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. 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.
Pursuing the Dash fat reduction intervention i seen zero relationship anywhere between a great urinary Na + :K + ratio and you can SBP in either SS or SR people
Compared to the fresh Pure , INTERSALT , and you may INTERMAP training, one to founded a society top confident organization anywhere between urinary Na + removal and you can blood circulation pressure, new Dash–Sodium Demo allows the newest institution of your salt sensitivity regarding bloodstream pressure when you look at the demo players. In contrast, for the SS professionals i noticed a mountain increment out of an increase into the SBP of just one.3 mmHg for each 1 g rise in urinary Na + excretion across the excretion variety of step three–5 g Na + /big date that’s in this regular mediocre selection of everyday Na + intake in the us . However, whenever examined along side entire range of seen urinary Na + removal, we observed zero relationship between urinary Na + removal and you will SBP in both SS or SR professionals. We imagine that it difference between a confident matchmaking between SBP and you will urinary Na + excretion when you look at the asked a number of diet Na + removal out-of step 3–5 grams/time without organization over the over range of philosophy shows brand new feeling of several participants from the Dash–Sodium study exhibiting large degrees of urinary Na + removal, higher than 5 g/date, and you will comparatively reduced blood pressure level. Significantly, the benefits gotten within analysis to own a rise in SBP within this 3–5 g/big date Na + removal is similar to one acquired throughout the Pure research and this advertised a positive hill increment from a-1.seven mmHg escalation in SBP for every 1 grams rise in urinary Na + excretion over the exact same selection of Na + removal beliefs . The essential difference between the new observed upsurge in SBP responding to help you increased urinary Na + excretion ranging from Dashboard-Salt and Sheer ple size and racial backgrounds of your own players and you may (2) the possibility variations in approaches to assess urine articles off 24-h urine collection compared to an evaluation in one day destination pee try in the Dash-Salt versus Absolute Investigation correspondingly. Our investigation help guidance in order to limitation weight reduction Na + consumption [5, 24] and you may recommend that reduced losing weight salt consumption may only straight down SBP when you look at the SS patients.
The influence of K + intake on blood pressure remains controversial, with conflicting data emerging from multiple clinical studies . In a randomized controlled trial conducted in free living non-dietary regulated participants with a mean SBP of 132 mmHg and not taking blood pressure lowering medication, K + intake was increased by dietary intake (via fruit and vegetable intake) or direct K + supplements. 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 K + at 3 g/day and a diet relatively low in http://datingranking.net/cs/datehookup-recenze 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.