30 .…”

“…However, this finding should be carefully analyzed, because the method for urine collection was different in previous studies. It is worth to mention that the subgroups that mostly benefitted from the reduction in salt consumption, such as hypertensive people, still consume much more than the recommended amount 29,31 . Similarly to what was observed in other studies 12,13,[23][24][25] , we observed moderate correlation between the salt intake estimated by casual urine and the consumption measured in 24 hours.…”

Blood Pressure and Left Ventricular Hypertrophy During American-Style Football Participation

“…Our analyses demonstrate that ASF athletes at the highest risk of developing hypertension can be identified by easily assessed characteristics, including field position, intraseason weight gain, and family history of hypertension. Hypertensive ASF athletes will likely benefit from increased surveillance, specifically measurements of resting BP before, during, and after competitive ASF participation, coupled with directed measures to treat hypertension, including dietary, 22,23 lifestyle, 24 and pharmacological interventions as recommended by current guidelines. 25 Potential treatment strategies should be carefully selected to preserve athletic performance and to simultaneously normalize BP.…”

“Slow”ing Cardiovascular Risk in Type 2 Diabetics by Restricting Dietary Salt Intake

“…A significant amount of data suggests that dietary salt restriction is an important clinical step toward blood pressure control in both normotensive and hypertensive populations, and especially in African Americans where the prevalence of salt-sensitive hypertension is high. 2 Nevertheless, whether it is appropriate to use population-wide strategies to reduce salt intake has remained a subject of debate over the past several decades. Adding to the debate, a recent meta-analysis of 269 reports set out to assess whether dietary salt reduction lowered allcause mortality and risk for cerebro-cardiovascular disease.…”