Blood pressure of people with metabolic syndrome is more sensitive to salt intake

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Public release date: 15-Feb-2009

http://www.eurekalert.org/pub_releases/2009-02/l-bpo021209.php

Contact: Dr Jing Chen

jchen@...

Lancet

Blood pressure of people with metabolic syndrome is more sensitive to

salt intake

A study of some 1900 Chinese people has revealed that the blood pressure

of people with metabolic syndrome is more sensitive to salt intake. Thus

reduction of salt intake could be an especially important component in

reducing blood pressure in patients with multiple risk factors for

metabolic syndrome. These are the conclusions of authors of an Article

published Online First and in an upcoming edition of The Lancet, written

by Dr Jing Chen, Tulane University School of Medicine, New Orleans, LA, USA.

Metabolic syndrome is a combination of medical disorders that increase

the risk of developing cardiovascular disease and diabetes. It affects

one in five people, and prevalence increases with age. Identification of

people or subgroups who are more sensitive to dietary salt intervention

has important clinical and public-health implications, and can aid the

targeting of salt reduction interventions at those who are most likely

to benefit. Small clinical studies have suggested that insulin

resistance might lead to sodium retention and extracellular fluid volume

expansion, thereby increasing blood pressure responses to sodium intake.

Since insulin resistance is thought to be the underlying mechanism for

metabolic syndrome, affected individuals are likely to be sensitive to a

dietary salt intervention. The authors examined the association between

metabolic syndrome and salt sensitivity of blood pressure.

The study analysed 1906 Chinese participants without diabetes, aged 16

years or more, who were selected to receive a low-sodium diet for 7 days

followed by a high-sodium diet (six-fold higher than the low-sodium

phase) for an additional 7 days. Participants were excluded from the

analysis if metabolic risk factor information was missing or if they did

not complete their dietary interventions. Blood pressure was measured at

baseline and on days 2, 5, 6, and 7 of each intervention. Metabolic

syndrome was defined as the presence of three or more of: abdominal

obesity, raised blood pressure, high triglyceride concentration, low HDL

cholesterol, or high glucose. High salt sensitivity was defined as a

decrease in mean arterial blood pressure of more than 5 mm Hg during

low-sodium or an increase of more than 5 mm Hg during high-sodium

intervention.

The researchers found that 283 of 1881 patients with complete data had

metabolic syndrome. In both the high-sodium and low-sodium phase, the

blood pressure of patients with metabolic syndrome was more sensitive to

changes in salt intake. Compared with those with no risk factors,

participants with four or five risk factors had a three-and-a-half times

higher risk of high salt-sensitivity during the low sodium phase and a

three-fold higher risk of high salt-sensitivity during the high-sodium

phase. The authors conclude: " These results suggest that metabolic

syndrome enhances blood pressure response to sodium intake. Reduction in

sodium intake could be an especially important component in reducing

blood pressure in patients with multiple risk factors for metabolic

syndrome. "

In an accompanying Comment, Gonghuan Yang, Chinese Centre for Disease

Control and Prevention, Beijing, China, say: " If salt-sensitive

hypertension is recorded in Chinese people more frequently than in other

countries, reduction of salt intake should become a national campaign,

including communication about the association between high salt intake

and hypertension, food labelling, the creation of new Chinese dishes

with low salt, and the cultivation of a dietary custom for a reduced

salty taste for children. "

###

Dr Jing Chen, Tulane University School of Medicine, New Orleans, LA, USA

T) +1 E) jchen@...

Gonghuan Yang, Chinese Centre for Disease Control and Prevention,

Beijing, China contact by e-mail E) yanggh@...

For full Article and Comment: http://press.thelancet.com/metabolicsalt.pdf

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