S-49-5: PRACTICAL AND PERSONAL EDUCATION OF DIETARY THERAPY IN HYPERTENSIVE PATIENTS

Abstract

Hypertension is the most important risk factor of cardiovascular death in Japan. The annual number of deaths due to hypertension is estimated to be 100,000 persons. The number of hypertensives in Japan is estimated to be 43 million. Of these individuals, 33% are estimated to be unaware of hypertension, 11 % are aware but untreated, and 29% are poorly controlled despite ongoing treatment. Thus, measures to reduce the number of untreated and poorly controlled hypertensive patients are needed. Lifestyle modifications including dietary therapy are quite important regardless of the use of antihypertensive drugs. Especially, salt reduction is most important because Japanese individuals still consume a significant amount of salt. The Dietary Reference Intakes for Japanese 2020, issued by the Ministry of Health, Labour and Welfare, propose a salt intake goal of < 7.5 g/day for men and < 6.5 g/day for women. Regarding the goal of salt reduction in hypertensive patients, the hypertension guideline by the Japanese Society of Hypertension 2019 (JSH2019) proposes a goal of < 6 g/day. Although salt intake in Japan gradually decreased in the early 2000 s, the declining trend has not been seen in recent years, and thus it seems difficult to achieve these target salt intake levels. To overcome this challenge, the JSH announced the JSH Tokyo Declaration and pledged to create a specific action plan to achieve the target salt intake level of < 6 g/day. Since the awareness of salt reduction may not necessarily lead to actual salt reduction, the assessment of salt intake of the individuals is essential when the medical stuffs provide the guidance of salt reduction. In the practical clinical settings, the combination of the assessment of dietary contents using simple questionnaires and the estimation of salt intake using spot urine specimen is recommended. Repeated assessment of salt intake and the practical guidance by the medical stuffs is useful for the long-term adherence of salt reduction. Nevertheless, it is difficult to achieve the target salt intake levels. To support individuals’ efforts to reduce salt intake, the JSH Salt Reduction Committee certifies 124 delicious low-salt foods as of April, 2022. Annual sales of these products are about 45 billion yen and the reduction in salt consumption is estimated to be about 1,000 tons. Through the utilization of these products and the efforts to improve the food environment, a society with low-salt and healthy diet will be expected to come.