期刊论文详细信息
Nutrition Journal
Feasibility and antihypertensive effect of replacing regular salt with mineral salt -rich in magnesium and potassium- in subjects with mildly elevated blood pressure
Leo K Niskanen3  Jay K Udani2  Taisa M Venäläinen4  Pia H Karjalainen1  Tarja H Niskanen1  Mika J Kastarinen3  Essi S Sarkkinen4 
[1] Oy Foodfiles Ltd, CRO in the field of nutrition, Neulaniementie 2 L 6, 70210 Kuopio, Finland;Medicus Research LLC/UCLA School of Medicine, Northridge, California, USA;Department of Medicine, Central Hospital Central Finland, Jyväskylä, Finland, and University of Eastern Finland, Faculty of Health Sciences, School of Medicine, Kuopio, Finland;University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Department of Clinical Nutrition, Food and Health Research Centre, Kuopio, Finland
关键词: high-potassium and high-magnesium salt;    low-sodium;    mineral salt;    sodium reduction;    hypertension;    blood pressure;   
Others  :  828864
DOI  :  10.1186/1475-2891-10-88
 received in 2011-03-03, accepted in 2011-09-02,  发布年份 2011
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【 摘 要 】

Background

High salt intake is linked to hypertension whereas a restriction of dietary salt lowers blood pressure (BP). Substituting potassium and/or magnesium salts for sodium chloride (NaCl) may enhance the feasibility of salt restriction and lower blood pressure beyond the sodium reduction alone. The aim of this study was to determine the feasibility and effect on blood pressure of replacing NaCl (Regular salt) with a novel mineral salt [50% sodium chloride and rich in potassium chloride (25%), magnesium ammonium potassium chloride, hydrate (25%)] (Smart Salt).

Methods

A randomized, double-blind, placebo-controlled study was conducted with an intervention period of 8-weeks in subjects (n = 45) with systolic (S)BP 130-159 mmHg and/or diastolic (D)BP 85-99 mmHg. During the intervention period, subjects consumed processed foods salted with either NaCl or Smart Salt. The primary endpoint was the change in SBP. Secondary endpoints were changes in DBP, daily urine excretion of sodium (24-h dU-Na), potassium (dU-K) and magnesium (dU-Mg).

Results

24-h dU-Na decreased significantly in the Smart Salt group (-29.8 mmol; p = 0.012) and remained unchanged in the control group: resulting in a 3.3 g difference in NaCl intake between the groups. Replacement of NaCl with Smart Salt resulted in a significant reduction in SBP over 8 weeks (-7.5 mmHg; p = 0.016). SBP increased (+3.8 mmHg, p = 0.072) slightly in the Regular salt group. The difference in the change of SBP between study groups was significant (p < 0.002).

Conclusions

The substitution of Smart Salt for Regular salt in subjects with high normal or mildly elevated BP resulted in a significant reduction in their daily sodium intake as well as a reduction in SBP.

Trial Registration

ISRCTN: ISRCTN01739816

【 授权许可】

   
2011 Sarkkinen et al; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]World Health Organization, International Society of Hypertension Writing Group: 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens 2003, 21:1983-1992.
  • [2]Cutler JA, Sorlie PD, Wolz M, Thom T, Fields LE, Roccella EJ: Trends in hypertension prevalence, awareness, treatment and control rates in United States adults between 1988-1994 and 1999-2004. Hypertension 2008, 52:818-27.
  • [3]Kastarinen MJ, Antikainen RL, Peltonen M, Laatikainen T, Barengo NC, Jula A, et al.: Prevalence, awareness and treatment of hypertension in Finland during 1982-2007. J Hypertens 2009, 27:1552-9.
  • [4]Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, et al.: Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (DASH) diet. N Engl J Med 2001, 344:3-10.
  • [5]Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM: Dietary approaches to prevent and treat hypertension: A scientific statement from the American Heart Association. Hypertension 2006, 47:296-308.
  • [6]Wexler R, Aukerman G: Nonpharmacologic strategies for managing hypertension. Am Fam Physician 2006, 73:1953-6.
  • [7]Bibbins-Domingo K, Chertow GM, Coxson PG, Moran A, Lightwood JM, Pletcher MJ, et al.: Projected effect of dietary salt reductions on future cardiovascular disease. New Engl J Med 2010, 362:590-9.
  • [8]Law MR, Frost CD, Wald NJ: By how much does dietary salt reduction lower blood pressure? III--Analysis of data from trials of salt reduction. BMJ 1991, 302:819-24. Erratum in BMJ 302,939
  • [9]Midgley JP, Matthew AG, Greenwood CM, Logan AG: Effect of reduced dietary sodium on blood pressure: a meta-analysis of randomized controlled trials. JAMA 1996, 275:1590-7.
  • [10]Cutler JA, Follmann D, Allender PS: Randomized trials of sodium reduction: an overview. Am J Clin Nutr 1997, 65(Suppl 2):643S-651S.
  • [11]Graudal NA, Galløe AM, Garred P: Effects of sodium restriction on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride: a meta-analysis. JAMA 1998, 279:1383-91.
  • [12]Alam S, Johnson AG: A meta-analysis of randomised controlled trials (RCT) among healthy normotensive and essential hypertensive elderly patients to determine the effect of high salt (NaCl) diet of blood pressure. J Hum Hypertens 1999, 13:367-74.
  • [13]He FJ, MacGregor GA: Effect of modest salt reduction on blood pressure: a meta-analysis of randomized trials. Implications for public health. J Hum Hypertens 2002, 16:761-70.
  • [14]He FJ, MacGregor GA: Effect of longer-term modest salt reduction on blood pressure. Cochrane Database Syst Rev 2004, CD004937.
  • [15]Jürgens G, Graudal NA: Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride. Cochrane Database Syst Rev 2004, CD004022.
  • [16]Neutel J: Replacing regular salt with sodium-reduced potassium- and magnesium-enriched mineral salt may offer non-pharmacological approach to lowering blood pressure. Am J Hypertens 1996, 9:94A.
  • [17]Whelton PK, He J, Cutler JA, Brancati FL, Appel LJ, Follmann D, et al.: Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA 1997, 277:1624-32.
  • [18]Hermansen K: Diet, blood pressure and hypertension. Br J Nutr 2000, 83:S113-S119.
  • [19]Jee SH, Miller ER, Guallar E, Singh VK, Appel LJ, Klag MJ: The effect of magnesium supplementation on blood pressure: a meta-analysis of randomized clinical trials. Am J Hypertens 2002, 15:691-6.
  • [20]Karppanen H, Tanskanen A, Tuomilehto J, Puska P, Vuori J, Jäntti V, et al.: Safety and effects of potassium- and magnesium-containing low sodium salt mixtures. J Cardiovasc Pharmacol 1984, 6(Suppl 1):S236-43.
  • [21]Geleijnse JM, Witteman JC, Bak AA, den Breeijen JH, Grobbee DE: Reduction in blood pressure with a low sodium, high potassium, high magnesium salt in older subjects with mild to moderate hypertension. BMJ 1994, 309:436-40.
  • [22]Omvik P, Myking OL: Unchanged central hemodynamics after six months of moderate sodium restriction with or without potassium supplement in essential hypertension. Blood Press 1995, 4:32-41.
  • [23]Gilleran G, O'Leary M, Bartlett WA, Vinall H, Jones AF, Dodson PM: Effects of dietary sodium substitution with potassium and magnesium in hypertensive type II diabetics: a randomised blind controlled parallel study. J Hum Hypertens 1996, 10:517-21.
  • [24]Kawasaki T, Itoh K, Kawasaki M: Reduction in blood pressure with a sodium-reduced, potassium- and magnesium-enriched mineral salt in subjects with mild essential hypertension. Hypertens Res 1998, 21:235-43.
  • [25]Katz A, Rosenthal T, Maoz C, Peleg E, Zeidenstein R, Levi Y: Effect of a mineral salt diet on 24-h blood pressure monitoring in elderly hypertensive patients. J Hum Hypertens 1999, 13:777-80.
  • [26]China Salt Substitute Study Collaborative Group: Salt substitution: a low-cost strategy for blood pressure control among rural Chinese. A randomized, controlled trial. J Hypertens 2007, 25:2011-8.
  • [27]Hooper L, Bartlett C, Davey Smith G, Ebrahim S: Systematic review of long term effects of advice to reduce dietary salt in adults. BMJ 2002, 325:628.
  • [28]Klaus D, Hoyer J, Middeke M: Salt restriction for the prevention of cardiovascular disease. Dtsch Arztebl Int 2010, 107:457-462.
  • [29]Kastarinen M, Laatikainen T, Salomaa V, Jousilahti P, Antikainen R, Tuomilehto J, et al.: Trends in lifestyle factors affecting blood pressure in hypertensive and normotensive Finns during 1982-2002. J Hypertens 2007, 25:299-305.
  • [30]Laatikainen T, Pietinen P, Valsta L, Sundvall J, Reinivuo H, Tuomilehto J: Sodium in the Finnish diet: 20-year trends in urinary sodium excretion among the adult population. Eur J Clin Nutr 2006, 60:965-70.
  • [31]Cappuccio FP, MacGregor GA: Does potassium supplementation lower blood pressure? A meta-analysis of published trials. J Hypertens 1991, 9:465-473.
  • [32]Khaw KT, Barrett-Connor E: The association between blood pressure, age and dietary sodium and potassium: a population study. Circulation 1988, 77:53-61.
  • [33]Wirell MP, Wester PO, Stegmayr BG: Nutritional dose of magnesium in hypertensive patients on beta blockers lowers systolic blood pressure: a double-blind, cross-over study. J Intern Med 1994, 236:189-95.
  • [34]Witteman JCM, Grobbee DE, Derkx FHM, Bouillon R, de Bruijn AM, Hofman A: Reduction of blood pressure with oral magnesium supplementation in women with mild and moderate hypertension. Am J Clin Nutr 1994, 60:129-135.
  • [35]Sanjuliani AF, de Abreu Fagundes VG, Francischetti EA: Effects of magnesium on blood pressure and intracellular ion levels of Brazilian hypertensive patients. Int J Cardiol 1996, 56:117-83.
  • [36]Itoh K, Kawasaka T, Nakamura M: The effects of high oral magnesium supplementation on blood pressure, serum lipids and related variables in apparently healthy Japanese subjects. Br J Nutr 1997, 78:737-50.
  • [37]Kawano Y, Matsuoka H, Takishita S, Omae T: Effects of magnesium supplementation in hypertensive patients: assessment by office, home and ambulatory blood pressure. Hypertension 1998, 32:260-5.
  • [38]Grobbee DE: Methodology of sodium sensitivity assessment. Hypertension 1991, 17:109-114.
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