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. 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.
After the Dash fat reduction intervention i observed zero relationship between a urinary Na + :K + ratio and you can SBP in a choice of SS otherwise SR members
In contrast to new Absolute , INTERSALT , and you will INTERMAP degree, you to definitely centered a populace top confident organization between urinary Na + excretion and blood pressure level, this new Dashboard–Sodium Demonstration allows new establishment of one’s sodium sensitiveness off bloodstream pressure inside the demo members. However, during the SS people i noticed a mountain increment off a growth into the SBP of just one.step 3 mmHg each step one g boost in urinary Na + removal along side removal selection of 3–5 g Na + /day that’s contained in this normal average list of each and every day Na + intake in america . In contrast, when examined across the whole list of observed urinary Na + removal, i observed zero association between urinary Na + excretion and you may SBP in either SS otherwise SR participants. We speculate that it discrepancy between a positive relationship ranging from SBP and you can urinary Na + excretion when you look at the expected selection of weightloss Na + removal of step three–5 grams/go out and no relationship across the over set of beliefs shows the newest impression off numerous professionals on the Dash–Sodium research exhibiting high amounts of urinary Na + removal, greater than 5 grams/day, and comparatively reduced blood pressure level. Significantly, the benefits gotten in this data getting a boost in SBP contained in this 3–5 grams/day Na + removal is similar to one to obtained from the Natural investigation and that reported a positive slope increment off a-1.7 mmHg increase in SBP for each step 1 g escalation in urinary Na + removal over the exact same directory of Na + excretion values . The essential difference between the latest noticed boost in SBP in reaction so you’re able to increased urinary Na + excretion between Dashboard-Salt and you can Pure ple dimensions and racial backgrounds top hookup apps for lesbian of your members and you may (2) the possibility differences in ways to determine urine stuff off twenty-four-h pee range versus an estimation from a single early morning destination urine decide to try in the Dash-Sodium rather than Absolute Investigation respectively. Our studies service guidance to help you restriction weight reduction Na + intake [5, 24] and advise that quicker dietary salt consumption may only straight down SBP into the SS patients.
The influence of K + intake on blood pressure remains controversial, with conflicting data emerging from multiple clinical studies . In a randomized controlled trial conducted in free living non-dietary regulated participants with a mean SBP of 132 mmHg and not taking blood pressure lowering medication, K + intake was increased by dietary intake (via fruit and vegetable intake) or direct K + supplements. 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.