Sodium blood pressure

Epidemiological studies suggest that high sodium intakes are linked to high blood pressure. As a person ages, changes in the hormonal systems that regulate the control of water and sodium balance lead to changes in blood pressure. The evidence for the role of sodium is strongest in those subjects with impaired ability to excrete sodium because of kidney disease or hormonal abnormalities. In these cases, restriction of dietary sodium promptly lowers blood pressure. The role of sodium in causing primary hypertension is more controversial.

Sodium blood pressureThe Intersalt study

Most studies find that high salt diets accelerate the increase in blood pressure that occurs with age. These include the Intersalt study, which is an international epidemiological study covering 32 countries and including 10,000 subjects. This study has shown a relationship between blood pressure and body mass index and alcohol consumption, but the data on salt has been interpreted differently by different researchers. The results suggest that dietary salt restriction has more effect on blood pressure in those aged 45 and older. In young people diet and exercise may play a more important part. Some patients with mild to moderate primary hypertension respond to moderate sodium restriction with a fall in blood pressure. This restriction also seems to reduce the amount of medication needed to keep blood pressure under control.

Salt-sensitivity

Some people are more susceptible than others to the blood pressure-raising effects of salt. This is known as salt-sensitivity. About 30 per cent of people and as many as 40 to 50 per cent of those suffering from hypertension may be salt-sensitive and respond favorably when salt is restricted. Salt-sensitivity is more common among certain population groups including black people, diabetics and the elderly. Reduction of salt intake is generally recommended to reduce the risk of developing high blood pressure as most Western diets are very high in salt.

A review published in 1997 in the American Journal of Clinical Nutrition showed that experimental data support the view that when adults meet or exceed the recommended dietary allowances of calcium, potassium, and magnesium, high sodium intakes are not associated with high blood pressure. Thus adequate mineral intake may protect against salt-sensitivity.

Sodium blood pressure and salt restriction

A new study of almost 1500 British people has found that those who eat the most salt tend to have the highest blood pressure. The study, which involved men and women aged 16 to 64 found that as daily salt intakes rose from 1600 mg to 9200 mg, so did blood pressures. A rise in salt consumption from 2300 mg to 4600 mg led to a 7.1 mmHg rise in systolic blood pressure for women and a 4.9 mmHg rise for men.

In a two-month double-blind, randomized, placebo-controlled crossover study published in 1997 in The Lancet, researchers found that modest reduction in salt in the diets of elderly people led to lower blood pressure. The study involved 29 patients with high blood pressure and 18 with normal blood pressure. The average blood pressure fall was 8.2/3.9 mmHg in the normal subjects and 6.6/2.7 mmHg in those with high blood pressure. In those with normal blood pressure, cutting salt may have little effect, according to an analysis of 83 studies published in the Journal of the American Medical Association in 1998.

Dietary sodium restriction is used to control pregnancy-related high blood pressure. It does not seem to lead to any adverse effects on other minerals or the baby. In fact, increasing evidence suggests that the amount of salt in a baby's diet affects blood pressure later in life. In a study published in 1997, Dutch researchers compared the effects of low salt and normal salt diets in 476 children born in 1980. They measured blood pressures in the first week of life and every four weeks after that for a six-month period. Fifteen years later, the study participants had their blood pressures measured again and the results showed that children who had been in the low salt group had lower blood pressures than those in the normal salt group.

Stress and sodium blood pressure

Stress may affect sodium excretion. In certain people, stress seems to contribute to high blood pressure, and this may be mediated via effects on sodium excretion. In a 1995 German study, researchers tested the effects of stress on 27 people with normal blood pressure and 21 with high blood pressure. The participants in the study took part in a 30-minute video game after which their excretion of sodium was measured. Seventy per cent of the people showed increased sodium excretion and 30 per cent showed decreased excretion. Those who excreted more sodium showed less stress-associated increases in blood pressure and greater expression of anger.

Chloride

Some evidence indicates that when sodium is combined with chloride, it exerts greater effects on raising blood pressure than when it is combined with other compounds such as phosphate. Dietary intake of both sodium and chloride may be necessary for the development of hypertension.

 
 
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