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(Hypertension. 2003;42:457.)
© 2003 American Heart Association, Inc.

Editorial Commentary

Reproducibility of BP Responses to Changes in Dietary Salt

Compelling Evidence for Universal Sodium Restriction?

Brent M. Egan

From the Medical University of South Carolina, Charleston.

Correspondence to Brent M. Egan, MD, Medical University of South Carolina, 96 Jonathan Lucas Street, CSB 826H, Charleston, SC 29425. E-mail eganbm@musc.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Hypertension is a highly prevalent disorder association with significant population-attributable risk for cardiovascular and renal morbidity and mortality. Given the high lifetime risk of hypertension and associated complications, a public health approach to prevention is logical. The DASH-Sodium trial represents a landmark study on nutrition and blood pressure (BP) regulation in a middle-aged population (48±10 years) comprised of overweight-obese (body mass index [BMI] 30±5 kg/m²), disproportionately minority (60%, mainly African American) volunteers with BP averaging in the high normal range at 134±10/86±5 mm Hg.¹ The findings from this carefully controlled feeding study, if applied to the general population, have the potential to reduce BP and delay and possibly prevent the development of hypertension and associated complications.

Based on a post hoc analysis on the reproducibility of salt sensitivity in the DASH-Sodium trial, Obarzanek and colleagues² conclude that salt sensitivity is not a highly reproducible finding. The authors interpret the low-order reproducibility of BP responses to changes of dietary sodium (r=0.27, r²=0.07) as further support for universal Na⁺ restriction in the entire population. They extend this reasoning to a recommendation for limiting sodium intake in food processing.

Obarzanek et al, acknowledge that this is a post hoc analysis of the DASH-Sodium data for which the study was not designed. In this regard, there are 3 significant limitations.

• Only 2 pairs of BP readings (4 total) were obtained during the run-in (high sodium) dietary phase. This is a limited amount of vitally important BP . . . [Full Text of this Article]

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