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Associations between dietary salt, potassium and blood pressure in South African adults: WHO SAGE Wave 2 Salt & Tobacco

Journal Article


Abstract


  • Background & aims: In June 2016, South Africa implemented legislation mandating maximum sodium levels in a range of processed foods with a goal of reducing population salt intake and disease burden from hypertension. Our aim was to explore the relationship between salt and blood pressure (BP) in a subsample of the World Health Organization Study on global AGEing and adult health (SAGE) Wave 2 before implementation of legislation in South Africa. Methods & results: Blood pressure (BP) was measured in triplicate (n = 2722; median age 56 years; 33% male) and 24-h urine collected in a nested subsample (n = 526) for sodium, potassium and creatinine analysis. Hypertension prevalence was 55% in older adults (50-plus years) and 28% in younger adults (18-49 years). Median salt intake (6.8 g/day) was higher in younger than older adults (8.6 g vs 6.1 g/day; p < 0.001), and in urban compared to rural populations (7.0 g vs 6.0 g/day; p = 0.033). Overall, 69% of participants had salt intakes above 5 g/day. Potassium intakes were generally low (median 35 mmol/day) with significantly lower intakes in rural areas and older adults. Overall, 91% of adults failed to meet the daily potassium recommendation of 90 mmol/d. Salt intakes above 5 g/day, and to a greater extent, a dietary sodium-to-potassium (Na:K) ratio above 2 mmol/mmol, were associated with significantly steeper regression slopes of BP with age. Conclusion: These preliminary results indicate that high dietary Na:K ratio may lead to a greater increase in BP and hypertension risk with age. Interventions to increase potassium intakes alongside sodium reduction initiatives may be warranted.

Authors


  •   Ware, Lisa J. (external author)
  •   Charlton, Karen E.
  •   Schutte, Aletta E. (external author)
  •   Cockeran, M (external author)
  •   Naidoo, Nirmala (external author)
  •   Kowal, Paul (external author)

Publication Date


  • 2017

Citation


  • Ware, L. J., Charlton, K., Schutte, A. E., Cockeran, M., Naidoo, N. & Kowal, P. (2017). Associations between dietary salt, potassium and blood pressure in South African adults: WHO SAGE Wave 2 Salt & Tobacco. Nutrition, Metabolism and Cardiovascular Diseases, 27 (9), 784-791.

Scopus Eid


  • 2-s2.0-85027257439

Ro Metadata Url


  • http://ro.uow.edu.au/smhpapers/4938

Number Of Pages


  • 7

Start Page


  • 784

End Page


  • 791

Volume


  • 27

Issue


  • 9

Place Of Publication


  • United Kingdom

Abstract


  • Background & aims: In June 2016, South Africa implemented legislation mandating maximum sodium levels in a range of processed foods with a goal of reducing population salt intake and disease burden from hypertension. Our aim was to explore the relationship between salt and blood pressure (BP) in a subsample of the World Health Organization Study on global AGEing and adult health (SAGE) Wave 2 before implementation of legislation in South Africa. Methods & results: Blood pressure (BP) was measured in triplicate (n = 2722; median age 56 years; 33% male) and 24-h urine collected in a nested subsample (n = 526) for sodium, potassium and creatinine analysis. Hypertension prevalence was 55% in older adults (50-plus years) and 28% in younger adults (18-49 years). Median salt intake (6.8 g/day) was higher in younger than older adults (8.6 g vs 6.1 g/day; p < 0.001), and in urban compared to rural populations (7.0 g vs 6.0 g/day; p = 0.033). Overall, 69% of participants had salt intakes above 5 g/day. Potassium intakes were generally low (median 35 mmol/day) with significantly lower intakes in rural areas and older adults. Overall, 91% of adults failed to meet the daily potassium recommendation of 90 mmol/d. Salt intakes above 5 g/day, and to a greater extent, a dietary sodium-to-potassium (Na:K) ratio above 2 mmol/mmol, were associated with significantly steeper regression slopes of BP with age. Conclusion: These preliminary results indicate that high dietary Na:K ratio may lead to a greater increase in BP and hypertension risk with age. Interventions to increase potassium intakes alongside sodium reduction initiatives may be warranted.

Authors


  •   Ware, Lisa J. (external author)
  •   Charlton, Karen E.
  •   Schutte, Aletta E. (external author)
  •   Cockeran, M (external author)
  •   Naidoo, Nirmala (external author)
  •   Kowal, Paul (external author)

Publication Date


  • 2017

Citation


  • Ware, L. J., Charlton, K., Schutte, A. E., Cockeran, M., Naidoo, N. & Kowal, P. (2017). Associations between dietary salt, potassium and blood pressure in South African adults: WHO SAGE Wave 2 Salt & Tobacco. Nutrition, Metabolism and Cardiovascular Diseases, 27 (9), 784-791.

Scopus Eid


  • 2-s2.0-85027257439

Ro Metadata Url


  • http://ro.uow.edu.au/smhpapers/4938

Number Of Pages


  • 7

Start Page


  • 784

End Page


  • 791

Volume


  • 27

Issue


  • 9

Place Of Publication


  • United Kingdom