Salt Restriction and Challenges in China for Hypertension Control

Current Cardiovascular Risk Reports

Volumn 5, Issue 2, 2011, Pages 180-186

  Yan, Li ^a   Li, Nicole ^b   Wu, Yangfeng ^a,b  

^a PEKING UNIVERSITY HEALTH SCIENCE CENTER   (China)

^b GEORGE INSTITUTE FOR GLOBAL HEALTH   (Australia)

Author keywords

Blood pressure; China; Hypertension; Salt; Salt substitute

Indexed keywords

MAGNESIUM SULFATE; POTASSIUM CHLORIDE; SODIUM;

BLOOD PRESSURE; BODY MASS; CARDIOVASCULAR MORTALITY; CARDIOVASCULAR RISK; CHINA; COST EFFECTIVENESS ANALYSIS; DISEASE ASSOCIATION; ELECTROLYTE EXCRETION; HEALTH INSURANCE; HOSPITALIZATION; HUMAN; HYPERTENSION; ISCHEMIC HEART DISEASE; META ANALYSIS (TOPIC); OBSERVATIONAL STUDY; PREVALENCE; PRIMARY HEALTH CARE; PUBLIC HEALTH; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; SODIUM EXCRETION; SODIUM RESTRICTION;

EID: 82155173987     PISSN: 19329520     EISSN: 19329563     Source Type: Journal    
DOI: 10.1007/s12170-011-0156-6     Document Type: Review

References (49)

1. World Health Organization. World Health Statistics 2006. Geneva: World Health Organization; 2006.
2. China Ministry of Health. 2010 Annual Report on Health Statistics. Beijing: Peking Union Medical College Publishing House; 2010.
3. World Health Organization. Preventing chronic diseases: A vital investment: A WHO Report. In. Geneva, Switzerland: World Health Organization; 2005.
4. Ezzati M, Vander Hoorn S, Lawes CMM, et al. Rethinking the "diseases of affluence" paradigm: global patterns of nutritional risks in relation to economic development. PLoS Med. 2005; 2: 404-12.
5. Burden of Disease/Comparative Risk Assessment. Available at: http://files. dcp2. org/pdf/expressbooks/burdeno. pdf. Accessed December 2010.
6. Ezzati M, Lopez AD, Rodgers A, et al. Selected major risk factors and global and regional burden of disease. Lancet. 2002; 360: 1347-60.
7. Kearney PM, Whelton M, Reynolds K, et al. Global burden of hypertension: analysis of worldwide data. Lancet. 2005; 365: 217-23.
8. Egan BM, Zhao Y, Axon RN. US trends in prevalence, awareness, treatment, and control of hypertension, 1988-2008. JAMA. 2010; 303: 2043-50.
9. Lane DA, Lip GY. Ethnic differences in hypertension and blood pressure control in the UK. QJM. 2001; 94: 391-6.
10. Wolf-Maier K, Cooper RS, Kramer H, et al. Hypertension treatment and control in five European countries, Canada, and the United States. Hypertension. 2004; 43: 10-7.
11. Nissinen A, Berrios X, Puska P. Community-based noncommunicable disease interventions: lessons from developed countries for developing ones. Bull World Health Organ. 2001; 79: 963-70.
12. Pereira M, Lunet N, Azevedo A, et al. Differences in prevalence, awareness, treatment and control of hypertension between developing and developed countries. J Hypertens. 2009; 27: 963-75.
13. Mori H, Ukai H, Yamamoto H, et al. Current status of antihypertensive prescription and associated blood pressure control in Japan. Hypertens Res. 2006; 29: 143-51.
14. Iso H, Shimamoto T, Naito Y, et al. Effects of a long-term hypertension control program on stroke incidence and prevalence in a rural community in northeastern Japan. Stroke. 1998; 29: 1510-8.
15. Wang L. Nutrition and health status in Chinese people. Beijing: People's Publishing House; 2005.
16. Tao S, Wu X, Duan X, et al. Hypertension prevalence and status of awareness, treatment and control in China. Chin Med J Engl. 1995; 108: 483-9.
17. Wu Y, Huxley R, Li L, et al. Prevalence, awareness, treatment, and control of hypertension in China: data from the China National Nutrition and Health Survey 2002. Circulation. 2008; 118: 2679-86.
18. Intersalt Cooperative Research Group. Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. Intersalt Cooperative Research Group. BMJ. 1988; 297: 319-28.
19. Elliott P, Stamler J, Nichols R, et al. Intersalt revisited: further analyses of 24 hour sodium excretion and blood pressure within and across populations. Br Med J. 1996; 312: 1249-53.
20. Stamler J, Elliott P, Dennis B, et al. INTERMAP: background, aims, design, methods, and descriptive statistics (nondietary). J Hum Hypertens. 2003; 17: 591-608.
21. Zhou BF, Stamler J, Dennis B, et al. Nutrient intakes of middle-aged men and women in China, Japan, United Kingdom, and United States in the late 1990s: the INTERMAP study. J Hum Hypertens. 2003; 17: 623-30.
22. Zhao LC, Stamler J, Yan LJL, et al. Blood pressure differences between northern and southern Chinese: role of dietary factors the international study on macronutrients and blood pressure. Hypertension. 2004; 43: 1332-7.
23. Nagata C, Takatsuka N, Shimizu N, et al. Sodium intake and risk of death from stroke in Japanese men and women. Stroke. 2004; 35: 1543-7.
24. Sacks FM, Svetkey LP, Vollmer WM, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. 2001; 344: 3-10.
25. The Trials of Hypertension Prevention Cooperative Research Group. The effects of nonpharmacologic interventions on blood pressure of persons with high normal levels. Results of the trials of hypertension prevention, Phase I. JAMA. 1992; 267: 1213-20.
26. Stevens VJ, Obarzanek E, Cook NR, et al. Long-term weight loss and changes in blood pressure: results of the trials of hypertension prevention, phase II. Ann Intern Med. 2001; 134: 1-11.
27. He FJ, MacGregor GA. Effect of longer-term modest salt reduction on blood pressure. Cochrane Database of Syst Rev. 2004; CD004937.
28. Cook NR, Cutler JA, Obarzanek E, et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ. 2007; 334: 885-8.
29. Gelejinske J. Reduction in blood pressure with a low sodium, high potassium, high magnesium salt in older subjects with mild to moderate hypertension. BMJ. 1994; 309: 456-9.
30. Kawasaki T, Itoh K, Kawasaki M. Reduction in blood pressure with a sodium-reduced, potassium- and magnesium-enriched mineral salt in subjects with mild essential hypertension. Hypertens Res Clin Exp. 1998; 21: 235-43.
31. Li NY, Wu Y, Barzi F, et al. A low sodium, high potassium salt substitute substantially lowers blood pressure levels among high-risk individuals in rural northern China-The China salt substitute study. J Hypertens. 2006; 24: S150-1.
32. China Salt Substitute Study Collaborative Group. Salt substitution: a low-cost strategy for blood pressure control among rural Chinese. A randomized, controlled trial. J Hypertens. 2007; 25: 2011-8.
33. • Hu J, Jiang X, Li N, et al.: Effects of salt substitute on pulse wave analysis among individuals at high cardiovascular risk in rural China: a randomized controlled trial. Hypertens Res Clin Exp. 2009; 32: 282-8. This article provided the only data that a salt subsititute can also decrease blood vessel stiffness besides effectively reducing blood pressure.
34. Li N, Prescott J, Wu Y, et al. The effects of a reduced-sodium, high-potassium salt substitute on food taste and acceptability in rural northern China. Br J Nutr. 2009; 101: 1088-93.
35. Chang H-Y, Hu Y-W, Yue C-SJ, et al. Effect of potassium-enriched salt on cardiovascular mortality and medical expenses of elderly men. Am J Clin Nutr. 2006; 83: 1289-96.
36. World Health Organisation. Reducing salt intake in populations-Report of a WHO Forum and Technical Meeting. In: World Health Organisation, ed.; 2007.
37. Anderson CA, Appel LJ, Okuda N, et al. Dietary sources of sodium in China, Japan, the United Kingdom, and the United States, women and men aged 40 to 59 years: the INTERMAP study. J Am Diet Assoc. 2010; 110: 736-45.
38. People's Republic of China-United States Cardiovascular and Cardiopulmonary Epidemiology Research Group. An epidemiological study of cardiovascular and cardiopulmonary disease risk factors in four populations in the People's Republic of China. Baseline report from the P. R. C.-U. S. A. Collaborative Study. Circulation 1992; 85: 1083-96.
39. Dennis B, Zhou BF, Liu X, et al. Changes in food, nutrient and energy intake in People's Republic of China samples of urban and rural north and south adults surveyed in 1983-84 and resurveyed in 1987-88. Asia Pac J Clin Nutr. 1997; 6: 277-86.
40. He FJ, MacGregor GA. How far should salt intake be reduced? Hypertension. 2003; 42: 1093-9.
41. • Strazzullo P, D'Elia L, Kandala N-B, et al. Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ. 2009; 339: b4567. This is the most updated meta-analysis that demonstrates the relationship between salt intake and cardiovascular diseases from prospective studies.
42. •• Bibbins-Domingo K, Chertow GM, Coxson PG, et al. Projected effect of dietary salt reductions on future cardiovascular disease. N Engl J Med. 2010, 362: 590-9. This article provides the most reliable estimates on the cost effectiveness of a population-wide salt-reduction strategy.
43. Staessen JA, Wang JG, Thijs L. Cardiovascular prevention and blood pressure reduction: a quantitative overview updated until 1 March 2003. J Hypertens. 2003; 21: 1055-76.
44. International Monetary Fund: World Economic Outlook Database-October 2010. Available at: http://en. wikipedia. org/wiki/List_of_countries_by_GDP_(nominal)_per_capita and http://www. imf. org/external/pubs/ft/weo/2010/02/weodata/index. aspx. Accessed December 2010.
45. Wu Y, Wang Z, Gao R. A survey on perception and knowledge of Chinese health care professionals in prevention and control of hypertension. Chin J Cardiol. 2004; 32: 264-9.
46. Loria CM, Obarzanek E, Ernst ND. Choose and prepare foods with less salt: dietary advice for all Americans. J Nutr. 2001; 131: 536S-51.
47. World Health Organization: Reducing salt intake in populations: report of a WHO forum and technical meeting, 5-7 October 2006, Paris, France. Available at: World Health Organization Web site www. who. int/dietphysicalactivity/SaltReport-VC-April07. pdf Accessed October 2010.
48. Application of lower sodium intake recommendations to adults-United States, 1999-2006. MMWR Morb Mortal Wkly Rep. 2009; 58: 281-3.
49. Chinese Nutrition Society. Meal guide for Chinese residents. Lhasa: People's Publision House of Tibet; 2008.