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). 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.
Blood pressure levels, the most common non-communicable condition global, represents a critical international personal health issue. In line with the 2017 American Center Relationship (AHA) guidance, the incidence off hypertension among us adults is actually estimated getting 46% ; concurrently,
50% out of hypertensive men and women are estimated is salt delicate (SS) . As the noted because of the Federal Cardio to own Chronic Situation Cures and Health Venture report
90% out-of Western people eat an excessive amount of dietary sodium (Na + ), with an average daily consumption exceeding 3400 milligrams within the adult Us people, a respect almost 3 times new each day usage needed because of the AHA and also the Federal Academy out-of Science, Engineering, and you will Treatments Losing weight Reference Intakes (DRI) . Just like the a lot of dietary Na + intake, which can drive this new salt awareness regarding hypertension and increase blood pressure levels risk, globally weight loss Na + consumption try a community fitness chance. The newest impact regarding weight reduction Na + consumption to the blood pressure level might have been examined for the numerous dieting input trials promoting research one shorter losing weight salt intake during the regulated setup contributes to decreases into the blood pressure levels [six,7,8]. Then, meta-analyses has synchronised weight loss Na + restriction with reductions inside the blood circulation pressure suggesting there is a health benefit in both normotensive and you may hypertensive some body irrespective of the brand new sodium sensitivity from blood pressure levels [nine, 10].
Relationship out of urinary sodium and you will potassium removal that have systolic blood circulation pressure from the Weight loss Remedies for End Blood pressure Sodium Trial
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 dating sites for people over 50 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.