Healthy Diet Does Not Blunt Effects of High Salt Intake

An otherwise healthy diet may only minimally mitigate the adverse association between high dietary sodium intake and blood pressure (BP), according to new study findings.

In the International Study on Macro/Micronutrients and Blood Pressure (INTERMAP) study, the researchers assessed 4680 men and women aged 40 to 59 years from various countries, including the United States.
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Ultimately, they found that 24-hour urinary sodium excretion and the urinary sodium/potassium ratio were directly associated with BP. Participants with normal weight or obesity demonstrated significant positive associations of BP with urinary sodium, but these associations were weaker among participants with overweight.

Furthermore, among the 2195 participants from the United States, a 118.7 mmol (2 standard deviation [SD]) increase in 24-hour urinary sodium excretion was associated with a 3.7 mm Hg increase in systolic BP. These associations remained significant following adjustment for 13 macronutrients, 12 vitamins, 7 minerals, and 18 amino acids, and various other factors, except for body mass index.

The researchers noted that potassium intake only helped mitigate the association between sodium intake and BP at lower levels of 24-hour sodium excretion vs higher levels.

“The adverse association of dietary sodium with BP is minimally attenuated by other dietary constituents; these findings underscore the importance of reducing salt intake for the prevention and control of prehypertension and hypertension,” the researchers concluded.

—Christina Vogt

Reference:

Stamler J, Chan Q, Daviglus ML, et al. Relation of dietary sodium (salt) to blood pressure and its possible modulation by other dietary factors [Published online March 5, 2018]. Hypertension. https://doi.org/10.1161/HYPERTENSIONAHA.117.09928.