Effects of High Salt Intake on Blood Pressure and Cardiovascular Disease: The Role of COX Inhibitors

The Interaction of Kidneys and Gut in Development of Salt-Sensitive Hypertension

The incidence of salt-sensitive hypertension is quite common and varies between 30-60% in hypertensive patients. Regarding the causal role of high salt intake in the development of salt-sensitive hypertension, recent evidence has demonstrated that the gut through its microbiota plays a significant role in its genesis. Besides the gut, the kidneys also play important role in salt-sensitive hypertension and there is clinical and experimental evidence of an interrelationship between the gut and the kidneys in the development of salt-sensitive hypertension through the so-called "gastro-renal axis." The gut besides being an absorptive organ, it is also a hormonal secretory organ involving the secretion of gastrin, dopamine, norepinephrine, angiotensin, and aldosterone which through their action with the kidneys are involved in the development of salt-sensitive hypertension. In addition, the kidneys exert a protective role against the development of hypertension through the secretion of prostaglandins and their vasodilatory action. To assess the current evidence on the role of high salt intake and the interplay of the gut and kidneys in its development, a Medline search of the English literature was contacted between 2012 and 2022, and 46 pertinent papers were selected. These papers together with collateral literature will be discussed in this review.

A New Natural Processing System Based on Slight Carbon Dioxide Pressure for Producing Black Table Olives with Low Salt Content

Naturally fermented black table olives are usually processed in brine with low pH and high NaCl content. Because salt is responsible for several cardiovascular problems, methods are needed to decrease the salt (NaCl) content in olive pulp. This study investigated a new natural processing system wherein microorganism growth is inhibited by slight pressure of CO2 (spCO2), in addition to low pH and NaCl, in brine with decreased salt content. The fermentation performed under spCO2 with a low-salt brine with 6% (w v-1) NaCl and 0.5% (w v-1) citric acid, unlike the traditional system, inhibited the growth of bacteria and fungi and decreased the concentration of yeasts. Processing tests with spCO2 in the presence of different salt and citric acid concentrations indicated a slight decrease in yeasts in brines containing 6% (w v-1) NaCl and 0.6% (w v-1) citric acid but not after inoculation of the same brines with Saccharomyces cerevisiae. In contrast, in the presence of 11% (w v-1) NaCl and 0.3% or 0.6% (w v-1) citric acid, the inhibitory effect of brines was greater compared to those with low-salt and it was also confirmed in the same brines inoculated with S. cerevisiae.

Protective effects and molecular mechanisms of tea polyphenols on cardiovascular diseases

Aging is the most important factor contributing to cardiovascular diseases (CVDs), and the incidence and severity of cardiovascular events tend to increase with age. Currently, CVD is the leading cause of death in the global population. In-depth analysis of the mechanisms and interventions of cardiovascular aging and related diseases is an important basis for achieving healthy aging. Tea polyphenols (TPs) are the general term for the polyhydroxy compounds contained in tea leaves, whose main components are catechins, flavonoids, flavonols, anthocyanins, phenolic acids, condensed phenolic acids and polymeric phenols. Among them, catechins are the main components of TPs. In this article, we provide a detailed review of the classification and composition of teas, as well as an overview of the causes of aging-related CVDs. Then, we focus on ten aspects of the effects of TPs, including anti-hypertension, lipid-lowering effects, anti-oxidation, anti-inflammation, anti-proliferation, anti-angiogenesis, anti-atherosclerosis, recovery of endothelial function, anti-thrombosis, myocardial protective effect, to improve CVDs and the detailed molecular mechanisms.

The Relationship between the Plasma Concentration of Electrolytes and Intensity of Sleep Bruxism and Blood Pressure Variability among Sleep Bruxers

Plasma sodium plays a major role in regulating blood pressure (BP). An augmented variability of BP is considered a risk factor for the development of arterial hypertension, which is prevalent among patients with suspected sleep bruxism (SB). The aims of this study were to assess the plasma concentration of electrolytes and their effect on the intensity of SB and BP variability among sleep bruxers. A total of 51 patients were enrolled in this prospective, observational study. A single full-night polysomnographic examination was conducted in the Wroclaw Medical University Sleep Laboratory, Poland, and based on the guidelines of the American Academy of Sleep Medicine, the results were analyzed. The monitoring of ambulatory BP was performed the next day, and the plasma levels of sodium, potassium, magnesium, and calcium were measured. The mean age of the studied group was 33.9 ± 11.2 years, and the mean bruxism episode index (BEI) was 4.94 ± 3.53. The study revealed statistically significant differences in the plasma concentrations of sodium in the SB group. A decreased sodium concentration was observed in the group of mild bruxers (2 ≤ BEI < 4) (139.7 ± 1.4 vs. 142.8 ± 3.2, p = 0.002) and severe bruxers (BEI ≥ 4) (140.5 ± 2.0 vs. 142.8 ± 3.2, p = 0.016) compared to nonbruxers (BEI < 2). A statistically significant positive linear correlation was found between plasma sodium concentration and daytime systolic BP variability (r = 0.32, p < 0.05) as well as between plasma sodium concentration and nighttime diastolic BP variability (r = 0.31, p < 0.05). The preliminary results suggest the probable relationship between the lower plasma concentration of sodium and increased intensity of SB and BP variability among suspected sleep bruxers.

Use of Slightly Pressurized Carbon Dioxide to Enhance the Antimicrobial Properties of Brines in Naturally Processed Black Table Olives

Naturally fermented black table olives are processed at low pH in the presence of high sodium chloride concentrations ranging from 8 to 12% (w v⁻¹). Reducing the salt content of brine has become an urgent issue as it is responsible for several health and environmental problems. The study aim was to evaluate slightly pressurized CO₂ (spCO₂) as a third barrier to microbial growth in naturally processed black table olives with low pH and a reduced NaCl concentration. Based on the assessments performed on a pilot plant scale, an spCO₂ of 1 bar completely inhibited the growth of the bacteria and molds in the presence of reduced saline concentrations. Furthermore, the amount of yeast decreased in the brine as a function of the NaCl content. Laboratory tests performed under spCO₂ conditions using a single yeast species from the same habitat confirmed the high sensitivity of some oxidizing yeasts and indicated that the fermenting yeast, Saccharomyces cerevisiae, is the most tolerant species. Overall, in the brine of naturally processed olives with a low pH between 4 and 4.2, the antimicrobial properties observed with the high concentrations of NaCl can be achieved with a lower salt dose of 5% (w v⁻¹) when combined with spCO₂.

Edible Mushrooms as Functional Ingredients for Development of Healthier and More Sustainable Muscle Foods: A Flexitarian Approach

Consumers are increasingly interested in nutritious, safe and healthy muscle food products with reduced salt and fat that benefit their well-being. Hence, food processors are constantly in search of natural bioactive ingredients that offer health benefits beyond their nutritive values without affecting the quality of the products. Mushrooms are considered as next-generation healthy food components. Owing to their low content of fat, high-quality proteins, dietary fibre and the presence of nutraceuticals, they are ideally preferred in formulation of low-caloric functional foods. There is a growing trend to fortify muscle food with edible mushrooms to harness their goodness in terms of nutritive, bioactive and therapeutic values. The incorporation of mushrooms in muscle foods assumes significance, as it is favourably accepted by consumers because of its fibrous structure that mimics the texture with meat analogues offering unique taste and umami flavour. This review outlines the current knowledge in the literature about the nutritional richness, functional bioactive compounds and medicinal values of mushrooms offering various health benefits. Furthermore, the effects of functional ingredients of mushrooms in improving the quality and sensory attributes of nutritionally superior and next-generation healthier muscle food products are also highlighted in this paper.

The pathophysiology and management of diuretic resistance in patients with heart failure

OBJECTIVES

The objectives of the study are to investigate the causes of diuretic resistance in patients with advanced congestive heart failure (CHF), since diuretics are the cornerstone of treatment of these patients. Several studies have shown that diuretic resistance in patients with advanced CHF is common, ranging from 25% to 50% in hospitalized patients.

METHODS

In order to get a current perspective as to the magnitude of diuretic resistance in such patients, a focused Medline search of the English language literature was conducted between 2015 and 2020 using the search terms, CHF, diuretics, treatment, resistance, frequency, and 30 papers with pertinent information were selected.

RESULTS

The analysis of data from the selected papers demonstrated that diuretic resistance is common in hospitalized patients with advanced CHF and frequently associated with renal failure, which is secondary to CHF.

CONCLUSIONS

Diuretic resistance appears to be common in patients with advanced CHF and it is mostly due to decreased cardiac output, low blood pressure, decreased glomerular filtration rate, decreased filtration of sodium, and increased tubular reabsorption of sodium. Diuretic resistance in such patients can be overcome with the combination of loop diuretics with thiazide and thiazide-like diuretics, aldosterone antagonists, as well as other agents. The data from these studies in combination with collateral literature will be discussed in this review.

Elevated Salt Taste Threshold Is Associated with Increased Risk of Coronary Heart Disease

High salt intake has been associated with coronary heart disease (CHD). The salt taste threshold could affect the salt intake, but its role in CHD is uncertain. We studied the association of salt taste threshold with CHD. In this study, the levels of salt detection threshold, recognition threshold, and taste preference were higher in CHD than in controls. The salt taste recognition threshold was significantly associated with CHD, and the significant association persisted after adjustment for traditional risk factors. Individuals with high level of salt taste recognition threshold were at a greater risk of CHD. Coincident occurrence of high level of salt taste recognition threshold, hypertension, and diabetes increased the risk of CHD. Thus, a high level of salt taste recognition threshold increases the risk of CHD, and the concurrence of high level of salt taste recognition threshold, hypertension, and diabetes further increases the risk of CHD.

Effects of sodium intake on postural lightheadedness: Results from the DASH-sodium trial

Lightheadedness after standing contributes to adverse clinical events, including falls. Recommendations for higher sodium intake to treat postural lightheadedness have not been evaluated in a trial setting. The Dietary Approaches to Stop Hypertension (DASH)-Sodium trial (1998-1999) tested the effects of the DASH diet and sodium reduction on blood pressure (BP). Participants were randomly assigned to DASH or a typical Western diet (control). During either diet, participants ate three sodium levels (50, 100, 150 meq/d at 2100 kcal) in random order for 30-days, separated by 5-day breaks. Participants reported the presence and severity of postural lightheadedness at baseline and after each feeding period. There were 412 participants (mean age 48 years; 57% women; 57% black). Mean baseline SBP/DBP was 135/86 mm Hg; 9.5% reported baseline lightheadedness. Among those consuming the DASH diet, high vs low sodium increased lightheadedness (OR 1.71; 95% CI: 1.01, 2.90; P = 0.047) and severity of lightheadedness (P = 0.02), but did not affect lightheadedness in those consuming the control diet (OR 0.77; 95% CI: 0.46, 1.29; P = 0.32). Among those consuming high vs low sodium in the context of the DASH diet, adults <60 vs ≥60 years old experienced more lightheadedness (P-interaction = 0.04), along with obese vs non-obese adults (P-interaction = 0.01). In the context of the DASH diet, higher sodium intake was associated with more frequent and severe lightheadedness. These findings challenge traditional recommendations to increase sodium intake to prevent lightheadedness.

Quality Characteristics of Low-salt Chicken Sausage Supplemented with a Winter Mushroom Powder

Chicken meat is a low-fat and high-protein food and consumption of chicken meat has been increasing globally. Various food ingredients are widely added for their specific purpose to processed chicken meat. Nonetheless, concerns about the association between high sodium intake and various diseases as well as negative perceptions of artificial additives are increasing. Therefore, in meat products, it is necessary to reduce the amount of salt and to replace artificial additives with natural ingredients. Our aim was to investigate the quality characteristics of low-salt chicken sausages manufactured with the addition of a winter mushroom powder. Sausages was manufactured with sodium pyrophosphate (0.3%) or winter mushroom powder (0%, 0.5% and 1.0%) to ground chicken breast. As a result of addition of the winter mushroom powder to low-salt chicken sausages, pH of the meat batter increased, and the proportion of jelly and melted fat exuded from sausages was reduced. The texture of sausages was softened and lipid oxidation in sausages was inhibited by the winter mushroom powder. This powder did not negatively affect the color and sensory properties of the sausages. According to the results of this study, the winter mushroom powder can serve as a natural ingredient to improve quality of low-salt chicken sausages.

Descriptive Epidemiology of Hypertension and Its Association With Obesity: Based on the WHO STEPwise Approach to Surveillance in Palau

The rise of noncommunicable diseases is a serious health burden for Palau. This study described the prevalence of hypertension, and assessed its association with obesity. Surveys following the WHO STEPwise approach to surveillance were conducted in 2529 adults. Multivariate prevalence ratios (PR) of hypertension for body mass index (BMI) categories were calculated by logistic regression models using conditional standardization procedure. Age- and sex-specified analyses were performed. Overall prevalence of obesity and hypertension were 40.4% and 46.8%, respectively. Prevalence of hypertension was positively associated with BMI. However, overweight men had as high prevalence of hypertension as the obese (multivariable-adjusted PR was 1.84 for overweight and 1.91 for obese compared with nonoverweight). The association between hypertension and BMI was similar across age groups. The prevalence of hypertension in women increased gradually with the increase of BMI whereas that in men reached a plateau already in the overweight.