Blood pressure cardiology concept

A recent study shows that reducing sodium intake can significantly lower blood pressure, even in people taking blood pressure medications. By reducing their salt intake by about one teaspoon per day, participants saw a noticeable drop in their systolic blood pressure, highlighting the crucial role of diet in blood pressure management.

Almost everyone can lower their blood pressure by reducing their salt intake, even those who take blood pressure medications.

Almost everyone can lower their blood pressure, even people currently taking antihypertensive medications, by reducing their sodium intake. That’s according to a new study from Vanderbilt University Medical Center (VUMC), Northwestern Medicine and the University of Alabama at Birmingham.

“In the study, middle-aged to elderly participants reduced their salt intake by about one teaspoon per day compared to their usual diet. The result was a drop in systolic blood pressure of about 6 millimeters of mercury (mm Hg), which is comparable to the effect produced by a commonly used first-line drug for high blood pressure,” Deepak said. Gupta, MD, MSCI, Associate. professor of medicine at VUMC and co-principal investigator.

“We found that 70 to 75 percent of all people, whether or not they already take blood pressure medications, are likely to see a reduction in their blood pressure if they lower the sodium content of their diet,” said the co-principal investigator. Norrina Allen, Ph.D., MPH, professor of preventive medicine at Northwestern University Feinberg School of Medicine.

Eat less salt

This study is among the most comprehensive studies to examine the impact of reducing dietary sodium on blood pressure in people with hypertension, including those already taking medications. Previously, it was unclear whether people taking blood pressure medications could further reduce their blood pressure by reducing their sodium intake.

This is one of the largest studies to investigate the effect of reducing sodium in the diet on blood pressure, including people with hypertension who are already taking medications.

“Previously, we didn’t know whether people already taking blood pressure medications could actually lower their blood pressure further by reducing their sodium intake,” said Allen, also the Quentin D. Young Professor of Health Policy and director of the Center for Epidemiology and Population. Health in the North West.

The study was published on November 11 in the Journal of the American Medical Association and was presented concurrently at the 2023 American Heart Association Scientific Sessions in Philadelphia.

Deepak Gupta

Deepak Gupta, MD, MSCI, associate professor of medicine at VUMC and co-principal investigator. Credit: Vanderbilt University Medical Center

The total daily sodium intake recommended by the AHA should be less than 1,500 milligrams, and this study was designed to lower it even lower than that, Allen said. “It can be difficult, but reducing your sodium intake, regardless of the amount, will be beneficial,” she said.

High blood pressure is the leading cause of morbidity and mortality worldwide. “High blood pressure can lead to heart failure, heart attacks and strokes because it puts extra pressure on your arteries,” Allen said. “This affects the heart’s ability to work efficiently and pump blood.”

How the study was carried out

Middle-aged to 50- to 70-year-old individuals from Birmingham, Alabama, and Chicago were randomized to either a high-sodium diet (2,200 mg per day in addition to their usual diet) or a low-sodium diet. in sodium (500 mg total per day). day) for a week, after which they switched to the opposite diet for a week.

The day before each study visit, participants wore blood pressure monitors and collected their urine for 24 hours. Among the 213 participants, systolic blood pressure was significantly reduced by 7 to 8 mm Hg when they followed a low-sodium diet compared to a high-sodium diet, and by 6 mm Hg compared to their usual diet.

Overall, 72% of participants saw a drop in their systolic blood pressure on the low-sodium diet compared to their usual diet.

Results and conclusions

“The effect of reducing dietary sodium on lowering blood pressure was consistent in almost all individuals, including those with normal blood pressure, elevated blood pressure, treated blood pressure, and untreated blood pressure” , Gupta said.

“Just like any physical activity is better than nothing for most people; any reduction in sodium from the current usual diet is probably better than nothing for most people when it comes to blood pressure,” he said.

“This reinforces the importance of reducing dietary sodium intake to help control blood pressure, even in people taking blood pressure medications,” Allen added.

The hypotensive effect of dietary sodium reduction was achieved quickly and safely within 1 week.

Public health implications

“The fact that blood pressure fell so significantly in just one week and was well tolerated is important and highlights the potential public health impact of reducing dietary sodium in the population, given that hypertension Blood pressure is a very important health problem worldwide,” said co-investigator Cora Lewis, MD, MSPH, professor and chair of the department of epidemiology and professor of medicine at the University of Alabama at Birmingham.

“It is particularly interesting that the products we use on the low sodium diet are generally available, so people have a real chance of improving their health by improving their diet in this way,” said Lewis.

Reference: “Effect of dietary sodium on blood pressure: a crossover trial” by Deepak K. Gupta, Cora E. Lewis, Krista A. Varady, Yan Ru Su, Meena S. Madhur, Daniel T. Lackland, Jared P. Reis , Thomas J. Wang, Donald M. Lloyd-Jones and Norrina B. Allen, November 11, 2023, JAMA.
DOI: 10.1001/jama.2023.23651

Other authors include Krista Varady, Ph.D., Yan Ru Su, MD, Meena Madhur, MD, Ph.D., Daniel Lackland, Ph.D., Jared Reis, Ph.D., Thomas Wang, MD, and Donald Lloyd Jones, MD

The research was supported by Grant R01HL148661 and Contracts 75N92023D00005 and 75N92023D00004 from the National Heart Lung and Blood Institute of the National Institutes of Health.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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