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Continuous salt intake responsible for increased high blood pressure

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Recent study by the European Society of Cardiology (ESC) has revealed that patients with high blood pressure still take excess salt, which triggers the heart condition despite warnings to stay off the chemical compound.The study, presented yesterday at the ESC Congress 2018, its yearly meeting, stated that patients with the heart condition are relying solely on medication to reduce their risk of heart attack, stroke and heart failure, rather than decreasing salt intake as instructed by their physicians.

Excessive salt intake is one of the most leading causes of hypertension and its restriction is a key strategy to managing it.The World Health Organisation Global Health Observatory (GHO) data estimated that high blood pressure to cause 7.5 million deaths, about 12.8 percent of all the total death worldwide, as it is a major risk factor for coronary heart disease and ischemic as well as hemorrhagic stroke.

According to lead author from Enshu Hospital, Hamamatsu, Japan, Dr Kazuto Ohno, lack of adherence to recommended lifestyle changes is leading to higher salt intake for hypertensive patients, adding that more medications are needed to treat their condition and more side effects from those medications.Although, few studies have been done on the relationship between salt intake and blood pressure in hypertensive patients undergoing antihypertensive drug treatment.

In the study, the authors enrolled 12,422 patients taking medication for hypertension, who visited the hospital for a physical checkup from 2010-2016 and the individual salt intake was estimated in grams per day using a spot urine calculation formula shown to be effective in previous studies2.The blood pressure levels and patients maintaining the target blood pressure of less than 140/90mmHg improved during the seven-year study among all groups, but individual salt intake increased across all groups as well.

The patients in the study were divided into three groups according to whether they were currently prescribed one, two, three or more antihypertensive drugs.The guidelines for the Management of Hypertension, 20143, published by the Japanese society of hypertension, according to Ohno, recommended less than six grams of salt intake per day, noting that less than four percent of study participants were following those recommendations.

Ohno said: “Patients may be able to improve this vicious cycle by restricting salt intake. In consequence, they may avoid diseases caused by hypertension, such as heart attacks, stroke and heart failure. Moreover, they may be able to avoid side effects from antihypertensive drugs, such as dizziness and fainting.”

The lead author explained that the observational study in hypertensive patients with antihypertensive drugs found two comparative facts, which are an improvement of blood pressure levels and an increase in salt intake, noting that in hypertensive patients with multiple antihypertensive drugs, salt intake was higher than those taking only one antihypertensive drug.

In the Dietary Reference Intakes for Japanese (2015) published by the Ministry of Health, Labor and Welfare4, salt intake for healthy people was targeted less than eight g/day for men and less than seven g/day for women. Ohno stressed that with the report of National Health and Nutrition Examination Survey 2016, on the level on salt intake in both men and women, more awareness about the harms of higher salt intake is needed in both hypertensive patients and healthy people.

“We can check the amount of salt in a lot of food and seasoning, such as soy sauce, miso paste, mayonnaise and so on, which are printed on the food labels. It is impossible to measure salt intake in every meal, so all of us should try to take food with reduced salt by referring to food labels.” He stated.

Ohno stressed that future research should consider whether nutritional guidance can improve the accomplishment rate of the target blood pressure and decrease the number of antihypertensive drug prescriptions.“As a new attempt, we have explained their estimated salt intake value and gave nutritional guidance including salt, calories and so on to participants since 2017. We think salt restriction is an important modifiable factor of lifestyle to treat and prevent high blood pressure,” he concluded.


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ESCKazuto Ohno
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