Hypertension, Salt, and Bread

Abstract

Hypertension is the major risk factor for development and progression in patients with chronic kidney disease (CKD) and has become the most important intervention in the management of all forms of CKD.1Bakris G.L. Ritz E. World Kidney Day 2009: Hypertension and kidney disease is a marriage that should be prevented.Am J Kidney Dis. 2009; 53: 373-376Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar The message of World Kidney Day 2009 is “Keep the pressure down.” Similarly, the theme for World Hypertension Day 2009 is “Salt and high blood pressure: two silent killers.” Reduction in dietary salt intake is one of the effective measures to prevent hypertension.2Chobanian A.V. Bakris G.L. Black H.R. et al.Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.Hypertension. 2003; 42: 1206-1252Crossref PubMed Scopus (10585) Google Scholar Average salt intake is 9 to 12 g/d in the Western world; however, the daily recommended amount is no more than 6 g.2Chobanian A.V. Bakris G.L. Black H.R. et al.Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.Hypertension. 2003; 42: 1206-1252Crossref PubMed Scopus (10585) Google Scholar The Relationship between Hypertension and Salt Intake in Turkish Population Study (SALTURK) showed that daily salt intake was about 18 g/person in Turkey.3Erdem Y. Arici M. Altun B. et al.The SALTURK (The Relationship between Hypertension and Salt Intake in Turkish Population) study.http://www.turkhipertansiyon.org/UserFiles/File/salt.pdfGoogle Scholar Bread is one of the major sources of calories/energy in Turkey, and average bread consumption is about 400 g/d/person. Based on these data, we suspected that bread may be a major source of salt intake in Turkey and therefore investigated the salt content of breads by using the titrimetric method. Results, as well as an estimate of daily salt intake from bread in the Turkish diet, are listed in Table 1. The estimated intake (7.28 g/d) is more than the upper limit of daily recommended amount. We suggest that local patient education programs focused on specific foods (such as the case of bread in Turkey) will decrease salt intake and be useful in the global prevention and treatment of hypertension, CKD, and related problems.Table 1Salt Content of Turkish Breads and Estimated Daily Salt Intake From BreadSodium chloride (g/100 g bread) Mean ± SD1.82 ± 0.41 25th percentile1.58 50th percentile1.76 75th percentile2.05Estimated daily intake from bread (g)⁎Equal to mean sodium chloride multiplied by average bread consumption.7.28Note: One hundred breads were studied from the 7 regions and 46 provinces of Turkey. The distribution of bread samples across regions and provinces was parallel to the populations of these regions and provinces. Equal to mean sodium chloride multiplied by average bread consumption. Open table in a new tab Note: One hundred breads were studied from the 7 regions and 46 provinces of Turkey. The distribution of bread samples across regions and provinces was parallel to the populations of these regions and provinces. We thank Hasan Yetim and Safa Karaman (Erciyes University) for performing salt content measurements. Support: The study was supported by the Turkish Society of Nephrology, Kayseri Branch. Financial Disclosure: None. World Kidney Day 2009: Hypertension and Kidney Disease Is a Marriage That Should Be PreventedAmerican Journal of Kidney DiseasesVol. 53Issue 3PreviewThe kidney is both a cause and victim of hypertension. High blood pressure is a key pathogenetic factor that contributes to deterioration of kidney function. Presence of kidney disease is a common and underappreciated preexisting medical cause of resistant hypertension.1 Therefore, treatment of hypertension has become the most important intervention in the management of all forms of chronic kidney disease (CKD). For this reason, the forthcoming World Kidney Day on March 12, 2009 will emphasize the role of hypertension in renal disease. Full-Text PDF