Determinants of Blood Pressure Response to Low-Salt Intake in a Healthy Adult Population

Authors

  • May E. Montasser PhD,

    1. From the Department of Medicine, Division of Endocrinology, Diabetes, and Nutrition, University of Maryland, School of Medicine, Baltimore, MD
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  • Julie A. Douglas PhD,

    1. the Department of Human Genetics, University of Michigan, School of Medicine, Ann Arbor, MI
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  • Marie-Hélène Roy-Gagnon PhD,

    1. the Department of Human Genetics, University of Michigan, School of Medicine, Ann Arbor, MI
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  • Cristopher V. Van Hout BS,

    1. the Department of Human Genetics, University of Michigan, School of Medicine, Ann Arbor, MI
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  • Matthew R. Weir MD,

    1. the Department of Medicine, Division of Nephrology, University of Maryland, School of Medicine, Baltimore, MD
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  • Robert Vogel MD,

    1. the Department of Medicine, Division of Cardiology, University of Maryland, School of Medicine, Baltimore, MD
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  • Afshin Parsa MD, MPh,

    1. the Department of Medicine, Division of Nephrology, University of Maryland, School of Medicine, Baltimore, MD
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  • Nanette I. Steinle MD,

    1. From the Department of Medicine, Division of Endocrinology, Diabetes, and Nutrition, University of Maryland, School of Medicine, Baltimore, MD
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  • Soren Snitker MD, PhD,

    1. From the Department of Medicine, Division of Endocrinology, Diabetes, and Nutrition, University of Maryland, School of Medicine, Baltimore, MD
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  • Nga H. Brereton RD,

    1. From the Department of Medicine, Division of Endocrinology, Diabetes, and Nutrition, University of Maryland, School of Medicine, Baltimore, MD
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  • Yen-Pei C. Chang PhD,

    1. From the Department of Medicine, Division of Endocrinology, Diabetes, and Nutrition, University of Maryland, School of Medicine, Baltimore, MD
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  • Alan R. Shuldiner MD,

    1. From the Department of Medicine, Division of Endocrinology, Diabetes, and Nutrition, University of Maryland, School of Medicine, Baltimore, MD
    2. the Geriatric Research and Education Clinical Center, Veterans Administration Medical Center, Baltimore, MD
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  • Braxton D. Mitchell PhD

    1. From the Department of Medicine, Division of Endocrinology, Diabetes, and Nutrition, University of Maryland, School of Medicine, Baltimore, MD
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  • Present address: Institute for Clinical and Translational Research, Johns Hopkins University, Baltimore, MD

Braxton D. Mitchell, PhD, 660 West Redwood Street, Room 492, Baltimore, MD 21201
E-mail:bmitchel@medicine.umaryland.edu

Abstract

J Clin Hypertens (Greenwich). 2011;13:795–800. ©2011 Wiley Periodicals, Inc.

Although the beneficial effects of lowering salt intake in hypertensive patients are widely appreciated, the impact of promoting dietary salt restriction for blood pressure (BP) reduction at the population level remains controversial. The authors used 24-hour ambulatory BP monitoring to characterize the determinants of systolic BP (SBP) response to low-salt intake in a large, relatively healthy Amish population. Patients received a high- and low-sodium diet for 6 days each, separated by a 6- to 14-day washout period. Variance component analysis was used to assess the association of several variables with SBP response to low-salt diet. Mean SBP was 0.7±5.8 mm Hg and 1.3±6.1 mm Hg lower on the low-salt compared with the high-salt diet during daytime (P=.008) and nighttime (P<.0001), respectively. SBP response to a low-salt diet was significantly associated with increasing age and pre-intervention SBP, in both daytime and nighttime, while the association with female sex and SBP response to cold pressor test (CPT) was significant only during nighttime. Our results suggest that salt reduction may have greater BP-lowering effects on women, older individuals, individuals with higher SBP, and individuals with higher SBP response to CPT.

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