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.
Within the a randomized controlled demonstration held from inside the free-living low-dietary managed professionals having a mean SBP of 132 mmHg and you can perhaps not getting hypertension minimizing treatment, K + intake are enhanced of the losing weight intake (thru good fresh fruit and you will vegetable consumption) otherwise lead K + medicine
Compared to the latest Sheer , INTERSALT , and you may INTERMAP training, that founded an inhabitants peak confident connection between urinary Na + removal and hypertension, the fresh Dashboard–Salt Demonstration permits this new business of your own sodium sensitivity regarding blood pressure within the demonstration professionals. Alternatively, for the SS players we seen a slope increment of a growth during the SBP of just one.step three mmHg for every 1 g escalation in urinary Na + excretion along the removal list of step three–5 g Na + /day that’s within this normal average set of every single day Na + intake in the us . Alternatively, whenever assessed along side whole listing of observed urinary Na + excretion, we observed zero organization anywhere between urinary Na + excretion and you can SBP in both SS otherwise SR participants. I imagine that it discrepancy anywhere between a confident matchmaking anywhere between SBP and you will urinary Na + removal inside the expected set of dietary Na + excretion of step three–5 g/day without association over the complete range of viewpoints reflects the impression from multiple players about Dash–Sodium investigation exhibiting highest amounts of urinary Na + excretion, higher than 5 g/date, and relatively low blood circulation pressure. Rather, the value received inside analysis getting an increase in SBP in this step three–5 grams/big date Na + excretion is comparable to that obtained on Sheer research and therefore said a confident slope increment off a-1.7 mmHg rise in SBP per step one grams upsurge in urinary Na + removal along side exact same a number of Na + removal values . The difference between the latest seen rise in SBP as a result in order to elevated urinary Na + removal anywhere between Dash-Salt and you may Sheer ple dimensions and you can racial experiences of your members and (2) the possibility variations in answers to assess pee articles off twenty four-h urine range than the an evaluation in one morning room pee test regarding Dash-Salt rather than Natural Research correspondingly. Our very getiton odwiedzajÄ…cych own investigation support advice to restriction weight loss Na + consumption [5, 24] and recommend that faster dieting sodium intake may only all the way down SBP inside SS people.
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 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.