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Role Of Salt In Hypertension.pptx

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  1. 1. Role Of Salt In Hypertension
  2. 2. Hypertension : A leading risk factor for death and disability
  3. 3. Prevalence Of Hypertension In India India: prevalence of hypertension by age and gender 2021 | Statista
  4. 4. Organ Damage Related To Hypertension
  5. 5. Lifestyle Risk Factors For Hypertension • High dietary salt intake • Obesity • High alcohol intake • Physical inactivity • Smoking • Inadequate vegetable and fruit intake • Inadequate milk product intake
  6. 6. Does Salt Have Any Role In Hypertension?
  7. 7. Sodium Intake, Life Expectancy And All-Cause Mortality European Heart Journal (2021) 42, 2013-2112, doi:10.1093/euheartj/ehaa947
  8. 8. Sodium Intake And Blood Pressure Values BMJ1988 Jul 30; 297(6644): 319–328. Mente A., O’Donnell M.J., Rangarajan S., McQueen M.J., Poirier P., Wielgosz A., Morrison H., Li W., Wang X., Di C., et al. Association of urinary sodium and potassium excretion with blood pressure. N. Engl. J. Med. 2014;371:601– 611. doi: 10.1056/NEJMoa1311989
  9. 9. Relationship Between High Salt Intake With Diet, Blood Pressure And Arterial Stiffness
  10. 10. Hypertension And Salt-Sensitivity It is a physiological trait present in rodents and other mammals, including humans, by which the blood pressure (BP) of some members of the population exhibits changes parallel to changes in salt intake
  11. 11. Renal Mechanisms For Salt Dependent Hypertension • Acute high salt intake - Renal retention of fluid blood pressure • Chronic high salt Intake - Resets renal threshold for salt excretion less salt excretion - Peripheral resistance - Subnormal vasodilation to salt load Nat. Med. 2008 14:64
  12. 12. Causes Of Salt Sensitivity Of Blood Pressure Intrauterine growth retardation Low nephron mass Renal diseases Genetic abnormalities Exogenous agents (e.g. DOCA) Ageing- salt secretion
  13. 13. Lower Salt Reduces Systolic Blood Pressure He FJ, MacGregor GA. J Hum Hyptens. 2002;16:761-70
  14. 14. Salt Induced Effects On Microvascular Function Marketou ME, Maragkoudakis S, Anastasiou I, Nakou H, Plataki M, Vardas PE, Parthenakis FI. Salt-induced effects on microvascular function: A critical factor in hypertension mediated organ damage. J Clin Hypertens (Greenwich). 2019 Jun;21(6):749-757. doi: 10.1111/jch.13535. Epub 2019 Apr 19. PMID: 31002481; PMCID: PMC8030330.
  15. 15. Role Of Salt And Gut Microbiota On The Regulation Of Blood Pressure Jose and Raij, Curr Opin Nephrol Hypertens 2015;24(5):403-9
  16. 16. International Target Recommendations For Sodium Intake
  17. 17. Mean Systolic Blood Pressure According To Sodium Excretion In PURE Study Mente et al, N Engl J Med 2014;371:601-11
  18. 18. Response of the Body to Step Changes in Salt Intake during the Mars 105 and the Mars 520 Balance Studies Rakova et al, Cell Metabolism. 2013, 17 (1): 125-131
  19. 19. Effects of low sodium diet versus high sodium diet on blood pressure: a Cochrane analysis Gradual et al. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Cochrane Database Syst Rev. 2017 Apr 9;4:CD004022
  20. 20. Effects of sodium reduction on systolic blood pressure in randomized controlled trials, by age (103 trials) Supplement to: Mozaffarian D, Fahimi S, Singh GM, et al. Global sodium consumption and death from cardiovascular causes. N Engl J Med 2014;371:624-34.
  21. 21. Relation of Dietary Sodium (Salt) to Blood Pressure and Its Possible Modulation by Other Dietary Factors: The INTERMAP Study Stamler J. et al. Hypertension. 2018;71:631-637
  22. 22. Mean Systolic and Diastolic Blood Pressure according to Sodium and Potassium Excretion in the PURE Study. Mente et al, NEJM, 2014
  23. 23. Salt intake and CV events in ONTARGET O’Donnell, JAMA. 2011;306(20):2229-2238
  24. 24. The Effect on Systolic BP and Diastolic BP of Reduced Sodium Intake and the DASH Diet. Sacks et al, NEJM, 2001; Jan 4;344(1):3-10
  25. 25. Effect of sodium restriction on ambulatory BP in patients with resistant hypertension Pimenta, E. et al. Hypertension 2009;54:475-481
  26. 26. Therapeutic Approaches In Resistant Hypertension
  27. 27. Comparative Health Benefits of Physical Activity And Aalt Reduction Turner and Avolio. International Journal of Sport Nutrition and Exercise Metabolism, 2016, 26, 377 -389
  28. 28. Salt In Patients With Orthostatic Hypotension Brignole et al, European Heart Journal (2018) 39, 1883–1948
  29. 29. Dietary Approaches To Stop Hypertension (DASH)
  30. 30. Conclusion • Dietary salt is an important contributor to high blood pressure • Reducing salt lowers blood pressure and prevents cardiovascular diseases • Policies to reduce population-wide salt intake are most effective and can have a high impact • Healthcare professionals can play a key role in educating people of all ages regarding their optimal dietary salt intake

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