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In the current study, using data from the DASH–Sodium trial, during screening when participants are consuming their normal dietary intake, we report a slope increment of an elevation in SBP of approximately 3 mmHg across the urinary Na + excretion range of 2–5 g/day in SS, but not SR participants. However, when assessed across the full range of observed urinary Na + excretion values we did not observe a positive correlation between SBP and urinary Na + excretion in either SS or SR participants. Significantly, despite urinary K + excretion of <1 g K + /day associating with higher SBP in SS and SR participants further increments in urinary K + excretion did not correlate with a reduction in SBP in either participant group. Furthermore, at baseline screening we did not observe a correlation between the urinary Na + :K + excretion ratio irrespective of the salt sensitivity of blood pressure. As such our data, from the DASH–Sodium Trial, in US participants at both baseline screening and following a highly controlled dietary intervention does not support the hypothesis that a reduced urinary Na + :K + ratio will be beneficial in population level blood pressure reduction or support the proposal for a urinary Na + :K + molar ratio of <1 to lower blood pressure.
After the Dash dietary intervention we seen no correlation between an effective urinary Na + :K + ratio and you can SBP in a choice of SS otherwise SR participants
Weighed against the fresh new Sheer , INTERSALT , and you will INTERMAP degree, one depending a populace peak confident organization anywhere between urinary Na + excretion and you can blood pressure levels, brand new Dashboard–Salt Trial permits new institution of one’s sodium awareness regarding blood pressure in trial people. Conversely, when you look at the SS people we noticed a hill increment from an increase in the SBP of just one.step 3 mmHg per step 1 grams increase in urinary Na + excretion along the removal selection of step 3–5 grams Na + /big date that’s contained in this regular mediocre listing of day-after-day Na + consumption 
in the us . Having said that, whenever reviewed over the whole set of observed urinary Na + excretion, i observed no association ranging from urinary Na + excretion and you may SBP either in SS or SR players. We speculate this difference ranging from a confident relationships anywhere between SBP and urinary Na + excretion during the expected list of losing weight Na + excretion away from step 3–5 g/big date without association over the complete a number of philosophy reflects the perception out of multiple people regarding Dashboard–Salt research showing highest quantities of urinary Na + excretion, more than 5 grams/day, and you will comparatively reduced blood pressure levels. Notably, the value received within data for a boost in SBP within this 3–5 grams/date Na + excretion is comparable to one obtained throughout the Pure data and that reported a confident hill increment away from a-1.7 mmHg increase in SBP for every step 1 grams escalation in urinary Na + excretion along the same a number of Na + excretion values . The essential difference between the fresh new noticed increase in SBP responding so you’re able to elevated urinary Na + excretion between Dash-Sodium and you will Absolute ple size and you will racial backgrounds of one’s members and (2) the possibility differences in remedies for determine urine posts of 24-h pee range as compared to an opinion from morning room urine sample about Dashboard-Salt in the place of Sheer Investigation respectively. Our very own analysis service recommendations in order to limitation diet Na + consumption [5, 24] and you will recommend that less slimming down salt consumption may only down SBP within the SS people.
The influence of K + intake on blood pressure remains controversial, with conflicting data emerging from multiple clinical studies . In a randomized controlled trial conducted in free living non-dietary regulated participants with a mean SBP of 132 mmHg and not taking blood pressure lowering medication, K + intake was increased by dietary intake (via fruit and vegetable intake) or direct K + supplements. In this study increased K + intake up to 40 mmol/day had no impact on blood pressure [22, 26]. A separate randomized placebo-controlled crossover trial was conducted in participants who have never received antihypertensive medication with mildly elevated blood pressure . Participants were maintained on their normal diet and received K + at 64 mmol/day for a 4-week period as either potassium chloride or bicarbonate-in this study there was no effect of K + supplementation on office blood pressure . In contrast in a randomized placebo-controlled, crossover study, in which untreated patients with a mean SBP of 145 mmHg blood pressure received 4 weeks of supplemental K + at 3 g/day and a diet relatively low in Na + reported a reduction in SBP of 3.9 mmHg. Beyond the highly controlled trials discussed above the PURE study reports that for each increment of 1 g/day of urinary K + excretion there is a reduction of 0.75 mmHg in SBP across the excretion range of <1.25 to 3 g K + /day . In the DASH–Sodium data, we observed an elevation in SBP in both SS and SR participants when urinary K + excretion was below 1 g/day. However, we did not observe any correlation between urinary K + excretion and SBP or an impact of urinary K + excretion on SBP over the range of <1 to >3 g K + excretion per day. We speculate that discrepancy between the PURE study data and our own analysis of the DASH-Sodium data may reflect the difference in SBP response to urinary K + excretion reported in PURE between Chinese and non-Chinese participants. Chinese participants exhibited a large reduction in SBP with increased urinary K + excretion versus a smaller SBP effect in participants from the rest of the world. As the DASH-Sodium trial did not contain Chinese participants this may have influenced the outcome.