The 2019 National Academy of Science, Engineering and Medicine Dietary Reference Intakes (DRI) for Sodium (Na + ) and Potassium (K + ) Report concluded there remains insufficient evidence to establish a K + DRI. This study tested the hypothesis that reduced Na + and increased K + excretion will positively associate with lower blood pressure in salt sensitive (SS) and salt resistant (SR) participants in the Dietary Approaches to Stop Hypertension Sodium Trial (DASH–Sodium). Via the NHLBI BioLINCC we accessed the DASH-Sodium dataset for data on systolic blood pressure (SBP), 24-h urinary Na + and K + excretion at screening (regular patient diet; N = 186, SS N = 222 SR) and post DASH diet (N = 71 SS, N = 119 SR) profile fastflirting. The relationships between SBP, urinary Na + and K + excretion, and Na + /K + ratio were assessed via linear regression. At screening elevated urinary Na + excretion positively associated with SBP in SS (1 g increase in urinary Na + excretion = +1 0 ± 0.4 mmHg) but not SR participants, and urinary K + excretion of <1 g K + /day was associated with higher SBP in SS and SR participants. Urinary K + excretion ?1 g/day, or a decreases in urinary Na + /K + ratio, was not associated with lower SBP. Post the DASH–sodium diet intervention, SBP was reduced in SS and SR participants. However, no correlation was observed between reduced SBP and urinary K + excretion or the urinary Na + /K + ratio irrespective of the salt sensitivity of blood pressure. Our data support the DRI recommendation not to establish a K + DRI and suggest further evidence is required to support a reduced Na + /K + ratio to lower SBP.
Introduction
Blood pressure levels, the most popular non-communicable situation around the globe, represents a serious globally public ailment. In accordance with the 2017 American Heart Organization (AHA) guidance, the incidence out of blood pressure levels in our midst grownups is actually projected to-be 46% ; concurrently,
Connection out-of urinary sodium and you may potassium excretion that have systolic blood pressure about Weightloss Methods to Stop Blood pressure Salt Demo
50% out-of hypertensive everyone is estimated getting sodium delicate (SS) . Since indexed of the Federal Cardiovascular system having Persistent State Protection and you will Wellness Promotion declaration
90% from Western people eat too much weight-loss sodium (Na + ), which have the average everyday application exceeding 3400 milligrams for the adult All of us males, a value almost 3 times this new every single day usage recommended by AHA and the Federal Academy regarding Research, Technology, and you will Medicine Dieting Site Intakes (DRI) . Once the an excessive amount of weight-loss Na + consumption, that drive the sodium sensitiveness from hypertension while increasing blood pressure exposure, in the world dieting Na + consumption try a public fitness chance. The brand new impact of diet Na + intake on blood pressure level has been examined for the numerous dieting input trials producing research one shorter weight-loss sodium intake from inside the managed options causes reductions in the blood circulation pressure [six,eight,8]. After that, meta-analyses features correlated fat reduction Na + restriction which have decreases within the blood pressure level suggesting there’s a healthcare work for both in normotensive and you may hypertensive people no matter what the sodium awareness out-of blood pressure levels [nine, 10].
Recent evidence suggests the salt sensitivity of blood pressure may be modulated, in part, by dietary potassium (K + ) intake. Increasing dietary K + intake appears to counteract the effects of dietary Na + intake on increasing blood pressure [11,12,13]. Despite several studies that have documented blood pressure lowering effects of increasing K + intake, the 2019 National Academy of Science, Engineering, and Medicine DRI for sodium and potassium Report did not establish a DRI for K + . This report concluded that more evidence is required to support a DRI of K + with particular reference to a lack of K + dose-response trials limiting the evidence to establish a K + DRI . Several studies have reported that the urinary Na + :K + ratio has a stronger association with blood pressure than Na + or K + independently [14, 15]. Largely based on these data, a urinary Na + to K + molar ratio of <1 has been recommended [16, 17] as a beneficial target to improve long-term blood pressure control. Given the high global dietary Na + intake this would necessitate dietary, or other means, of K + supplementation-for which a DRI has not been established . A leading dietary intervention study was the Dietary Approaches to Stop Hypertension 2 Trial (DASH-Sodium) conducted between 1997 and 2002 . The DASH-Sodium trial was a multicenter, randomized clinical trial that examined the impact of three levels dietary Na + intake in combination with either a control or DASH diet (rich in fruits, vegetables, and low-fat dairy products, and reduced in total fat) on blood pressure. This study demonstrated substantial effects of dietary Na + reduction and the DASH diet on reducing blood pressure, with more significant blood pressure lowering effects with the combination of a DASH diet plus dietary Na + reduction than dietary Na + restriction alone in individuals with higher than optimal blood pressure . Given that the DASH diet intervention elevated dietary K + intake by increasing dietary intake of fruits and vegetables in combination with modifying daily dietary Na + intake, examining the potential interaction between dietary Na + and K + intake on blood pressure in the DASH trial will provide valuable insight into the potential influence of dietary K + on blood pressure.