Abstract
BackgroundA high salt diet is associated with the development of hypertension, one of the most important cardiovascular risk factors. A reduction in sodium intake seems to have an effect on increasing serum triglycerides (TGs). Elevated TGs are independently linked to cardiovascular risk. However, there is limited evidence of a possible interactive effect of sodium intake and serum TGs on high blood pressure (BP).MethodsWe conducted a nationwide, population-based interaction analysis using the Kawasaki method for estimating 24-h urinary sodium excretion (e24hUNaEKawasaki) as a candidate indicator of dietary sodium intake. All native Koreans aged 20 years or older without significant medical illness were eligible for inclusion.ResultsA total of 16936 participants were divided into quintiles according to their e24hUNaEKawasaki results. Participants in the highest quintile were more obese and hypertensive and had higher white blood cell count, lower hemoglobin, greater glycemic exposure, and poor lipid profiles compared to the same parameters of individuals in other quintiles. Linear regression revealed that e24UNaEKawasaki was related to systolic BP, diastolic BP, and TGs. Multiple logistic regression, adjusted for dietary sodium intake and various conventional risk factors for chronic vascular diseases, showed that both e24UNaEKawasaki and TGs were significant predictors of hypertension. Our interaction analysis demonstrated that increased sodium intake was associated with higher risk of hypertension in participants with elevated TGs than in those without (adjusted RERI = 0.022, 95% CI = 0.017–0.027; adjusted AP = 0.017, 95% CI = 0.006–0.028; adjusted SI = 1.010, 95% CI = 1.007–1.014).ConclusionOur findings suggest that the interaction between a high salt diet and elevated TGs may exert synergistic biological effects on the risk of hypertension.
Highlights
Hypertension (HTN), one of the most well-known chronic diseases, has a multifactorial nature linked to the possible interaction of genetic and environmental risk factors [1, 2]
Our findings suggest that the interaction between a high salt diet and elevated TGs may exert synergistic biological effects on the risk of hypertension
These findings suggest that an excess sodium diet is one of the most important modifiable risk factors for HTN and other cardiovascular diseases (CVDs)
Summary
Hypertension (HTN), one of the most well-known chronic diseases, has a multifactorial nature linked to the possible interaction of genetic and environmental risk factors [1, 2]. Previous studies reported that high sodium intake was strongly related to the development of HTN and increased risk of cardiovascular diseases (CVDs) and that dietary intervention could decrease arterial blood pressure (BP) and reduce left ventricular mass in hypertensive individuals [5,6,7,8,9]. These findings suggest that an excess sodium diet is one of the most important modifiable risk factors for HTN and other CVDs. These findings suggest that an excess sodium diet is one of the most important modifiable risk factors for HTN and other CVDs In this respect, the accurate estimation of dietary sodium intake is critical to reduce future cardiovascular outcomes. The validity of these estimated 24-h urinary sodium excretion (e24hUNaE) methods in relation to arterial BP remains to be evaluated
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