Sodium

NA: Dietary Factors and Effect on Sodium and Blood Pressure (2010)

• Assessment
  In adults and children, what is the effect of dietary calcium on the sodium and blood pressure relationship?

  • Conclusion

    There is no evidence to examine how dietary calcium affects the relationship between sodium and blood pressure. More research is needed in this area.

     

  • Grade: V
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Search Plan and Results: NA: Dietary Factors Affecting the Sodium-Blood Pressure Relationship - 2010
     
  In adults and children, what is the effect of dietary potassium on the sodium and blood pressure relationship?

  • Conclusion

    In six out of seven studies that included adolescents (age 13 to 16 years) and adults, potassium (K) significantly affected the relationship between sodium (Na) and blood pressure (BP). A greater effect of K on the Na-BP relationship was observed in the following groups: Subjects with salt-sensitivity, black subjects, females, and in older subjects.

    * In some studies, PHTN may also include NTN, due to changes in the definition of each.

  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of dietary potassium on the sodium and blood pressure relationship?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Geleijnse JM, Kok FJ, Grobbee DE. Blood pressure response to changes in sodium and potassium intake: a metaregression analysis of randomised trials. Journal of Human Hypertension, 2003; 17: 471-480.
      • Hu G, Tian H. A comparison of dietary and non-dietary factors of hypertension and normal blood pressure in a Chinese population. J Hum Hypertens. 2001; (15) 7: 487-493.
      • Khaw KT, Bingham S, Welch A, Luben R, O'Brien E, Wareham N, Day N. Blood pressure and urinary sodium in men and women: the Norfolk Cohort of the European Prospective Investigation into Cancer (EPIC-Norfolk). Am J Clin Nutr. 2004; 80: 1,397-1,403. 
      • Liu L, Liu L, Ding Y, Huang Z, He B, Sun S, Zhao G, Zhang H, Miki T, Mizushima S, Ikeda K, Nara Y, Yamori Y. Ethnic and environmental differences in various markers of dietary intake and blood pressure among Chinese Han and three other minority peoples of China: results from the WHO Cardiovascular Diseases and Alimentary Comparison (CARDIAC) Study. Hypertens Res. 2001; 24 (3): 315-322.
      • Morris RC Jr, Sebastian A, Forman A, Tanaka M, Schmidlin O. Normotensive salt sensitivity: Effects of race and dietary potassium. Hypertension. 1999 Jan; 33(1): 18-23. PMID: 9931076 
      • Nowson CA, Morgan TO, Gibbons C. Decreasing dietary sodium while following a self-selected potassium-rich diet reduces blood pressure. J Nutr. 2003 Dec; 133(12): 4118-4123.
      • Wilson DK, Sica DA, Miller, SB. Effects of potassium on blood pressure in salt-sensitive and salt-resistant black adolescents. Hypertension. 1999 Aug; 34(2): 181-186.
  • Search Plan and Results: NA: Dietary Factors Affecting the Sodium-Blood Pressure Relationship - 2010
     
  In adults and children, what is the effect of mineral interactions and other dietary factors on the sodium and blood pressure relationship?

  • Conclusion

    Limited research indicates mixed results regarding the relationship between mineral interactions and other dietary factors on the sodium and blood pressure (BP) relationship. Two studies found that calcium (10 to 25mmol per day) and potassium (10 to 60mmol per day) prevented the age-related rise in BP in children who were salt-sensitive or improved BP control in adults on less than 2,400mg per day sodium diet. A third study failed to show a relationship. More research is needed to clarify the relationship.

     

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of mineral interactions and other dietary factors on the sodium and blood pressure relationship?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Grossman E, Vald A, Peleg E, Sela B, Rosenthal T. The effect of a combined low-sodium, high-potassium, high-calcium diet on blood pressure in patients with mild hypertension. J Hum Hypertens. 1997 11: 789-794.
      • Mu JJ, Liu ZQ, Liu WM, Liang YM, Yang DY, Zhu DJ, Wang ZX. Reduction of blood pressure with calcium and potassium supplementation in children with salt sensitivity: A 2-year double-blinded placebo-controlled trial. J Hum Hypertens. 2005 Jun; 19(6): 479-483.
      • Schroder H, Schmelz E, Marrugat J. Relationship between diet and blood pressure in a representative Mediterranean population. Eur J Nutr. 2002; 41 (4): 161-167. 
  • Search Plan and Results: NA: Dietary Factors Affecting the Sodium-Blood Pressure Relationship - 2010