TABLE I-1a Mean Blood Pressure by Diet and by Sodium Level, Dietary Approaches to Stop Hypertension (DASH)-Sodium Trial
Diet |
Systolic |
Diastolic |
||||
Higher |
Intermediate |
Lower |
Higher |
Intermediate |
Lower |
|
Control diet (n = 204) |
132.8 |
130.7 |
126.1 |
83.4 |
82.3 |
79.9 |
DASH diet (n = 208) |
126.9 |
125.6 |
123.9 |
80.5 |
79.9 |
78.9 |
SOURCE: Sacks et al. (2001). |
TABLE I-1b Effect of Decreased Sodium on Systolic and Diastolic Blood Pressure, Control Diet (n = 204) in DASH-Sodium Trial
|
Systolic |
Diastolic |
||||
Mean Change |
Standard Error |
P-value |
Mean Change |
Standard Error |
P-value |
|
Higher to lower |
−6.7 |
0.58 |
< 0.0001 |
−3.5 |
0.38 |
< 0.0001 |
Higher to intermediate |
−2.1 |
0.58 |
0.0003 |
−1.1 |
0.38 |
0.0044 |
Intermediate to lower |
−4.6 |
0.60 |
< 0.0001 |
−2.4 |
0.39 |
< 0.0001 |
SOURCE: Sacks et al. (2001). |
TABLE I-1c Effect of Decreased Sodium on Systolic and Diastolic Blood Pressure, DASH Diet (n = 208), in DASH-Sodium Trial
|
Systolic |
Diastolic |
||||
Mean Change |
Standard Error |
P-value |
Mean Change |
Standard Error |
P-value |
|
Higher to lower |
−3.0 |
0.58 |
< 0.0001 |
−1.6 |
0.37 |
< 0.0001 |
Higher to intermediate |
−1.3 |
0.58 |
0.03 |
−0.6 |
0.37 |
0.09 |
Intermediate to lower |
−1.7 |
0.59 |
0.003 |
−1.0 |
0.38 |
0.01 |
SOURCE: Sacks et al. (2001). |
TABLE I-2 Design Features of Dose-Response Trials that Tested the Effects of Sodium Intake on Blood Pressure
Study |
Figure (Appendix I) |
Reference |
N |
Nonhypertensive |
|||
1 |
1 |
Roos et al. (1985) |
8 |
2 |
2 |
Sullivan et al. (1980) |
6 |
3 |
3 |
Luft et al. (1979) |
14 |
4 |
4 |
Fuchs et al. (1987), at risk of hypertension |
17 |
|
5 |
Fuchs et al. (1987), not at risk of hypertension |
17 |
5 |
6 |
Kirkendall et al. (1976) |
8 |
6 |
7 |
Bruun et al. (1990) |
10 |
7 |
8 |
Johnson et al. (2001) |
17 |
Hypertensive |
|||
|
9 |
Bruun et al. (1990) |
12 |
8 |
10 |
Ferri et al. (1996) |
61 |
9 |
11 |
MacGregor et al. (1989) |
20 |
|
12 |
Johnson et al. (2001), systolic-diastolic hypertension |
8 |
|
13 |
Johnson et al. (2001), isolated systolic hypertension |
15 |
Both nonhypertensive and hypertensive |
|||
10 |
14 |
Sacks et al. (2001) DASHc diet Control diet 204 |
208 |
a Urinary sodium. b Urinary potassium. c DASH = Dietary Approaches to Stop Hypertension. |
REFERENCES
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Ferri C, Bellini C, Carlomagno A, Desideri G, Santucci A. 1996. Active kallikrein response to changes in sodium-chloride intake in essential hypertensive patients. J Am Soc Nephrol 7:443–453.
Fuchs FD, Wannmacher CM, Wannmacher L, Guimaraes FS, Rosito GA, Gastaldo G, Hoeffel CP, Wagner EM. 1987. Effect of sodium intake on blood pressure, serum levels and renal excretion of sodium and potassium in normotensives with and without familial predisposition to hypertension. Braz J Med Biol Res 20:25–34.
Johnson AG, Nguyen TV, Davis D. 2001. Blood pressure is linked to salt intake and modulated by the angiotensinogen gene in normotensive and hypertensive elderly subjects. J Hypertens 19:1053–1060.
Kirkendall WM, Conner EW, Abboud F, Rastogi SP, Anderson TA, Fry M. 1976. The effect of dietary sodium chloride on blood pressure, body fluids, electro-
Duration (days) |
Feeding Study |
Design |
Range of Sodium g/d (mmol/d) |
Potassium Level g/d (mmol/d) |
|
Lowest |
Highest |
||||
5 |
Yes |
Dose-escalation |
0.46 (20) |
25.9 (1,128) |
3.1 (80) |
4 |
Yes |
Crossover |
0.23 (10) |
9.2 (400) |
2.3 (60) |
3–7 |
Yes |
Dose-escalation |
0.23 (10) |
34.5 (1,500) |
3.1 (80) |
9 |
No |
Crossover |
3.7 (16)a |
5.5 (239)a |
≈ 1.9 (50)b |
9 |
No |
Crossover |
0.18 (8)a |
5.6 (245)a |
≈ 1.9 (50)b |
28 |
Yes |
Crossover |
0.23 (10) |
9.4 (410) |
3.9 (100) |
4 |
Yes |
Crossover |
1.2 (50) |
8.7 (380) |
3.1 (80) |
14 |
Yes |
Crossover |
0.92 (40) |
7.8 (340) |
≈ 1.2 (30)b |
4 |
Yes |
Crossover |
1.2 (50) |
8.7 (380) |
3.1 (80) |
14 |
Yes |
Crossover |
0.46 (20) |
7.4 (320) |
2.7 (70) |
28 |
No |
Crossover |
1.2 (50) |
4.6 (200) |
2.7 (70) |
14 |
Yes |
Crossover |
0.92 (40) |
7.8 (340) |
≈ 1.2 (30)b |
14 |
Yes |
Crossover |
0.92 (40) |
7.8 (340) |
≈ 1.2 (30)b |
28 |
Yes |
Crossover |
1.5 (67)a |
3.3 (144) |
3.1 (79)b |
28 |
Yes |
Crossover |
1.5 (64)a |
3.2 (141)a |
1.6 (41)b |
lytes, renal function, and serum lipids of normotensive man. J Lab Clin Med 87:418–434.
Luft FC, Rankin LI, Bloch R, Weyman AE, Willis LR, Murray RH, Grim CE, Weinberger MH. 1979. Cardiovascular and humoral responses to extremes of sodium intake in normal black and white men. Circulation 60:697–706.
MacGregor GA, Markandu ND, Sagnella GA, Singer DRJ, Cappuccio FP. 1989. Double-blind study of three sodium intakes and long-term effects of sodium restriction in essential hypertension. Lancet 2:1244–1247.
Roos JC, Koomans HA, Dorhout-Mees EJ, Delawi IMK 1985. Renal sodium handling in normal humans subjected to low, normal, and extremely high sodium supplies. Am J Physiol 249:F941–F947.
Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harsha D, Obarzanek E, Conlin PR, Miller ER, Simons-Morton DG, Karanja N, Lin PH. 2001. Effects of blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med 344:3–10.
Sullivan JM, Ratts TE, Taylor JC, Kraus DH, Barton BR, Patrick DR, Reed SW. 1980. Hemodynamic effects of dietary sodium in man. Hypertension 2:506–514.