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Associations between dietary salt, potassium and blood pressure in South African adults: WHO SAGE Wave 2 Salt & Tobacco.
Nutr Metab Cardiovasc Dis. 2017 Sep; 27(9):784-791.NM

Abstract

BACKGROUND & AIMS

In June 2016, South Africa implemented legislation mandating maximum sodium levels in a range of processed foods with a goal of reducing population salt intake and disease burden from hypertension. Our aim was to explore the relationship between salt and blood pressure (BP) in a subsample of the World Health Organization Study on global AGEing and adult health (SAGE) Wave 2 before implementation of legislation in South Africa.

METHODS & RESULTS

Blood pressure (BP) was measured in triplicate (n = 2722; median age 56 years; 33% male) and 24-h urine collected in a nested subsample (n = 526) for sodium, potassium and creatinine analysis. Hypertension prevalence was 55% in older adults (50-plus years) and 28% in younger adults (18-49 years). Median salt intake (6.8 g/day) was higher in younger than older adults (8.6 g vs 6.1 g/day; p < 0.001), and in urban compared to rural populations (7.0 g vs 6.0 g/day; p = 0.033). Overall, 69% of participants had salt intakes above 5 g/day. Potassium intakes were generally low (median 35 mmol/day) with significantly lower intakes in rural areas and older adults. Overall, 91% of adults failed to meet the daily potassium recommendation of 90 mmol/d. Salt intakes above 5 g/day, and to a greater extent, a dietary sodium-to-potassium (Na:K) ratio above 2 mmol/mmol, were associated with significantly steeper regression slopes of BP with age.

CONCLUSION

These preliminary results indicate that high dietary Na:K ratio may lead to a greater increase in BP and hypertension risk with age. Interventions to increase potassium intakes alongside sodium reduction initiatives may be warranted.

Authors+Show Affiliations

Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa. Electronic address: lisa.jayne.ware@gmail.com.School of Medicine, University of Wollongong, New South Wales, Australia. Electronic address: karenc@uow.edu.au.Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, South Africa. Electronic address: alta.schutte@nwu.ac.za.Statistical Consultation Services, North-West University, Potchefstroom, South Africa. Electronic address: marike.cockeran@nwu.ac.za.World Health Organization (WHO), Geneva, Switzerland. Electronic address: naidoon@who.int.World Health Organization (WHO), Geneva, Switzerland; University of Newcastle Research Centre for Generational Health and Ageing, Newcastle, Australia; University of Oregon, Department of Anthropology, Eugene, OR, USA. Electronic address: kowalp@who.int.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

28800936

Citation

Ware, L J., et al. "Associations Between Dietary Salt, Potassium and Blood Pressure in South African Adults: WHO SAGE Wave 2 Salt & Tobacco." Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, vol. 27, no. 9, 2017, pp. 784-791.
Ware LJ, Charlton K, Schutte AE, et al. Associations between dietary salt, potassium and blood pressure in South African adults: WHO SAGE Wave 2 Salt & Tobacco. Nutr Metab Cardiovasc Dis. 2017;27(9):784-791.
Ware, L. J., Charlton, K., Schutte, A. E., Cockeran, M., Naidoo, N., & Kowal, P. (2017). Associations between dietary salt, potassium and blood pressure in South African adults: WHO SAGE Wave 2 Salt & Tobacco. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, 27(9), 784-791. https://doi.org/10.1016/j.numecd.2017.06.017
Ware LJ, et al. Associations Between Dietary Salt, Potassium and Blood Pressure in South African Adults: WHO SAGE Wave 2 Salt & Tobacco. Nutr Metab Cardiovasc Dis. 2017;27(9):784-791. PubMed PMID: 28800936.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations between dietary salt, potassium and blood pressure in South African adults: WHO SAGE Wave 2 Salt & Tobacco. AU - Ware,L J, AU - Charlton,K, AU - Schutte,A E, AU - Cockeran,M, AU - Naidoo,N, AU - Kowal,P, Y1 - 2017/07/08/ PY - 2017/03/13/received PY - 2017/06/14/revised PY - 2017/06/26/accepted PY - 2017/8/13/pubmed PY - 2017/9/12/medline PY - 2017/8/13/entrez KW - Aging KW - Health policy KW - Hypertension KW - Potassium KW - Public health KW - Salt KW - Sodium KW - South Africa SP - 784 EP - 791 JF - Nutrition, metabolism, and cardiovascular diseases : NMCD JO - Nutr Metab Cardiovasc Dis VL - 27 IS - 9 N2 - BACKGROUND & AIMS: In June 2016, South Africa implemented legislation mandating maximum sodium levels in a range of processed foods with a goal of reducing population salt intake and disease burden from hypertension. Our aim was to explore the relationship between salt and blood pressure (BP) in a subsample of the World Health Organization Study on global AGEing and adult health (SAGE) Wave 2 before implementation of legislation in South Africa. METHODS & RESULTS: Blood pressure (BP) was measured in triplicate (n = 2722; median age 56 years; 33% male) and 24-h urine collected in a nested subsample (n = 526) for sodium, potassium and creatinine analysis. Hypertension prevalence was 55% in older adults (50-plus years) and 28% in younger adults (18-49 years). Median salt intake (6.8 g/day) was higher in younger than older adults (8.6 g vs 6.1 g/day; p < 0.001), and in urban compared to rural populations (7.0 g vs 6.0 g/day; p = 0.033). Overall, 69% of participants had salt intakes above 5 g/day. Potassium intakes were generally low (median 35 mmol/day) with significantly lower intakes in rural areas and older adults. Overall, 91% of adults failed to meet the daily potassium recommendation of 90 mmol/d. Salt intakes above 5 g/day, and to a greater extent, a dietary sodium-to-potassium (Na:K) ratio above 2 mmol/mmol, were associated with significantly steeper regression slopes of BP with age. CONCLUSION: These preliminary results indicate that high dietary Na:K ratio may lead to a greater increase in BP and hypertension risk with age. Interventions to increase potassium intakes alongside sodium reduction initiatives may be warranted. SN - 1590-3729 UR - https://www.unboundmedicine.com/medline/citation/28800936/Associations_between_dietary_salt_potassium_and_blood_pressure_in_South_African_adults:_WHO_SAGE_Wave_2_Salt_&_Tobacco_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0939-4753(17)30138-2 DB - PRIME DP - Unbound Medicine ER -