Recensione

Bibliografia__________________________________________________________

(1) Patience S. Understanding the relationship between salt intake and hypertension. Nurs Stand. 2013 Jan 2-8;27(18):45-7. doi: 10.7748/ns2013.01.27.18.45.c9487. 

Abstract. Hypertension is a public health problem that contributes significantly to the non-communicable disease burden. A review of the epidemiological literature demonstrates that the relationship between salt and hypertension is unequivocal. The Department of Health has reported some success promoting awareness of the need to reduce salt consumption, but more work needs to be done in this area.

(2) Borghi C, Tartagni E. The older patient with hypertension: care and cure. Ther Adv Chronic Dis. 2012 Sep;3(5):231-6. doi: 10.1177/2040622312452189. 

Abstract. Hypertension is one of the most important clinical conditions affecting older people. Its prevalence in this group of subjects is above 60% and continues to grow. Isolated systolic hypertension accounts for the majority of cases as systolic blood pressure increases with advancing age, while diastolic blood pressure remains unchanged or even decreases. Nowadays hypertension is a well established risk factor for stroke and cardiovascular disease among older people and its treatment is considered mandatory. The general recommended blood pressure goal in uncomplicated hypertension is less than 140/90 mmHg, even if this target in older people is based mainly on expert opinion. All patients should receive nonpharmacological treatment, in particular reduction in excess body weight when body mass index is greater than 26 kg/m(2) and dietary salt restriction. Older patients with hypertension may also benefit from smoking cessation, physical activity and alcohol restriction. In relation to drug therapy, a low-dose thiazide diuretic could be a good first step. Other first-line drugs are long-acting calcium channel blockers, generally dihydropyridines, and angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. The HYVET study showed a specific protective effect of indapamide with or without perindopril in people older than 80 years. Since monotherapy normalizes blood pressure in only 40-50% of cases, a combination of two or more drugs is often required. Moreover the addiction of a second drug may reduce the dose-related adverse effects of the first one. Finally, compliance with treatment should always be achieved by giving complete information to patients and simplifying the drug regimen as much as possible.

He FJ, Campbell NR, MacGregor GA. Reducing salt intake to prevent hypertension and cardiovascular disease. Rev Panam Salud Publica. 2012 Oct;32(4):293-300. doi: 10.1590/s1020-49892012001000008.

Abstract. There is compelling evidence that dietary salt intake is the major cause of raised blood pressure (BP) and that a reduction in salt intake from the current level of ≈ 9 - 12 g/day in most countries to the recommended level of < 5 g/day lowers BP. A further reduction to 3 - 4 g/day has a greater effect and there needs to be ongoing consideration of lower targets for population salt intake. Cohort studies and outcome trials have demonstrated that a lower salt intake is related to a reduced risk of cardiovascular disease. Salt reduction is one of the most cost-effective measures to improve public health worldwide. In the Americas, a salt intake of > 9 g/day is highly prevalent. Sources of salt in the diet vary hugely among countries; in developed countries, 75% of salt comes from processed foods, whereas in developing countries such as parts of Brazil, 70% comes from salt added during cooking or at the table. To reduce population salt intake, the food industry needs to implement a gradual and sustained reduction in the amount of salt added to foods in developed countries. In developing countries, a public health campaign plays a more important role in encouraging consumers to use less salt coupled with widespread replacement of salt with substitutes that are low in sodium and high in potassium. Numerous countries in the Americas have started salt reduction programs. The challenge now is to engage other countries. A reduction in population salt intake will result in a major improvement in public health along with major health-related cost savings.

(3) Campagnoli T, Gonzalez L, Santa Cruz F. Salt intake and blood pressure in the University of Asuncion-Paraguay youths: a preliminary study. J Bras Nefrol. 2012 Oct-Dec;34(4):361-8. doi: 10.5935/0101-2800.20120026. 

Abstract. Introduction: High salt intake is a major risk factor related to many cardiovascular and renal diseases. World Action on Salt and Health is a newly formed coalition of heath professionals whose goal is to implement changes in salt consumption in their respective countries for the goal of reducing blood pressure. In the same vein, we have decided to study the amount of salt intake in Paraguay to determine if a relationship exists between salt intake and blood pressure. Objective: A preliminary study was undertaken to determine salt intake in Paraguay and its relationship with blood pressure, in order to implement a national program to combat hypertension.... Conclusion: Salt intake and blood pressure were found to be significantly elevated in young adults in Paraguay and argues for the importance of instituting a national campaign to reduce salt intake in this society.

(4) Woodruff SJ, Fryer K, Campbell T, Cole M. Associations among blood pressure, salt consumption and body weight status of students from south-western Ontario. Public Health Nutr. 2014 May;17(5):1114-9. doi: 10.1017/S1368980013000335.

Abstract. Objective: The purpose was to examine the associations among body weight status, blood pressure and daily Na intake among grade 7 students from south-western Ontario, Canada. Design: Cross-sectional. Data were collected using the Food Behaviour Questionnaire, including a 24 h diet recall. Measured height and weight were used to determine BMI. Blood pressure was taken manually using mercury sphygmomanometers.... Conclusions: High intakes of Na, coupled with high SBP and DBP, were associated with overweight and obesity status among the grade 7 sample from south-western Ontario, Canada.

(5) Grimes CA, Riddell LJ, Campbell KJ, Nowson CA. Dietary salt intake, sugar-sweetened beverage consumption, and obesity risk. Pediatrics. 2013 Jan;131(1):14-21. doi: 10.1542/peds.2012-1628.

Abstract. Objective: To determine the association among dietary salt, fluid, and sugar-sweetened beverage (SSB) consumption and weight status in a nationally representative sample of Australian children aged 2 to 16 years....Conclusions: Dietary salt intake predicted total fluid consumption and SSB consumption within consumers of SSBs. Furthermore, SSB consumption was associated with obesity risk. In addition to the known benefits of lowering blood pressure, salt reduction strategies may be useful in childhood obesity prevention efforts.

(6) Wick JY. Salt: important element, invisible menace. Consult Pharm. 2012 Nov;27(11):756-62. doi: 10.4140/TCP.n.2012.756.

Wenstedt EFE, Beugelink L, Schrooten EM, Rademaker E, Rorije NMG, Wouda RD, Schlingemann RO, Wong TY, Vogt L. High-salt intake affects retinal vascular tortuosity in healthy males: an exploratory randomized cross-over trial. Sci Rep. 2021 Jan 12;11(1):801. doi: 10.1038/s41598-020-79753-6.

Abstract. The retinal microcirculation is increasingly receiving credit as a relatively easily accessible microcirculatory bed that correlates closely with clinical cardiovascular outcomes. The effect of high salt (NaCl) intake on the retinal microcirculation is currently unknown. Therefore, we performed an exploratory randomized cross-over dietary intervention study in 18 healthy males. All subjects adhered to a two-week high-salt diet and low-salt diet, in randomized order, after which fundus photographs were taken and assessed using a semi-automated computer-assisted program (SIVA, version 4.0). Outcome parameters involved retinal venular and arteriolar tortuosity, vessel diameter, branching angle and fractal dimension. At baseline, participants had a mean (SD) age of 29.8 (4.4) years and blood pressure of 117 (9)/73 (5) mmHg. Overall, high-salt diet significantly increased venular tortuosity (12.2%, p = 0.001). Other retinal parameters were not significantly different between diets. Changes in arteriolar tortuosity correlated with changes in ambulatory systolic blood pressure (r = - 0.513; p = 0.04). In conclusion, high-salt diet increases retinal venular tortuosity, and salt-induced increases in ambulatory systolic blood pressure associate with decreases in retinal arteriolar tortuosity. Besides potential eye-specific consequences, both phenomena have previously been associated with hypertension and other cardiovascular risk factors, underlining the deleterious microcirculatory effects of high salt intake.

Piecha G, Koleganova N, Ritz E, Müller A, Fedorova OV, Bagrov AY, Lutz D, Schirmacher P, Gross-Weissmann ML. High salt intake causes adverse fetal programming--vascular effects beyond blood pressure. Nephrol Dial Transplant. 2012 Sep;27(9):3464-76. doi: 10.1093/ndt/gfs027. 

Abstract. Background: High salt intake causes hypertension, adverse cardiovascular outcomes and potentially also blood pressure (BP)-independent target organ damage. Excess salt intake in pregnancy is known to affect BP in the offspring. The present study was designed to assess whether high salt in