From inside the SR users i observed no matchmaking between urinary Na + excretion and you may SBP

From inside the SR users i observed no matchmaking between urinary Na + excretion and you may SBP


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.

Inside the a good randomized controlled demonstration used inside free living low-losing weight controlled players having a mean SBP out-of 132 mmHg and you can maybe not providing hypertension reducing cures, K + intake try improved from the weight-loss consumption (via fruits and you can veggie intake) or direct K + medicine

Compared with new Absolute , INTERSALT , and you may INTERMAP training, you to definitely depending a population level confident association anywhere between urinary Na + removal and you will blood circulation pressure, the fresh Dash–Salt Demonstration permits this new facilities of salt sensitivity off blood stress inside trial users. Conversely, into the SS players we seen a hill increment from a growth into the SBP of 1.3 mmHg for each and every step 1 g boost in urinary Na + removal over the removal selection of step three–5 g Na + /time that’s within this normal average directory of every single day Na + consumption in america . Conversely, whenever assessed along the whole listing of observed urinary Na + removal, i noticed zero organization between urinary Na + excretion and you may SBP in both SS otherwise SR users. We imagine so it difference between an optimistic relationships anywhere between SBP and you may urinary Na + removal for the requested selection of fat reduction Na + excretion off step three–5 g/go out and no relationship along the done list of values shows new perception from numerous participants throughout the Dashboard–Sodium data exhibiting large levels of urinary Na + excretion, more than 5 grams/date, and you may relatively low blood circulation pressure. Rather, the importance obtained contained in this data to own a boost in SBP within 3–5 g/time Na + excretion resembles that acquired on Sheer analysis and that advertised a positive slope increment off a mmHg boost in SBP for every single 1 grams upsurge in urinary Na + excretion along the same directory of Na + excretion philosophy . The essential difference between the newest observed increase in SBP as a result so you’re able to raised urinary Na + excretion anywhere between Dashboard-Salt and you may Sheer ple proportions and you can racial backgrounds of your own people and (2) the possibility variations in approaches to determine pee stuff out-of twenty-four-h pee range compared to the an estimate from one early morning place urine decide to try on Dashboard-Sodium rather than Absolute Investigation respectively. Our very own data support guidelines in order to restriction losing weight Na + intake [5, 24] and you may suggest that reduced weight loss salt intake may only down SBP when you look at the SS patients.

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.