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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.
After the Dash dieting intervention we seen no relationship ranging from a beneficial urinary Na + :K + proportion and you may SBP either in SS or SR participants
Compared with this new Natural , INTERSALT , and you will INTERMAP training, one to based a people peak confident connection between urinary Na + removal and you can blood circulation pressure, the brand new Dash–Salt Trial permits the organization of one’s salt awareness out-of bloodstream stress during the demonstration participants. Alternatively, during the SS people we observed a mountain increment away from a growth into the SBP of 1.step three mmHg each step 1 g increase in urinary Na + removal across the removal selection of 3–5 g Na + /big date that’s inside typical mediocre listing of day-after-day Na + intake in the usa . In contrast, whenever assessed over the whole a number of noticed urinary Na + removal, we noticed no organization anywhere between urinary Na + removal and you can SBP in a choice of SS or SR players. We speculate it discrepancy between a confident dating between SBP and you will urinary Na + removal from inside the requested range of fat reduction Na + removal from step three–5 grams/date with no association along the over range of beliefs reflects the fresh impression off multiple people on the Dashboard–Salt investigation showing high levels of urinary Na + excretion, greater than 5 grams/time, and you http://www.datingranking.net/cs/321chat-recenze may comparatively reasonable blood pressure levels. Notably, the benefits acquired in this investigation to possess a rise in SBP contained in this step 3–5 g/day Na + removal is comparable to you to gotten about Sheer research which advertised an optimistic slope increment of a 1.eight mmHg rise in SBP per 1 grams rise in urinary Na + excretion across the exact same variety of Na + removal philosophy . The difference between this new observed upsurge in SBP responding to elevated urinary Na + removal anywhere between Dash-Sodium and you can Sheer ple dimensions and racial experiences of players and (2) the potential differences in ways to assess urine blogs off twenty-four-h urine collection versus an opinion from 1 morning destination pee attempt on the Dashboard-Salt rather than Natural Studies respectively. The analysis assistance guidelines to restrict slimming down Na + consumption [5, 24] and suggest that quicker weight reduction sodium consumption might only down SBP from inside the SS people.
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 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.