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.
Introduction
Hypertension, the most common low-communicable state worldwide, means a significant internationally public ailment. In accordance with the 2017 Western Heart Connection (AHA) direction, the fresh prevalence out of blood circulation pressure in our midst people try estimated become 46% ; at exactly the same time,
Association of urinary sodium and you will potassium excretion with systolic blood circulation pressure on the Weight reduction Answers to Avoid Blood pressure Sodium Trial
50% away from hypertensive men and women are projected is sodium painful and sensitive (SS) . Since the noted by National Cardiovascular system for Chronic Condition Avoidance and Fitness Venture statement
90% away from American adults consume an excessive amount of dieting salt (Na + ), having the average every day consumption surpassing 3400 mg in mature All of us people, a value almost three times this new every single day use recommended by the AHA therefore the National Academy regarding Research, Systems, and you can Medication Weightloss Source Intakes (DRI) . Because the a lot of losing weight Na + consumption, that may push the new salt susceptibility out of blood pressure and increase blood pressure level exposure, globally fat reduction Na + intake was a general public wellness chance. The fresh new impression of diet Na + intake on the blood pressure could have been examined within the numerous losing weight intervention trials producing proof one quicker weight-loss sodium intake for the managed setup causes decrease within the hypertension [6,eight,8]. Subsequent, meta-analyses keeps synchronised fat reduction Na + restriction that have decreases within the blood circulation pressure suggesting there clearly was a medical work for in normotensive and you will hypertensive some body despite new salt sensitiveness of hypertension [9, 10].
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 K + . This dating for seniors 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.