Document Detail

Salt and hypertension at the close of the millenium.
MedLine Citation:
PMID:  9746958     Owner:  NLM     Status:  MEDLINE    
"Can that which is unsavory be eaten without salt?" This question was directed at none other than God by Job, who also had other important problems to ponder. The question posed in this review is the notion that essential hypertension is induced and/or sustained by an unnecessarily high salt intake. If this is indeed the case, then a reduction of salt intake might prevent or effectively treat essential hypertension. A cross-sectional epidemiological study of salt intake in populations showed a positive association of sodium excretion with median blood pressure and the prevalence of hypertension; however, when four disparate populations were deleted, the associations disappeared. A Scottish report on a similarly large population minimized the importance of dietary sodium. A recently analysis of the National Health and Nutrition Examination Survey (NHANES) data base does not support the idea that lower salt intake improves all-cause or cardiovascular mortality; however, the analysis is not without weaknesses. Salt-sensitivity is based on the idea that some persons might be more susceptible to salt-induced effects on blood pressure than others. Indeed, several monogenic syndromes exhibit marked salt-sensitivity and their clarification has facilitated our understanding of basic mechanisms. Allelic variants of several genes may be important in salt-sensitive patients with essential hypertension. Meta-analyses of intervention trials in patients with essential hypertension show about a 5 mm Hg decrease in blood pressure with salt restriction. Among the normotensive, this decrease is less than 2 mm Hg. In terms of efficacy, salt restriction has not been shown superior to weight loss or a "vegetable" diet. Nonpharmacological approaches in hypertensive patients should be based on a comprehensive approach.
F C Luft
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Wiener klinische Wochenschrift     Volume:  110     ISSN:  0043-5325     ISO Abbreviation:  Wien. Klin. Wochenschr.     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-12-23     Completed Date:  1998-12-23     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  21620870R     Medline TA:  Wien Klin Wochenschr     Country:  AUSTRIA    
Other Details:
Languages:  eng     Pagination:  459-66     Citation Subset:  IM    
Franz Volhard Clinic, Max Delbrück Center for Molecular Medicine, Medizinsche Fakultät der Charité, Humboldt University of Berlin, Federal Republic of Germany.
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MeSH Terms
Diet, Sodium-Restricted
Hypertension / etiology*,  prevention & control
Sodium Chloride, Dietary / adverse effects*
Reg. No./Substance:
0/Sodium Chloride, Dietary

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