Excessive Salt Intake Research Articles

Isolated systolic hypertension of the young and sodium intake.

Isolated systolic hypertension is associated with higher risk of cardiovascular disease and all-cause mortality. Despite being the most common form of hypertension in the elderly, it is also detectable among young and middle-aged subjects. Dietary salt (sodium chloride) intake is an important determinant of blood pressure, and high salt intake is associated with greater risk of hypertension and cardiovascular events. In most countries, habitual salt intake at all age categories largely exceeds the international recommendations. Excess salt intake, often interacting with overweight and insulin resistance, may contribute to the development and maintenance of isolated systolic hypertension in young individuals by causing endothelial dysfunction and promoting arterial stiffness through a number of mechanisms, namely increase in the renin-angiotensin-aldosterone system activity, sympathetic tone and salt-sensitivity. This short review focused on the epidemiological and clinical evidence, the mechanistic pathways and the cluster of pathophysiological factors whereby excess salt intake may favor the development and maintenance of isolated systolic hypertension in young people.

Abstract MP22: Dietary Salt Restriction And High Salt Intake Exaggerate Sympathetic Reflexes And Sensitize Central Autonomic Networks: Potential Mechanisms Of The J-shaped Curve

Observational cohort studies suggest that severe salt restriction increases cardiovascular morbidity/mortality, and the relationship between cardiovascular morbidity and dietary salt intake resembles a J-shaped curve. A high salt diet exaggerates sympathetic nerve activity (SNA) and arterial blood pressure (ABP) responses to several cardiovascular reflexes in salt-resistant animals. This study assessed whether salt restriction also exaggerates cardiovascular reflex responses and sensitizes central autonomic networks. To test this hypothesis, male Sprague-Dawley rats were fed low (0.01% NaCl), normal (0.1% NaCl), and high (4.0% NaCl) salt diet for 14-21 days. Baseline mean ABP was not different across groups (low: 104±4, normal: 107±4, high: 107±4mmHg). Activation of sciatic afferents (1ms pulse, 500uA, 5s duration, 2-20Hz) produced significantly greater increases in renal SNA (5Hz; low: 196±12, normal: 136±9, high: 177±8%, n=8, P<0.05) and ABP (5Hz; low: 29±3, normal: 16±1, high: 24±2 mmHg, n=8, P<0.05) of rats fed low and high versus normal NaCl diets. Activation of the aortic depressor nerve (2ms pulse, 500uA, 15s duration, 2-20Hz) produced significantly greater decreases in renal SNA (5Hz; low: -55±9, normal: -34±8, high: -63±13%, n=7-8, P<0.05) and ABP (5Hz; low: -31±3, normal: -15±5, high: -32±5 mmHg, n=7-8, P<0.05) of rats fed low and high versus normal NaCl diets. To test whether dietary salt intake sensitized central sympathetic circuits, microinjection of L-glutamate (0.1-1nmol, 30nL) in the rostral ventrolateral medulla produced significantly greater increases in renal SNA (0.1nmol; low: 212±15, normal: 149±8, high: 183±17%, n=7-8, P<0.05) and ABP (0.1Hz; low: 20±2, normal: 12±2, high: 22±2 mmHg, n=7-8, P<0.05) of rats fed low and high versus normal NaCl diets. Finally, rats fed low or high NaCl versus normal NaCl diets displayed exaggerated cardiovascular responses to cage switch or mild restraint and increased 24-h blood pressure variability. The present findings show that severe salt restriction and excess dietary salt intake exaggerate sympathetic and cardiovascular responses, and may be explained by a parallel change in the sensitivity of central autonomic networks to resemble a J-shaped curve.

Abstract P246: Relationship Between Urinary Sodium/potassium Ratio And Systolic Blood Pressure In Salt Sensitive Subjects In The Dash-sodium Trial

Excessive salt intake is associated with hypertension and cardiovascular morbidity. However, identifying those at risk of salt sensitive hypertension (SSH) remains a challenge due to its unequal distribution among populations and inaccurate assessment of dietary sodium (Na) and potassium (K) intake. The objective of this study was to compare indices of dietary Na intake in relation to systolic blood pressure (SBP) in salt sensitive (SS) and salt resistant (SR) subjects from the Dietary Approaches to Stop Hypertension (DASH)-Sodium trial. We hypothesized that when compared to urinary Na or K independently, Na/K ratio is a better predictor of SSH when defined as a 5-10 mmHg change in SBP from low to high dietary Na. Among 404 Black and White subjects, baseline classifications included 177 SS and 227 SR. After diet randomization, on the control 107 were SS and 92 SR and on the DASH 70 were SS and 135 SR. Descriptive statistics, bivariate analysis, followed by linear regression models for baseline and multilevel mixed-effects models after intervention were used to assess the relationship between SBP and dietary Na (as measured by urinary Na/K ratio or Na and K independently) using SS as a categorical factor. SBP was consistently associated with SS, Na/K ratio, and age in all models . At baseline, SBP was significantly higher in SS and SR subjects of the same race and sex, after controlling for age and urinary Na/K ratio and was highest for White females, SS:142.3 (138.8, 145.7) vs. SR:133.2 (130.7, 135.7), and for Black males, SS:137.0 (133.8, 140.1) vs. SR: 129.6 (127.0, 132.3). On average, SBP increased 1.02 (0.065, 1.98) mmHg with each unit increase in Na/K ratio and 3.30 (2.41, 4.19) mmHg with each 10-year increase in age. After randomization and exposure to increasing levels of sodium, SBP increased in SS subjects on the control diet:125.3 (123.2, 127.3) to 136.8 (134.8, 138.9), an effect that was greater in White vs Black females and in Black vs White males. SBP increased in SS subjects on the DASH diet: 121.4 (118.8, 124.0) to 131.2 (128.7, 133.7), but there were no differences by race and sex. These results suggest that a 5-10 mmHg change in SBP in subjects on a typical American diet and Na/K ratio are good predictors of SSH and that the DASH diet may help to reduce race and sex disparities.

Biochemical and histological investigation on the protective effect of poly-herbal extract in high salt diet-fed male Wistar rats

BackgroundThrough different mechanisms, excessive intake of dietary salt has been documented as a risk factor for the development of elevated blood pressure and organ dysfunction. Therefore, this study evaluated the efficacy of combined extracts of four medicinal plants against high salt diet-induced succinate dehydrogenase depletion and alteration in vital organ (kidney, liver, and cardiac) hemostasis. MethodsThirty-five male Wistar rats with an average weight of 130 g were divided into 5 groups of 7 animals each. Group 1 and 2 rats were fed with normal rat chow (NRC) and 16% high salt diet (HSD) only respectively. Rats in groups 3, 4, and 5 were fed with 16% HSD and 800, 400, and 200 mg/kg poly-herbal extract (PHE), respectively, once daily for 4 weeks. The concentration and activities of creatinine, urea, sodium, magnesium, chloride, potassium, albumin, globulin, total protein, and alkaline phosphate (ALP) were estimated in the serum. Aspartate and alanine aminotransferases (AST and ALT), lactate dehydrogenase (LDH), succinate dehydrogenase (SDH) were estimated in the serum, liver, and aorta. The result revealed that the combined extract significantly (p < 0.05) lowered HSD-induced elevated serum concentration of kidney function markers and electrolytes. More so, a significant (p < 0.05) reduction in serum and tissue activities of liver and cardiac function markers was demonstrated by the poly-herbal extract. No significant changes were observed in serum albumin and globulin level, however total protein and tissue activities of SDH were significantly (p < 0.05) elevated by the PHE. The histopathological examination showed to a large extent, the extract conferred significant protection on the cytoarchitecture of the kidney, liver, and aorta. ConclusionConclusively, combined plants extract protected against high salt diet-induced biochemical and histological derangement in male Wistar rats.

Impact of high salt diets on CHOP-mediated apoptosis and renal fibrosis in a rat model.

Prolonged and excessive salt intake accelerates oxidative stress in kidney tissues, which brings about ER stress. The PERK/ATF4/CHOP/BCL-2 signaling pathway has an essential role in ER stress-induced apoptosis. The present study aimed to investigate the effect of high salt diets on the development of renal fibrosis through CHOP-mediated apoptosis. Twenty-five male Wistar rats were randomly divided into five groups (n = 5 each). Groups 1-5 were treated with 0%, 0.5%, 1%, 1.2%, 1.5% of NaCl dissolved in distilled water, respectively, for 8weeks. To detect the degree of renal tubular damage, urinary KIM-1 was measured. The slides of renal tissues were stained via Masson's Trichrome staining methods for fibrosis detection. The relative gene expression of ATF4, CHOP, and BCl-2 in renal tissues were analyzed using the qRT-PCR method. The results revealed no significantdifference between the urea, creatinine, and urine flow rate of the rats receiving different concentrations of NaCl (groups 2-5) and those of the control group (group 1). The rats treated with 1.5% NaCl (group 5) showed significant elevations in urinary KIM-1 and the mRNA level of CHOP compared to the control group. Mild renal fibrosis was also observed in group 5. Excessive salt intake leads to fibrosis as it induces the PERK/ATF4/CHOP/BCL-2 signaling pathway in renal tissues. KIM-1 is detectable in urine before the impairment of renal function which can be used as a diagnostic marker to prevent the development of progressive renal failure.

Preliminary Study on Human Host Factors Perpetuating the Transmission of Schistosomiasis in Endemic Community of Wudil, Kano State, Nigeria

Objective: A cross-sectional study was conducted to determine the human host factors that contribute to the perpetuation of schistosomiasis transmission in endemic communities of Wudil, Kano State, Nigeria.&#x0D; Methods: Information was derived from structured questionnaires supplemented with oral interviews, on perception of the community on the cause of urogenital schistosomiasis, using self-reported macrohaematuria, as the disease proxy, water-use practices, riverside urination and defaecation, and the choice for treatment of schistosome infection.&#x0D; Results: Out of 139 study participants, the perceived causes of gross haematuria by the respondents were Excessive Salt Intake (41.73%); Scorching Sun (20.86%); Unknown (17.27%); Infection (10.07%); Supernatural Force (5.86%) and Water Contact (4.32%). The respondents with self-reported terminal haematuria were 49.64%; riverine water contact 75.54% and riverside contamination 65.41%. Of the 72.46% of the respondents with gross haematuria who attempted for medication only 8.0% visited health facilities, while majority relied on traditional herbalists (39.13%) and roadside medicine stores (20.29%) for treatment. There was a strong association between riverine water contact and terminal haematuria (Odds Ratio: 6.09, 95% CI, 2.825-13.131, P&lt;0.0001; Relative Risk: 2.737, 95% CI, 1.664-4.502, P&lt;0.0001).&#x0D; Conclusion: Exposure to contaminated water as a result of socioeconomic activities, riverside, poor perception on the cause of the disease and lack of adherence to orthodox treatment of positive cases are the key promoters of schistosomiasis transmission in the study area. Excessive salt intake and scorching sun are the major perceived causes of haematuria among the study participants. This underpins the need for health education and other efficacious interventions for community awareness on the disease etiology which is central to effective elimination campaign.

“Front-of-pack” nutrition labeling

Excess intake of energy, sugars, salt and saturated fats is an important causal factor of obesity and related non-communicable diseases. In order to help consumers to make healthy food choices, many European countries have developed proposals for “front-of-pack” food labeling, intended as an integration to the nutritional information provided by the mandatory nutritional declaration. Based on the European strategic program “Farm to Fork”, the intention is to achieve a harmonized front-of-pack label proposal by Q4 2022.Among the different proposals, the one which received most attention by experts and greater feedback by the EU member countries is the Nutri-Score, a tool based on an algorithm whereby a “quality” category ranging from A to E is assigned to each single food on a background colored from dark green to dark orange. As an alternative to Nutri-Score, the NutrInform Battery has been developed by Italy in association with a few other EU member states: this proposal is objectively alternative to the Nutri-Score proposal due to a different underlying philosophy, in particular for its informative and educational intent rather than purchase orientation.The present document, prepared by the Scientific Board and reviewed by the Scientific Council of the Italian Society of Human Nutrition, represents the scientific-based position of the Society in relation to the general theme of front-of-pack labeling and in particular to the dualism created between the Nutri-Score and NutrInform Battery proposals.

Elabela Protects Spontaneously Hypertensive Rats From Hypertension and Cardiorenal Dysfunctions Exacerbated by Dietary High-Salt Intake.

Objectives: Arterial hypertension, when exacerbated by excessive dietary salt intake, worsens the morbidity and mortality rates associated with cardiovascular and renal diseases. Stimulation of the apelinergic system appears to protect against several circulatory system diseases, but it remains unknown if such beneficial effects are conserved in severe hypertension. Therefore, we aimed at determining whether continuous infusion of apelinergic ligands (i.e., Apelin-13 and Elabela) exerted cardiorenal protective effects in spontaneously hypertensive (SHR) rats receiving high-salt diet.Methods: A combination of echocardiography, binding assay, histology, and biochemical approaches were used to investigate the cardiovascular and renal effects of Apelin-13 or Elabela infusion over 6 weeks in SHR fed with normal-salt or high-salt chow.Results: High-salt intake upregulated the cardiac and renal expression of APJ receptor in SHR. Importantly, Elabela was more effective than Apelin-13 in reducing high blood pressure, cardiovascular and renal dysfunctions, fibrosis and hypertrophy in high-salt fed SHR. Unlike Apelin-13, the beneficial effects of Elabela were associated with a counter-regulatory role of the ACE/ACE2/neprilysin axis of the renin-angiotensin-aldosterone system (RAAS) in heart and kidneys of salt-loaded SHR. Interestingly, Elabela also displayed higher affinity for APJ in the presence of high salt concentration and better resistance to RAAS enzymes known to cleave Apelin-13.Conclusion: These findings highlight the protective action of the apelinergic system against salt-induced severe hypertension and cardiorenal failure. As compared with Apelin-13, Elabela displays superior pharmacodynamic and pharmacokinetic properties that warrant further investigation of its therapeutic use in cardiovascular and kidney diseases.

Associations of eating and drinking habits with cardiovascular disease and diabetes in the adult population: data from the ESSE-RF epidemiological study

The presence of a disease, the prognosis of which can be improved by dietary modification, motivates a patient to change their eating habits.Aim. To study the associations of dietary patterns and alcohol consumption with cardiovascular diseases (CVDs), diabetes, myocardial infarction (MI), and stroke in the adult population.Material and methods. The analysis was carried out using data from representative samples of population from 13 Russian regions aged 2564 years (n=19520; men, 7329; women, 12191). The response rate was ~80%. Dietary characteristics were assessed by frequency method.Results. In the diet of people with CVDs, the daily intake of vegetables/ fruits increases by 84% in men and by 19% in women, while the use of animal fats in cooking decreases by 28% and 20%m respectively (p&lt;0,0001). Women with CVDs reduce the consumption of processed meat and sweets by 16 and 19%, respectively (p&lt;0,005). Persons with prior MI reduce the consumption of sweets in the diet: men by 38% and women by 30%. Men with prior MI have higher daily consumption of cereals by 31%, vegetables and fruits by 46%, low-fat dairy products — 2,4 times. In addition, they are more adherent to a healthy and cardioprotective diet by 3,65 and 1,75 times, respectively. Dietary changes in those with prior stroke were noted only in women in the form of a 29% decrease in excess salt intake (p=0,0075). In the diet of people with diabetes, there is decreased consumption of sweets and an increased intake of vegetables/fruits: by 77 and 69% in men and by 79 and 69% in women, respectively (p&lt;0,0001). Men with diabetes are 3 times more likely to adhere to a healthy diet, and women — 2,3 times (p=0,0039 and p&lt;0,0001, respectively).Conclusion. Patients with CVDs, MI, and diabetes have a healthier diet than healthy persons.

Thromboxane A2 receptor antagonist (ONO-8809) attenuates renal disorders caused by salt overload in stroke-prone spontaneously hypertensive rats.

Epidemiological and clinical studies have demonstrated that excessive salt intake causes severe hypertension and exacerbates organ derangement, such as in chronic kidney disease (CKD). In this study, we focused on evaluating the histological and gene expression effects in the kidneys of stroke‐prone spontaneously hypertensive rats (SHRSP) with a high salt intake and the thromboxane A2/ prostaglandin H2 receptor (TPR) blocker ONO‐8809. Six‐week‐old SHRSPs were divided into three groups and were fed normal chow containing 0.4% NaCl, 2.0%NaCl or 2.0%NaCl + ONO‐8809 (0.6 mg/kg p.o. daily). Histological analyses with immunohistochemistry and a gene expression assay with a DNA kidney microarray were performed after 8 weeks. The following changes were observed in SHRSPs with the high salt intake. Glomerular sclerotic changes were remarkably observed in the juxtamedullary cortex areas. The ED1, monocyte chemoattractant protein‐1 (MCP‐1), nitrotyrosine and hypoxia inducible factor 1α (HIF‐1α) staining areas were increased in the glomeruli and interstitial portion of the kidneys. The genes Tbxa2r (that encodes TPR), Prcp and Car7 were significantly underexpressed in the kidneys. The plasma 8‐isoprostane level was significantly elevated and was attenuated with the ONO‐8809 treatment. Thromboxane A2 (TXA2) and oxidative stress exaggerated renal dysfunction in the salt‐loaded SHRSPs, and ONO‐8809 as a TPR blocker suppressed these changes. Therefore, ONO‐8809 is a candidate drug to prevent CKD in hypertensive patients when CKD is associated with a high salt intake.

Clinical data analysis of telmisartan for hypertension management in Indian population.

It is of interest to evaluate the clinical characteristics, treatment patterns, clinical effectiveness, and safety of telmisartan as a monotherapy or as part of combination therapy in Indian adults (>18 years old) with hypertension. All patients were receiving telmisartan as monotherapy, or as a combination therapy for hypertension management. Demographics, risk factors, existing comorbidity, and ongoing medical therapies were retrieved from the patients’ medical records. A total of 8607 patients with hypertension (median age, 51.0 years) were part of the study. The gender distribution suggested, 5534(64.3%) patients were male, and 3073 (35.7%) were female patients. The excess salt intake (39.0%) was the most common risk factor according to the results. The analysis revealed telmisartan dual therapy (57.9%) as the most prescribed therapy, followed by monotherapy (32.5%), and triple therapy (9.6%). Further, telmisartan 40mg (21.3%) and telmisartan 40mg plus amlodipine 5mg (17.6%) were the most commonly prescribed therapies. The data suggested that only 17.2% of patients required dose titration. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) (mmHg) were significantly decreased with monotherapy (mean change: 19.8 [15.1] mmHg and 8.8[8.2] mmHg), dual therapy (mean change: 23.7 [16.6] mmHg and 10.3[8.5] mmHg), and triple therapy (mean change: 28.6 [19.0] mmHg and 12.1[10.8] mmHg) after the treatment (P<0.001). A total of 98.4% of the patients were compliant, and 97.6% achieved the target blood pressure goal with telmisartan-based therapy. There were 157 adverse events reported altogether. The Physicians' global evaluation of efficacy and tolerability showed the majority of the patients receiving telmisartan-based therapy on a good to excellent scale. Telmisartan used as a monotherapeutic agent or as a part of combination therapy was successful and effective in reducing blood pressure and achieving the blood pressure target. Irrespective of the patient’s age, duration, and stages of hypertension, the study resulted in a good to excellent scale in efficacy and tolerability in the Indian patients having hypertension.

To Check the Knowledge of Hypertension amongst Undergraduate Physiotherapy Students

Aim: To check the knowledge of hypertension amongst undergraduate physiotherapy students. Background: Hypertension is considered to be a serious medical condition that significantly increases the risk of heart, brain, kidney and other diseases. It is also called the “silent killer”. Sedentary lifestyle, obesity, excessive salt intake, consumption of tobacco are risk factors of hypertension. Hypertension is present in the curriculum of the 4 year long bachelor of physiotherapy course where main emphasis on this topic is usually in the last year of the course. Methodology: 125 students filled a hypertension knowledge assessment questionnaire. The mean result obtained was 12.8 from an 18 point questionnaire. Conclusion: The study concludes that there is moderate knowledge of hypertension amongst undergraduate physiotherapy students. Clinical Significance: Knowledge of hypertension is needed in physiotherapy students to help prescribe a proper exercise regime for patients suffering from hypertension and also help them improve their quality of life. Physiotherapist can also play a major role in preventing hypertension. Keywords: Hypertension, knowledge, undergraduate physiotherapy students.

Association between female urinary urgency and aponeurotic ptosis: Results from a community-based cross-sectional study in Japan.

To investigate the relationship between urinary urgency (UU) and aponeurotic ptosis (AP) in a health promotion project. This cross-sectional study analyzed 658 women in Aomori, Japan. The presence of UU was evaluated using the Overactive Bladder Symptom Score. The distance from the light reflex on the cornea to the upper eyelid (margin reflex distance-1 [MRD-1]) was measured. AP was defined as MRD-1 of less than 2.0 mm. The daily salt intake amount was estimated using the dietary questionnaire. Daily salt intake was defined as excessive if it was 10 g/day or higher. Independent factors of UU and AP were analyzed via multivariable logistic regression model. The number of women with UU and AP was 193 and 65, respectively. Similar background differences were observed in age, cardiovascular disease history, renal function, hypertension, diabetes mellitus, dyslipidemia, and daily salt intake between participants with UU and those with AP. Participants with UU had a higher prevalence of AP (19% vs. 6.2%) than those without. Moreover, more than 50% of the women with AP experienced UU. Multivariable logistic analysis on UU showed that age (≥65 years), diabetes mellitus, daily salt intake (≥10 g/day), and AP (odds ratio, 2.07, p = .014) were independent factors. Multivariable analysis on AP revealed that age (≥65 years), hypertension, daily salt intake (≥10 g/day), and UU were independent factors. AP was an independent indicator of UU, in addition to excessive daily salt intake. Women with AP may tend to intake excessive salt and experience UU.

Comparison of Salt-Related Knowledge and Behaviors Status of WeChat Users between 2019 and 2020.

In order to identify the status of salt-related knowledge and behavior of the residents who were active in WeChat software between 2019 and 2020, 10-day salt-related surveys were conducted in 2019 and 2020 based on the WeChat public platform of China Healthy Lifestyle for All Campaign. Distribution and scores of salt-related knowledge, salt reduction behavior and high-salt intake behavior between 2019 and 2020 were compared. Data of 2109 participants in 2019 and 12,732 participants in 2020 were left for analysis. Overall, 88.2% of participants in 2019 had a willingness to reduce the amount of cooking salt in their households, significantly lower than 90.2% in 2020 (p-value < 0.05). In 2019 and 2020, over 80% of the participants knew fine dried noodles contain salt, but less than 30% knew ice cream contains salt. Over 78% of participants chose 5 g or 6 g for the maximum daily salt intake of healthy adults, and about 98% of participants knew that excessive salt intake would increase the risk of hypertension in both years. The percentage of participants who used salt measuring spoons asked restaurants to use less salt, read the sodium content on the nutrition facts table, chose foods with low sodium content and regularly used low-sodium salt, were 36.1%, 45.0%, 44.1%, 40.3% and 35.8% in 2019, and the percentage increased significantly to 46.4%, 49.2%, 50.8%, 47.1% and 43.4% in 2020 (all p-value < 0.05). The percentage of people regularly eating pickled mustard tubers, salted vegetables and sauce foods or using high-salt condiments also increased from 2019 to 2020. The median of salt-related knowledge scores, salt reduction behavior scores and high-salt intake behavior scores were 11, 2, 5 points in 2019, and 10, 3, 5 points in 2020, respectively. Compared to 2019, the salt-related knowledge score was relatively lower, while the salt reduction behavior score and high-salt intake behavior score were relatively higher in 2020. Besides, the score of salt-related knowledge and behaviors differed in different gender, age and hypertension groups. The COVID-19 epidemic may have influenced the salt-related knowledge and behaviors status of WeChat users in China. Promotion and education of salt-related knowledge and online behavior intervention are still needed, particularly for male and hypertension patients in the future.

Risk factors for cardiovascular diseases in rural residents of the Altai Krai: data from the ESSE-RF study

Aim. To study the prevalence of behavioral and biological risk factors for noncommunicable diseases among rural residents of the Altai Krai.Material and methods. The object is a sample of male and female population obtained during the ESSE-RF study. The survey was conducted using a standard questionnaire. We assessed the level of blood pressure (BP), total cholesterol, height, weight of the respondents. The study involved 765 people living in rural areas aged 25-64 years, 35,4% of whom were men (n=271) and 64,6% — women (n=494). The mean age was 44,8±11,6 and 45,6±11,8, respectively.Results. The prevalence of hypertension was 40,3% (men, 42,1%; women, 39,4%). In addition, 77,6% of the respondents were informed about their blood pressure. With age, the incidence of elevated blood pressure increases, from 13,8% at 25-34 years to 64% in the 55-64 age group. Obesity was revealed in 34,2% of the population (men, 22,4%; women, 44,9%). Hypercholesterolemia occurs in 56,2% (men, 45,9%; women, 62,4%). The prevalence of diabetes was 4,3% (men, 2,2%; women, 5,7%). The prevalence of smoking in the sample was 24,1% (men, 50,9%; women, 9,6%). Excessive salt intake was found in 60,4%, insufficient consumption of vegetables and fruits — in 62,1% of respondents.Conclusion. The study made it possible to assess the prevalence of risk factors for chronic noncommunicable diseases in rural residents of the Altai Krai. Analysis shows that smoking dominates in men, while obesity and hypercholesterolemia — in women. Among the representatives of both sexes, a high rate of low physical activity and poor nutrition was noted. The data obtained determines the need and priorities for preventive measures to increase the motivation of residents to follow a healthy lifestyle.

Effect of Gender and Risk Factors in Complications of Type 2 Diabetic Mellitus among Patients Attending Diabetic Clinic in Mnazi Mmoja Hospital, Zanzibar

Diabetes type 2 (T2D) had caused the loss of millions of lives all over the world. About 50% of the patients with T2D die because of cardiovascular disease (CVD), primarily myocardial infarction and stroke. Many of the leading risk factors for CVD coexist and act synergistically to increase cardiovascular events. The purpose of this descriptive cross-sectional study was to determine the prevalence, patterns, and certain predictive factors in the complications of T2D patients attending diabetic clinics at Mnazi Mmoja hospital. A total of 138 respondents made up of 58 females and 80 males within the age brackets of 30-40, 41-50, 51 – 60, and 61 above were recruited for this study. Data were analysed and interpreted based on certain predictive factors and variables, including smoking, alcohol, excessive salt intake, lipid intake, sedentary lifestyle, family history of diabetes, and hypertension, on how they relate to the development of complications of type 2 diabetes. Pearson Chi-Square test was used to compare the levels of significances. Probability values of less or equal to 0.05 were accepted to be significant. The combination of salt intake, sedentary lifestyle, family history of diabetes, and lipid intake was the commonest risk factor for developing complications of T2D. However, alcohol and cigarette smoking had the most negligible impact on developing complications in T2D. The result also shows the patients between the age bracket of 30 and 40 have more risk factors for developing complications. The result showed no gender difference in the number of risk factors. There was a statistically significant association between some of the risk factors (smoking, alcohol, sedentary lifestyle, and salt intake) and the gender of respondents (p&lt;0.05). Males smoked (43.8%) and consumed alcohol (32.5%) than females, while females were prone to a sedentary lifestyle (63.8%) and consume salt (82.8%) than males. On the other hand, this research showed that the significant complication for both males and females are numbness, pain sensation, and dry skin (diabetic neuropathy). Gender and certain predictive risk factors like salt intake, sedentary lifestyle, and family history of diabetes, and lipid intake are fundamental parameters to be tackled to reduce the complications of type 2 diabetes mellitus. There is a greater need now for awareness of the risk factors through effective health promotion in Zanzibar. Also, secondary prevention through regular screening, early detection, and appropriate treatment of chronic complications could reduce the morbidity and mortality caused by diabetes mellitus.

Salt intake causes B-type natriuretic peptide elevation independently of blood pressure elevation in the general population without hypertension and heart disease.

Excessive salt intake causes hypertension and cardiovascular diseases (CVDs). B-type natriuretic peptide (BNP) is synthesized and released from the ventricle, and is a surrogate marker reflecting various CVDs. Moreover, when a slight BNP elevation is shown, it leads to a poor prognosis in the general population. However, the relationship between salt intake and BNP levels in the general population remains unclear, especially in those without hypertension and heart diseases.In this study, we recruited 1404 participants without hypertension and electrocardiogram abnormalities, who received regular annual health check-ups in Japan. Plasma BNP levels were measured, and daily salt intake levels were evaluated using urinary samples. In addition, some clinical parameters were obtained, and the data were cross-sectionally analyzed.The median of plasma BNP levels was 10.50 pg/mL, and daily salt intake was 8.50 ± 1.85 g. When dividing participants into quartiles according to daily salt intake, those with the highest daily salt intake revealed the highest plasma BNP levels. Plasma BNP levels were significantly and positively associated with daily salt intake. Moreover, multiple linear regression analyses revealed that plasma BNP levels showed a significant positive association with daily salt intake levels after adjustments.Plasma BNP levels were significantly and positively associated with daily salt intake after adjustment in the general population. Plasma BNP levels may be a surrogate marker reflecting salt-induced heart diseases.

Estimating 24 Hour Sodium Urine from Spot Urine: A Correlation Model Among Aged 25-64 in Indonesia

INTRODUCTION: Excess salt intake is known to raise blood pressure and turn increase the risk of cardiovascular disease. Data and information on sodium consumption in Indonesia based is limited, while examination method using 24-hour urine examination is a complex method to apply in population based survey. Objective: to estimate value of spot urinary excretion against 24-hour urine values ​​and correction factors. &#x0D; &#x0D; METHOD: Validation was carried out through 24-hour urine and spot urine examination, in 423 individual aged 25-65 years in t Kebun Kelapa Village, Bogor City, Indonesia in 2017. Urine sodium examination method was carried out by laboratory examination inductively coupled plasma optical emission spectrometry (ICP-OES). Accuracy and precision are valued by paired test correlations and mean differences. The coefficient of determination (R Square) of is calculated for sodium intake estimation and correction factors. &#x0D; &#x0D; RESULTS: The morning value of sodium spot urine has better precision and a stronger correlation with the 24-hour sodium urine than the afternoon spot urine. The difference in average morning sodium urine with 24-hour urine sodium according to age and sex was not significantly different (t test 0.30 and p = 0.77), had a positive and moderate correlation (paired r = 0.50 and p = 0.00). The average difference between the estimated evening urine sodium spot was different (t test = 7.32 and p = 0.00), and the correlation was very weak (r = 0.25; p = 0.00).&#x0D; &#x0D; CONCLUSION: The urine content / sodium spot level was accurate to estimate urine sodium value / content 24 hours.

Modifiable Risk Factors for Non-Communicable Diseases among Undergraduate Students in Dar es Salaam, Tanzania: A Cross-Sectional Study

Background Non-Communicable Diseases (NCDs) are among the global health problems accounting for more than 70% of deaths. Yet, healthcare, workers, university and college students who are key educators to the public about health matters are ironically at high risk for NCDs. We aimed to assess modifiable risk factors for NCDs among undergraduates in Dar es Salaam, Tanzania. Methods This was a cross-sectional study among respondents from six universities. The sample was split equally between universities with medical and those without medical courses. Respondents were randomly selected from each of the two clusters of universities. We administered a modified World Health Organization (WHO) STEP-1 questionnaire to collect data on modifiable risk factors for NCDs. Results Of the 574 undergraduates studied, 275 (47.9%) were in medical programmes. Among medical students, 262 (95.3%), as compared to 291 (97.3%) of the non-medical undergraduates had at least one NCD modifiable risk factor. While 15 (4.8%) of undergraduates in medical cluster reported consuming heavy alcohol, non-medical undergraduates reporting similar behaviour were 6 (2.3%). The proportion of non-medical undergraduates reporting to lead a sedentary lifestyle was significantly higher, 97 (37.5%), as compared to 82 (31.2%) of their counterparts (p<0.01). Independent of age, marital status and year of study, male undergraduates in non-medical programmes had 16% increased prevalence ratio of modifiable risk factors compared to females, (aPR=1.16, 95%CI: 1.03–1.30). Conclusions On one hand, use of tobacco, heavy alcohol consumption and excessive salt intake among undergraduates are low. On the other, the proportions of undergraduates having inadequate fruits and vegetables and physical inactivity are extremely high. Keywords: Non-Communicable Diseases, Modifiable Risk Factors, STEPS Survey, Undergraduates, Tanzania.

EXCESSIVE SALT INTAKE: PREVALENCE AND ECONOMIC BURDEN IN THE RUSSIAN FEDERATION

Objective: WHO recommended average salt intake is 5 g/day. However, in the Russian market basket (the minimum food consumption norms approved by the government) include the salt norm is 10.1 g / day for the working population. Aim. To assess the prevalence of excess salt intake (ESI) and the economic burden (EB) of ESI in the Russian Federation (RF) in 2016: direct costs of the health care system and indirect economic losses due to morbidity and mortality from chronic non-communicable diseases (CNCD) associated with ESI. Design and method: A cross-sectional study Epidemiology of cardiovascular diseases in the RF (ESSE) was carried out in 14 Russian regions (2012–13). Randomly selected aged 25–64 years males (N = 8304), females (N = 13464) were included (response rate&gt;80%). Standard epidemiology methods and criteria were used. The prevalence of ESI was determined using questionnaire. Data sources included federal statistics, regulatory documents. Based on prevalence ESI in the RF and relative risks (RR) derived from meta-analyzes, population attributable risk (PAR) for cardiovascular diseases (CVD), stroke, type 2 diabetes (T2D), stomach cancer (SC) was calculated. Indirect costs (IC) associated with ESI included costs of premature death and disability. The calculations were performed in Microsoft Excel 10.0. Results: The prevalence of ESI was 49.9%, higher among males (54.2% vs 47.1%, p &lt; 0,001). PAR of ESI was 5% for CVD mortality, 6% for CVD morbidity; stroke: 17%&amp;10% accordingly, 18% for DM2 morbidity, and 7% for SC morbidity. The highest contribution of the ESI to the EB is associated with CVD (122.8 billion rubles), where half(68,1 billion rubles) is attributable to the EB associated with stroke. In the structure of the EB of each analyzed CNCD, ESI cause from 4.5% (CVD) to 16,1% (stroke) and 17% (for T2D) of the entire burden. The economic burden to CNCD associated with ESI in the RF in 2016 reached 160.9 billion rubles. Conclusions: ESI was found in half of Russian population aged 25–64. In the burden structure the direct costs were only12%, the economics losses were 88%. Total economic impact due to ESI in the RF was 0.19% of the gross domestic product(2016).