Key takeaways:
- When a low-salt diet was adopted, there was a reduction in systolic blood pressure of at least 7 mm
- The benefit was reported by 75% of participants and was comparable to hydrochlorothiazide.
The CARDIA-SSBP trial provided compelling evidence, in a ground-breaking presentation at the American Heart Association Scientific Sessions, that adopting a low-sodium diet can result in blood pressure benefits comparable to those attained with hydrochlorothiazide, a commonly prescribed first-line antihypertensive medication. The trial's randomized-order crossover design strengthened the results and emphasized the importance of dietary interventions in the treatment of hypertension.
The study's findings are timely as the world's medical community struggles to manage the rising prevalence of hypertension and looks for practical, workable methods to lower blood pressure. The trial's scientific significance and rigor are further highlighted in the parallel publication in JAMA, which also presents dietary modifications as a powerful weapon in the fight against hypertension.
These results show promise for those managing hypertension issues because they provide a comprehensive and possibly medication-free method of controlling blood pressure. This research has implications that go beyond the clinical setting, supporting lifestyle interventions that enable people to actively manage their cardiovascular health. The CARDIA-SSBP trial adds a critical chapter to the growing conversation about managing hypertension by highlighting the transformative power of dietary choices in the pursuit of healthier blood pressure profiles.
When a low-salt diet was adopted, there was a reduction in systolic blood pressure of at least 7 mm Hg.
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As Director of the Vanderbilt Translational and Clinical Cardiovascular Research Center and Associate Professor of Medicine, Dr. Deepak K. Gupta says there are serious concerns about the alarmingly high daily consumption of sodium in the United States, which is approximately 3,500 mg. This consumption greatly exceeds the recommended daily intake of 1,500 mg to 2,300 mg as advocated by the Department of Health and Human Services, the World Health Organization, and the American Heart Association.
During a press conference, Dr. Gupta emphasized the alarming effects of excessive sodium consumption on the population, estimating that, according to 2019 data, it causes an astounding 1.9 million deaths worldwide each year.
Reducing sodium consumption to the recommended levels has substantial potential benefits; estimates range from 44,000 to 92,000 fewer deaths in the US annually, and there could be significant economic savings of $12 billion to $20 billion. These numbers highlight the critical need for focused interventions to reduce sodium intake, for the benefit of everyone's health as well as the larger social and economic cohesion.
Dr. Deepak K. Gupta and associates carried out a rigorous randomized trial with 213 participants, emphasizing diversity with a median age of 61 years, 65% women, 64% Black, and 21% with diabetes in order to evaluate the effect of sodium intake on blood pressure. Randomly chosen participants were put on a low-sodium diet that allowed them to consume no more than 500 mg of sodium per day, or a high-sodium diet that allowed them to consume an additional 2,200 mg of sodium daily. The results of this extensive study are especially pertinent to the populations of people with diabetes and those already taking antihypertensive drugs.
With a seven-day waiting period following randomization, each participant in the trial followed one diet for seven days before switching to the other for a further seven days, all part of an exacting design. Bouillon packets were given as sodium supplements to the high-sodium group, guaranteeing regulated and constant sodium levels. The low-sodium diet was carefully standardized, prepared in University of Alabama at Birmingham and Northwestern University metabolic kitchens, and easily accessible to participants via supermarkets and internet retailers. The study's results are more reliable and applicable due to the strong methodology, which also offers insightful information about how reducing sodium affects blood pressure in practical settings.
Strong evidence supporting the cardiovascular advantages of a low-sodium diet was found in the CARDIA-SSBP trial, which was consistent with the effects of hydrochlorothiazide, a commonly prescribed antihypertensive drug. The investigation's principal investigator, Dr. Deepak K. Gupta, presented key findings, highlighting the high frequency of high sodium intake—an average of 4,450 mg per day—in the participants' baseline diets. Subgroups that included people with normal blood pressure, people with controlled and untreated hypertension, and people with uncontrolled hypertension were distinguished, highlighting the study's diverse sample.
Individuals who made the switch to the high-sodium diet saw a small increase in average systolic blood pressure from 125 mm Hg to 126 mm Hg, along with a nominal increase in daily sodium intake to about 5,000 mg. On the other hand, those following the low-sodium diet showed a noteworthy decrease in daily sodium consumption to 1,270 mg, along with a noteworthy reduction in systolic blood pressure to 119 mm Hg. The effects of the low-sodium diet were especially noticeable, with a significant drop in systolic blood pressure of -8 mm Hg after the first week when compared to the high-sodium group, and a consistent drop to -7 mm Hg after the second week.
Most importantly, the research showed significant declines in a number of subgroups, including age, sex, race, and the presence or absence of hypertension and diabetes at baseline. Significantly, the effect of dietary sodium reduction on systolic blood pressure was similar for people taking antihypertensive medications and those who did not, demonstrating the broad applicability of this intervention. About 75% of those following the low-sodium diet showed significant systolic blood pressure drops, comparable to what hydrochlorothiazide does. This was noted by Dr. Gupta. This demonstrates the safety and efficacy of dietary interventions in a diverse cohort of middle-aged and older people, underscoring the clinical significance of quickly achieving meaningful blood pressure reductions.
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