Within the SR participants i seen zero relationships ranging from urinary Na + removal 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 randomized controlled demonstration conducted within the free-living low-weight loss controlled users which have a suggest SBP off 132 mmHg and you can perhaps not getting blood pressure level lowering medication, K + consumption are increased because of the weight loss intake (through fruits and veggie consumption) otherwise lead K + medicine
Compared to the latest Pure , INTERSALT , and you will INTERMAP studies, that centered a people level positive organization ranging from urinary Na + excretion and you may hypertension, the fresh Dashboard–Salt Demo allows the newest organization of salt sensitiveness regarding bloodstream tension when you look at the demonstration users. On the other hand, in the SS participants we seen a slope increment out-of a rise in SBP of 1.step three mmHg each step 1 grams rise in urinary Na + excretion along side excretion directory of step 3–5 grams Na + /go out that’s inside regular average selection of each and every day Na + intake in america . However, when examined across the whole range of seen urinary Na + removal, we observed no organization between urinary Na + removal and SBP in a choice of SS otherwise SR people. I imagine that it difference between an optimistic dating between SBP and urinary Na + removal inside expected range of weight loss Na + excretion off 3–5 g/go out no organization over the over list of thinking shows brand new feeling out-of multiple users throughout the Dash–Salt studies demonstrating high degrees of urinary Na + removal, higher than 5 g/big date, and you may relatively lower blood pressure. Somewhat, the significance obtained contained in this data having an increase in SBP in this step 3–5 grams/date Na + removal is comparable to that gotten throughout the Absolute studies and that stated a confident slope increment from a-1.7 mmHg boost in SBP for every step one g escalation in urinary Na + removal along the exact same directory of Na + excretion philosophy . The difference between brand new noticed increase in SBP as a result so you’re able to elevated urinary Na + excretion between Dashboard-Salt and Natural ple dimensions and you will racial experiences of the users and you can (2) the possibility differences in solutions to evaluate urine content away from twenty-four-h pee range as compared to an estimate from 1 early morning room urine sample regarding Dashboard-Sodium instead of Pure Data respectively. The investigation help direction so you’re able to limitation slimming down Na + consumption [5, 24] and recommend that quicker weight-loss salt intake might only lower SBP during 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 interracial dating central 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.