Salt Restriction Improves Blood Pressure and Proteinuria in Blacks

Modest reductions in dietary salt improve blood pressure and proteinuria in black patients with hypertension.

Lead investigator Dr. Pauline A. Swift from St. George’s Hospital Medical Center, London stated that, "This study…contributes to the growing and compelling evidence that salt reduction reduces blood pressure and thus will reduce cardiovascular risk. "It also demonstrates for the first time that salt reduction reduces urine protein excretion, which in turn will reduce the risk of progressive renal disease and may also further reduce cardiovascular risk."

Dr. Swift and colleagues investigated the effects of reducing salt intake from about 10 grams per day to 5 grams per day in 40 nondiabetic black patients with hypertension. None of the subjects were receiving blood pressure lowering medications.
With salt restriction, the mean blood pressure fell from 159/101 mm Hg to 151/98 mm Hg, the authors report. There were parallel falls in mean daytime and nighttime ambulatory blood pressures.

During the same interval, urine protein excretion declined by 18 mg per 24 hours and the mean urine protein to creatine ratio decreased from 6.6 mg/mmol to 5.7 mg/mmol, the results indicate.

Urine protein excretion did not correlate with blood pressure changes, the researchers note, but the change in urine sodium excretion correlated significantly with the change in urinary protein excretion.

Plasma renin activity increased from 0.1 ng/mL to 0.2 ng/mL with salt reduction, the investigators report.

"Groups with the highest cardiovascular and renal risk, such as diabetics or individuals with renal disease, might be expected to have the greatest personal benefits from salt reduction," Dr. Swift explained. "In terms of preventing cardiovascular deaths, however, all populations worldwide, should be encouraged to reduce salt intake, at least to the WHO recommended intake of 5 g/day."

Hypertension 2005;46:308-312.

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FACT:
Research suggests that the reason why elderly population differs in their ability to exercise for better physical ability may be genetical by nature.

More than a third of adults in the USA in the age group of 70 and older report having difficulty walking a quarter-mile or climbing 10 stairs. Researchers found that an enzyme involved in blood pressure regulation may influence how the body responds to exercise. The study is the first to show that a gene that controls levels of angiotensin converting enzyme (ACE) in the body may be associated with physical function in older adults. The researchers found that older exercisers who inherited a gene combination associated with the lowest ACE production were 45 percent more likely to develop difficulties with climbing stairs or walking a quarter-mile than exercisers with gene combinations associated with higher levels of ACE. Journal of the American Medical Association Aug. 15, 2005

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