Dialogue
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. Following the DASH dietary intervention we observed no correlation between a urinary Na + :K + ratio and SBP in either SS or SR participants. 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.
In the a good randomized regulated demo used inside the free living non-weightloss controlled professionals which have a mean SBP from 132 mmHg and you can maybe not bringing blood pressure levels lowering procedures, K + intake was improved of the fat reduction consumption (thru fruits and veggie intake) otherwise direct K + medicine
Weighed against brand new Pure , INTERSALT , and you will INTERMAP knowledge, you to founded a population level confident connection anywhere between urinary Na + excretion and you may blood pressure level, the brand new Dash–Sodium Demonstration enables the fresh new establishment of salt awareness regarding blood pressure inside demo people. However, into the SS players i noticed a slope increment regarding a growth for the SBP of just one.step 3 mmHg for each step 1 g boost in urinary Na + excretion along the excretion selection of 3–5 g Na + /go out that’s within regular mediocre selection of day-after-day Na + consumption in the usa . Alternatively, whenever reviewed along side whole set of noticed urinary Na + excretion, i seen zero connection ranging from urinary Na + removal and you will SBP https://datingranking.net/pl/livelinks-recenzja/ either in SS otherwise SR players. I speculate so it difference between an optimistic dating ranging from SBP and you may urinary Na + removal into the asked range of dietary Na + excretion out-of step 3–5 g/go out and no association across the done range of opinions reflects new effect off multiple users on Dashboard–Sodium studies showing high degrees of urinary Na + excretion, greater than 5 grams/go out, and you may relatively lowest hypertension. Significantly, the importance acquired contained in this data for a rise in SBP inside 3–5 grams/day Na + removal is similar to one to acquired regarding Pure study and therefore claimed a confident mountain increment from a-1.eight mmHg boost in SBP for each step one g boost in urinary Na + removal over the same directory of Na + excretion opinions . The difference between new seen escalation in SBP in response in order to increased urinary Na + excretion anywhere between Dashboard-Sodium and you may Natural ple size and you will racial backgrounds of people and you may (2) the possibility variations in methods to assess pee posts out of twenty four-h pee collection versus an evaluation from a single morning room urine test about Dash-Sodium instead of Sheer Investigation correspondingly. The studies help guidelines to limitation fat loss Na + consumption [5, 24] and advise that reduced dietary salt consumption may only straight down SBP within the SS people.
The influence of K + intake on blood pressure remains controversial, with conflicting data emerging from multiple clinical studies . 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.