Abstract

High salt intake is related to an increase in blood pressure and development of hypertension. However, currently, there are no national representative data in Brazil using the gold standard method of 24-h urine collection to measure sodium consumption. This study aimed to determine salt intake based on 24-h urine collection in a sample of 272 adults of both genders and to correlate it with blood pressure levels. We used a rigorous protocol to assure an empty bladder prior to initiating urine collection. We excluded subjects with a urine volume <500 mL, collection period outside of an interval of 23-25 h, and subjects with creatinine excretion that was not within the range of 14.4-33.6 mg/kg (men) and 10.8-25.2 mg/kg (women). The mean salt intake was 10.4±4.1 g/day (d), and 94% of the participants (98% of men and 90% of women) ingested more than the recommended level of 5 g/d. We found a positive association between salt and body mass index (BMI) categories, as well as with salt and blood pressure, independent of age and BMI. The difference in systolic blood pressure reached 13 mmHg between subjects consuming less than 6 g/d of salt and those ingesting more than 18 g/d. Subjects with hypertension had a higher estimated salt intake than normotensive subjects (11.4±5.0 vs 9.8±3.6 g/d, P<0.01), regardless of whether they were under treatment. Our data indicate the need for interventions to reduce sodium intake, as well the need for ongoing, appropriate monitoring of salt consumption in the general population.

Highlights

  • High blood pressure (BP) is one of the most important risk factors for worldwide morbidity and mortality [1] and a strong surrogate for stroke [2]

  • There are many studies indicating the important role of salt consumption on BP levels [6,16,17] and the high prevalence of hypertension in the Brazilian population [18]

  • Data on salt consumption in the general population based on urine collection are still scarce

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Summary

Introduction

High blood pressure (BP) is one of the most important risk factors for worldwide morbidity and mortality [1] and a strong surrogate for stroke [2]. An increase in BP is associated with several biological, environmental, and life-style factors, including age, accumulation of body fat, physical activity, and insulin resistance. There is a large body of evidence relating high salt intake to an increase in age-dependent blood pressure and development of hypertension [3,4,5,6]. Studies of the association of salt intake with cardiovascular outcomes have been questioned because of methodological inconsistencies [7,8]. Cook et al [9] recently reported an association of sodium with cardiovascular events in a well-controlled study. Identifying and monitoring the distribution of sodium intake in the population as a whole prior to any public health planning and intervention should be mandatory

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