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Is There Association between Altered Adrenergic System Activity and Microvascular Endothelial Dysfunction Induced by a 7-Day High Salt Intake in Young Healthy Individuals.
Stupin, A, Drenjančević, I, Šušnjara, P, Debeljak, Ž, Kolobarić, N, Jukić, I, Mihaljević, Z, Martinović, G, Selthofer-Relatić, K
Nutrients. 2021;(5)
Abstract
This study aimed to test the effect of a 7-day high-salt (HS) diet on autonomic nervous system (ANS) activity in young healthy individuals and modulation of ANS on microvascular endothelial function impairment. 47 young healthy individuals took 7-day low-salt (LS) diet (3.5 g salt/day) followed by 7-day high-salt (HS) diet (~14.7 g salt/day). ANS activity was assessed by 24-h urine catecholamine excretion and 5-min heart rate variability (HRV). Skin post-occlusive reactive hyperemia (PORH) and acetylcholine-induced dilation (AChID) were assessed by laser Doppler flowmetry (LDF). Separately, mental stress test (MST) at LS and HS condition was conducted, followed by immediate measurement of plasma metanephrines' level, 5-min HRV and LDF microvascular reactivity. Noradrenaline, metanephrine and normetanephrine level, low-frequency (LF) HRV and PORH and AChID significantly decreased following HS compared to LS. MST at HS condition tended to increase HRV LF/HF ratio. Spectral analysis of PORH signal, and AChID measurement showed that MST did not significantly affect impaired endothelium-dependent vasodilation due to HS loading. In this case, 7-day HS diet suppressed sympathetic nervous system (SNS) activity, and attenuated microvascular reactivity in salt-resistant normotensive individuals. Suppression of SNS during HS loading represents a physiological response, rather than direct pathophysiological mechanism by which HS diet affects microvascular endothelial function in young healthy individuals.
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2.
Dietary Salt (Sodium Chloride) Requirement and Adverse Effects of Salt Restriction in Humans.
Nishimuta, M, Kodama, N, Yoshitake, Y, Shimada, M, Serizawa, N
Journal of nutritional science and vitaminology. 2018;(2):83-89
Abstract
Inevitable sodium loss under sodium restriction must not be construed as evidence for the estimated average requirement (EAR) for sodium (Na) in humans. We conducted human mineral balance studies to determine the EAR for some minerals (Na, K, Ca, Mg, P, Zn, Fe, Cu and Mn). Na concentration in arm sweat was low while those of calcium (Ca) and magnesium (Mg) were high, during relatively heavy bicycle-ergometer exercise under relatively low Na intake (100 mmol/d). This suggests that Na was released from the bone, the sole pool of Na, with Ca and Mg. Additionally, the negative balances of Ca and Mg was observed under a relatively low sodium intake (100 mmol/d) even with the sufficient supply and intake of Ca and Mg into human body. Finally, we found no correlation between the Na intake and the Na balance, while the Na-intake was correlated significantly to the balances of K, Ca and Mg. The Na intake necessary to keep the balances of Ca and Mg positive was calculated to be 68 mg/kg body weight/d. To learn the signs and symptoms of low sodium intake, we compared the results of a metabolic study in which subjects consumed diets with 6 g and 12 g salt/d respectively. The blood pressure decreased only with the 6 g/d group. Fecal moisture contents of the 6 g/d group were lower than for the 12 g/d group, suggesting the fecal Na was strongly reabsorbed with water when the dietary Na was insufficienct. Indiscriminate Na restriction may have adverse effects on health.
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3.
Ambulatory blood pressure and blood pressure load responses to low sodium intervention in Han Chinese population.
Liu, F, Chen, P, Li, D, Yang, X, Huang, J, Gu, D
Clinical and experimental hypertension (New York, N.Y. : 1993). 2015;(7):551-6
Abstract
We aimed to illustrate ambulatory blood pressure monitoring parameters responses to low sodium intake and their differences between salt-sensitive and non-salt-sensitive individuals. A total of 186 participants were included in this analysis. Twenty-four hour, day-time and night-time blood pressure (BP) and BP load decreased during low sodium intervention, especially in salt-sensitive (SS) group. After multivariable adjustment, 24-h systolic BP, diastolic BP, mean arterial pressure and BP load responses to low sodium intervention of SS individuals were more pronounced than those of non-salt-sensitive individuals. Thus, reducing salt intake is potentially needed for the prevention of hypertension, especially in SS individuals.
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4.
The effect of lowering salt intake on ambulatory blood pressure to reduce cardiovascular risk in chronic kidney disease (LowSALT CKD study): protocol of a randomized trial.
McMahon, EJ, Bauer, JD, Hawley, CM, Isbel, NM, Stowasser, M, Johnson, DW, Hale, RE, Campbell, KL
BMC nephrology. 2012;:137
Abstract
BACKGROUND Despite evidence implicating dietary sodium in the pathogenesis of cardiovascular disease (CVD) in chronic kidney disease (CKD), quality intervention trials in CKD patients are lacking. This study aims to investigate the effect of reducing sodium intake on blood pressure, risk factors for progression of CKD and other cardiovascular risk factors in CKD. METHODS/DESIGN The LowSALT CKD study is a six week randomized-crossover trial assessing the effect of a moderate (180 mmol/day) compared with a low (60 mmol/day) sodium intake on cardiovascular risk factors and risk factors for kidney function decline in mild-moderate CKD (stage III-IV). The primary outcome of interest is 24-hour ambulatory blood pressure, with secondary outcomes including arterial stiffness (pulse wave velocity), proteinuria and fluid status. The randomized crossover trial (Phase 1) is supported by an ancillary trial (Phase 2) of longitudinal-observational design to assess the longer term effectiveness of sodium restriction. Phase 2 will continue measurement of outcomes as per Phase 1, with the addition of patient-centered outcomes, such as dietary adherence to sodium restriction (degree of adherence and barriers/enablers), quality of life and taste assessment. DISCUSSION The LowSALT CKD study is an investigator-initiated study specifically designed to assess the proof-of-concept and efficacy of sodium restriction in patients with established CKD. Phase 2 will assess the longer term effectiveness of sodium restriction in the same participants, enhancing the translation of Phase 1 results into practice. This trial will provide much-needed insight into sodium restriction as a treatment option to reduce risk of CVD and CKD progression in CKD patients. TRIAL REGISTRATION Universal Trial Number: U1111-1125-2149. Australian New Zealand Clinical Trials Registry Number: ACTRN12611001097932.
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5.
Effectiveness of a spot urine method in evaluating daily salt intake in hypertensive patients taking oral antihypertensive drugs.
Kawamura, M, Kusano, Y, Takahashi, T, Owada, M, Sugawara, T
Hypertension research : official journal of the Japanese Society of Hypertension. 2006;(6):397-402
Abstract
Kawasaki et al. developed a spot urine method (SUM) for evaluating daily salt intake using one pre-breakfast sample obtained after initial voiding upon arising. Their subjects were healthy persons who were not taking any regular medications. To determine whether SUM can be successfully used for patients taking antihypertensive drugs, we estimated daily salt intake in 73 hypertensive patients by SUM and by a food consumption method (FCM) when they were at home, and also by SUM in the hospital with a defined intake of 7 g of sodium chloride (NaCl). Forty-one patients took oral antihypertensive medications once daily, while 32 patients took none. Mean daily salt intakes by SUM during admission were 7-8 g of NaCl in both groups (95% confidence intervals: 5.0-10.6 g in the medication group; 5.2-11.1 g in the no-medication group), which corresponded well to the diet. In contrast, ambulatory daily salt intake by SUM varied widely (95% confidence intervals: 5.5-20.7 g in the medication group; 7.6-22.8 g in the no-medication group). However, the daily salt intakes determined by SUM and FCM correlated significantly with each other in the medication group (r=0.69, p<0.01) and the no-medication group (r=0.66, p<0.01). SUM is therefore a reliable method for evaluating daily salt intake in patients taking antihypertensive medication as well as unmedicated patients.
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6.
Persistence of normotension after discontinuation of lifestyle intervention in the trial of TONE. Trial of Nonpharmacologic Interventions in the Elderly.
Kostis, JB, Wilson, AC, Shindler, DM, Cosgrove, NM, Lacy, CR
American journal of hypertension. 2002;(8):732-4
Abstract
BACKGROUND Weight loss and sodium reduction programs are effective in treating hypertension, but there is little information about the persistence of the benefit after discontinuation of the intervention. METHODS The Trial of Nonpharmacologic Interventions in the Elderly (TONE) was a four-center controlled clinical trial of weight loss, reduced sodium intake, or both in maintaining normotension after withdrawal of antihypertensive drug therapy in older men and women whose hypertension was controlled with a single antihypertensive medication. Information on maintenance of normotension without need for drug therapy was obtained on 222 of 223 participants at the Robert Wood Johnson Medical School clinical center on average of 48.4 months (range 45 to 54 months) after the end of TONE. RESULTS At the end of TONE follow-up, 43% of participants in the combined intervention group were off medication compared with 25% in the usual care group (P = .011). At 48 months after the end of TONE and discontinuation of contact of the participants with the clinical center, 23% of the combined intervention group v 7% in the usual care group were off medication (P = .012). CONCLUSIONS Some benefits of structured dietary intervention appears to persist long term in a significant number of patients after discontinuation of the intervention.
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7.
The role of gender and family support on dietary compliance in an African American adolescent hypertension prevention study.
Wilson, DK, Ampey-Thornhill, G
Annals of behavioral medicine : a publication of the Society of Behavioral Medicine. 2001;(1):59-67
Abstract
Social support experiences vary markedly across gender groups, and little is known about the role of social support in promoting healthy dietary compliance in African American adolescents who are at increased risk for developing hypertension. This study examined the relation between gender, dietary social support, and compliance to a low sodium diet. Casual blood pressures were also examined in relation to dietary compliance and gender One hundred eighty-four healthy African American adolescents (83 boys, 101 girls) participated in an intensive 5-day low sodium diet (50 mEq/24 hr) as part of a hypertension prevention program. Emotional dietary social support from family members and friends was measured at baseline. Compliance was defined as urinary sodium excretion of < or = 50 mEq/24 hr at postsodium restriction. The results indicated a significant Gender x Compliance effect for positive family support (p < .05). Girls who were compliant reported higher levels of dietary support from family members (19.2 +/- 7.8) than boys who were compliant (16.9 +/- 7.0). In contrast, boys who were compliant reported lower levels of dietary support from family members (16.9 +/- 7.0) than boys who were not compliant (20.2 +/- 7.5). Systolic blood pressure showed a trend toward decreasing in compliant participants (104.4 +/- 8.4 vs. 101.7 +/- 8.0, mm Hg, p < .06), but the effect diminished when Quetelet Index (kg/m2) was controlled for in the analyses (p < .12). These results suggest that higher levels of emotional dietary support from family members are associated with better adherence to short-term sodium restriction for African American girls as compared to boys. Further research is needed to determine the long-term impact of social support on sodium restriction in adolescent populations.
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8.
Renal effects of ibuprofen during sodium restriction in the aged.
Farquhar, W, Kenney, L
Journal of the American Geriatrics Society. 2000;(1):106-8