Author: ian.hughes@bluewin.ch

Salt and fluid intakes are essential physiological determinants of blood pressure (BP). Numerous epidemiological studies have demonstrated a significant association between salt intake and BP, the most recent being the Prospective Urban Rural Epidemiology study, which included 102 216 adults from 18 countries [1]. Meta-analyses and systematic reviews have also demonstrated that salt intake is associated with an increased risk of cardiovascular complications, mainly stroke.

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High-sodium intake and low-potassium intake are known dietary risk factors for arterial hypertension (AH) [1–3]. High-potassium intake reduces blood pressure (BP) and the risk of stroke [4]. Data regarding their role in cardiovascular morbidity and mortality are more controversial. In the US The National Health and Nutrition Examination Survey (NHANES) study, sodium intake and sodium-to-potassium intake ratio estimated by 24-h dietary recalls were associated with higher all-cause and cardiovascular mortality, whereas potassium intake appeared to be protective, with the strongest predictive value for the sodium-to-potassium intake ratio [5]. In the Prospective Urban Rural Epidemiology study, a large worldwide study, similar results were obtained using the Kawasaki formula to estimate 24-h urinary sodium and potassium excretions [3]. A similar association with cardiovascular events was found by using sodium-to-potassium excretion ratio in 24-h urine [6]. On the contrary, some studies rather showed an increase in mortality with lower sodium intake either at population or more recently at a community level [7,8].

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