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Cutting
Salt isn't the only way to reduce Blood
Pressure
Newswise — Most people know that too much
sodium from foods can increase blood
pressure.
A new study suggests that people trying to
lower their blood pressure should also boost
their intake of potassium, which has the
opposite effect to sodium.
Researchers found that the ratio of
sodium-to-potassium in subjects' urine was a
much stronger predictor of cardiovascular
disease than sodium or potassium alone.
"There isn't as much focus on potassium, but
potassium seems to be effective in lowering
blood pressure and the combination of a
higher intake of potassium and lower
consumption of sodium seems to be more
effective than either on its own in reducing
the risk of cardiovascular disease," said
Dr. Paul Whelton, senior author of the study
in the January 2009 issue of the Archives of
Internal Medicine.
Whelton is an epidemiologist and president
and CEO of Loyola University Health System.
Researchers determined average sodium and
potassium intake during two phases of a
study known as the Trials of Hypertension
Prevention.
They
collected 24-hour urine samples
intermittently during an 18-month period in
one trial and during a 36-month period in a
second trial. The 2,974 study participants
initially aged 30-to-54 and with blood
pressure readings just under levels
considered high, were followed for 10-15
years to see if they would develop
cardiovascular disease.
Whelton was national chair of the Trials of
Hypertension Prevention.
Those with the highest sodium levels in
their urine were 20 percent more likely to
suffer strokes, heart attacks or other forms
of cardiovascular disease compared with
their counterparts with the lowest sodium
levels. However this link was not strong
enough to be considered statistically
significant.
By contrast, participants with the highest
sodium-to-potassium ratio in urine were 50
percent more likely to experience
cardiovascular disease than those with the
lowest sodium-to-potassium ratios. This link
was statistically significant.
Most previous studies of the relationship
between sodium or potassium and
cardiovascular disease have had to rely on
people’s recall or record of what foods they
eat to estimate their level of sodium
consumption.
This is a less precise measure of sodium
intake than urine samples. In addition, many
have been cross-sectional rather than
follow-up studies.
The new study "is a quantum leap in the
quality of the data compared to what we have
had before," Whelton said.
Whelton was a member of a recent Institute
of Medicine panel that set dietary
recommendations for salt and potassium. The
panel said healthy 19-to-50 year-old adults
should consume no more than 2,300 milligrams
of sodium per day -- equivalent to one
teaspoon of table salt.
More than 95 percent of American men and 75
percent of American women in this age range
exceed this amount.
To lower blood pressure and blunt the
effects of salt, adults should consume 4.7
grams of potassium per day unless they have
a clinical condition or medication need that
is a contraindication to increased potassium
intake.
Most American adults aged 31-to-50 consume
only about half as much as recommended in
the Institute of Medicine report. Changes in
diet and physical activity should be under
the supervision of a health care
professional.
Good potassium sources include fruits,
vegetables, dairy foods and fish. Foods that
are especially rich in potassium include
potatoes and sweet potatoes, fat-free milk
and yogurt, tuna, lima beans, bananas,
tomato sauce and orange juice. Potassium
also is available in supplements.
Whelton is among the nation's top experts on
high blood pressure. He has published more
than 400 papers on the subject, and has been
the principal investigator on more than $100
million of studies funded by the National
Institutes of Health.
Co-authors of the Archives study include
Nancy Cook (first author), Julie Buring and
Dr. Kathryn Rexrode of Brigham and Women's
Hospital; Eva Obarzanek and Dr. Jeffrey
Cutler of the National Heart, Lung and Blood
Institute; Dr. Lawrence Appel of Johns
Hopkins University and Shiriki Kumanyika of
the University of Pennsylvania.
Based in the western suburbs of Chicago,
Loyola University Health System is a
quaternary care system with a 61-acre main
medical center campus, the 36-acre Gottlieb
Memorial Hospital campus and 25 primary and
specialty care facilities in Cook, Will and
DuPage counties.
The medical center campus is conveniently
located in Maywood, 13 miles west of the
Chicago Loop and 8 miles east of Oak Brook,
Ill.
The heart of the medical center campus,
Loyola University Hospital, is a
570-licensed bed facility. It houses a Level
1 Trauma Center, a Burn Center and the
Ronald McDonald® Children’s Hospital of
Loyola University Medical Center.
Also on campus are the Cardinal Bernardin
Cancer Center, Loyola Outpatient Center,
Center for Heart & Vascular Medicine and
Loyola Oral Health Center as well as the LUC
Stritch School of Medicine, the LUC Marcella
Niehoff School of Nursing and the Loyola
Center for Fitness. Loyola's Gottlieb campus
in Melrose Park includes the 250-bed
community hospital, the Gottlieb Center for
Fitness and the Marjorie G. Weinberg Cancer
Care Center.
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