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Zhang Q, Shen Y, Yu M, Yang Z, Huang Z, Ding J, Zhu X. Associations between estimation of salt intake and salt-restriction spoons and hypertension status in patients with poorly controlled hypertension: a community-based study from Huzhou City, Eastern China. Nutr J 2024; 23:9. [PMID: 38225607 PMCID: PMC10789056 DOI: 10.1186/s12937-024-00912-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/03/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND As the prevalence of hypertension increases in China, it is advised to use salt-restriction spoons (SRS) as a lifestyle modification. This study aimed to examine the associations between estimated salt consumption, SRS usage, and the hypertension status in individuals with poorly controlled hypertension. METHODS Data was collected in Huzhou City, Zhejiang Province, in 2021 using convenience sampling. The analysis involved ordinal logistic regression and restricted cubic splines to assess the relevant factors. RESULTS The study found that 73.34% of the 1215 patients had uncontrolled blood pressure (BP). Urinary excretion was assessed through the utilization of the Kawasaki, INTERSALT, and Tanaka formulas. The outcomes of these three methodologies revealed average daily sodium excretion values of 208.70 (65.65), 154.78 (33.91), and 162.61 (40.87) mmol, respectively. The prevalence of utilizing SRS was found to be 37.78% in this study. Despite the acknowledgment among SRS users of the potential hazards associated with excessive salt consumption, there exists a contradictory pattern of attitudes and behaviors concerning salt reduction. Among individuals with different levels of salt intake (quartiles 1-4, Q1 vs Q4), there was a positive association between limiting salt and hypertension status when controlling for other variables (Kawasaki adjusted OR = 0.58, 95% CI = 0.43-0.79; INTERSALT adjusted OR = 0.62, 95% CI = 0.41-0.92; Tanaka adjusted OR = 0.61, 95% CI = 0.45-0.92, p < 0.05). Our research also revealed that using or used SRS was a protective factor for blood BP control (adjusted OR = 0.79, 95% CI = 0.64-0.99, P < 0.05). The restricted cubic spline plots illustrated a monotonic upward relationship between estimated 24-h urinary Na and BP (P-overall association < 0.05; P-non-linear association > 0.05). CONCLUSIONS The use of dietary SRS could result in decrease in daily salt intake for BP control in patients with poorly controlled hypertension. To reduce the impact of high BP in China, additional studies are required to create interventions that can enhance the results for patients.
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Affiliation(s)
- Qi Zhang
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, China
| | - Yimei Shen
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, China.
| | - Meihua Yu
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, China
| | - Zhongrong Yang
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, China
| | - Zheng Huang
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, China
| | - Jingying Ding
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, China
| | - Xinfeng Zhu
- Huzhou Center for Disease Control and Prevention, Huzhou, Zhejiang Province, China
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Etiological Diagnosis and Personalized Therapy for Hypertension: A Hypothesis of the REASOH Classification. J Pers Med 2023; 13:jpm13020261. [PMID: 36836495 PMCID: PMC9960440 DOI: 10.3390/jpm13020261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/08/2023] [Accepted: 01/28/2023] [Indexed: 01/31/2023] Open
Abstract
With the epidemic of risk factors such as unhealthy lifestyle, obesity and mental stress, the prevalence of hypertension continues to rise across the world. Although standardized treatment protocols simplify the selection of antihypertensive drugs and ensure therapeutic efficacy, the pathophysiological state of some patients remains, which may also lead to the development of other cardiovascular diseases. Thus, there is an urgent need to consider the pathogenesis and selection of antihypertensive drug for different type of hypertensive patients in the era of precision medicine. We proposed the REASOH classification, based on the etiology of hypertension, including renin-dependent hypertension, elderly-arteriosclerosis-based hypertension, sympathetic-active hypertension, secondary hypertension, salt-sensitive hypertension and hyperhomocysteinemia hypertension. The aim of this paper is to propose a hypothesis and provide a brief reference for the personalized treatment of hypertensive patients.
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Zhou C, Chen J, Tan F, Lai S, Li X, Pu K, Wu J, Dong Y, Zhao F. Relationship between self-care compliance, trust, and satisfaction among hypertensive patients in China. Front Public Health 2023; 10:1085047. [PMID: 36743158 PMCID: PMC9889937 DOI: 10.3389/fpubh.2022.1085047] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/29/2022] [Indexed: 01/20/2023] Open
Abstract
Introduction Hypertension is a growing public health concern worldwide. It is a leading risk factor for all-cause mortality and may lead to complications such as cardiovascular disease, stroke, and kidney failure. Poor compliance of hypertensive patients is one of the major barriers to controlling high blood pressure. Compliance is not ideal among Chinese patients, and increasing patient self-care compliance with hypertension is necessary. Methods This article analyzes the status of self-care compliance, trust, and satisfaction among Chinese hypertensive patients using cross-sectional data from Zhejiang Province. We use a multi-group structural equation model (MGSEM) to compare the interrelationships across genders. Results The study's findings show that the average trust, satisfaction, and compliance scores are 3.92 ± 0.55, 3.98 ± 0.61, and 3.33 ± 0.41, respectively. Female patients exhibit higher average total scores for trust and compliance than male patients. The SEM results indicate that trust has a direct positive association with compliance [β = 0.242, 95% CI: (0.068, 0.402)] and satisfaction [β = 0.260, 95% CI: (0.145, 0.367)], while their satisfaction is not directly associated with compliance. The results of MGSEM show that trust has an indirect effect on compliance in the male group through satisfaction [β = 0.051, P < 0.05, 95% CI: (0.012, 0.116)]. In the female group, trust has a direct effect on satisfaction [β = 0.235, P < 0.05, 95% CI: (0.041, 0.406)] and compliance [β = 0.319, P < 0.01, 95% CI: (0.086, 0.574)]. Discussion This study reveals the mechanisms of self-care compliance, trust, and satisfaction among Chinese hypertensive patients. Its findings may serve as a reference for guiding primary healthcare providers to improve hypertension patients' compliance and implement gender-targeted health interventions.
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Affiliation(s)
- Chi Zhou
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China,*Correspondence: Chi Zhou ✉
| | - Jingchun Chen
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Fang Tan
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sihong Lai
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Xu Li
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Ke Pu
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Jiahui Wu
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Yin Dong
- Department of Hospital Office, The People's Hospital of Yuhuan, Taizhou, China,Yin Dong ✉
| | - Falin Zhao
- Department of Health Management, School of Public Health, Hangzhou Normal University, Hangzhou, China,Falin Zhao ✉
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Chan A, Chan SWC, Khanam M, Kinsman L. Factors affecting reductions in dietary salt consumption in people of Chinese descent: An integrative review. J Adv Nurs 2022; 78:1919-1937. [PMID: 35384036 PMCID: PMC9323495 DOI: 10.1111/jan.15237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/20/2022] [Accepted: 03/13/2022] [Indexed: 11/29/2022]
Abstract
Aims To identify and synthesize the evidence on the perceptions of the health effects of dietary salt consumption and barriers to sustaining a salt‐reduced diet for hypertension in Chinese people. Design A systematic integrated review integrating quantitative and qualitative studies using the PRISMA guidelines. Data sources Three databases, MEDLINE, PubMed and CINAHL, were systematically searched for articles published between January 2001 and July 2020. Review methods The quality of the included studies was appraised using the Joanna Briggs Institute's critical appraisal tools for cross‐sectional and qualitative studies. Descriptive analysis and constant comparison methods were used to analyse the extracted data. Results Fourteen studies met the inclusion criteria. The synthesized results identified that (i) adequate salt‐related health education had a positive influence on dietary behaviour modifications, (ii) the level of educational exposure to the health benefits of salt reduction influenced Chinese people's perceptions of the health impact associated with high salt intake, (iii) the complexity of salt measurement was a barrier to salt reduction, (iv) salt reduction is a challenge to Chinese food culture, and (v) Chinese migrants may experience linguistic and cultural challenges when they seek appropriate dietary education and advice for hypertension management in their host countries. Conclusion There is room for improvement in recognizing and translating the knowledge of salt‐related health issues and the benefits of that knowledge about salt reduction into action. Future nursing interventions should incorporate individuals' cultural needs and the dietary culture of immediate family members. Impact This integrative review reveals that unique Chinese customs and practices reduce the effectiveness of salt reduction campaigns. The effects of education vanish without family support, resulting in suboptimal adherence to dietary salt reduction strategies.
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Affiliation(s)
- Alex Chan
- School of Nursing and Midwifery, University of Newcastle, Callaghan, New South Wales, Australia.,School of Nursing, University of Wollongong, Liverpool, New South Wales, Australia
| | | | - Masuma Khanam
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Leigh Kinsman
- School of Nursing and Midwifery, University of Newcastle, Callaghan, New South Wales, Australia
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Yang Y, Wang J, Ma J, Shi W, Wu J. Comparison of Salt-Related Knowledge and Behaviors Status of WeChat Users between 2019 and 2020. Nutrients 2021; 13:2141. [PMID: 34206633 PMCID: PMC8308297 DOI: 10.3390/nu13072141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/04/2021] [Accepted: 06/21/2021] [Indexed: 12/11/2022] Open
Abstract
In order to identify the status of salt-related knowledge and behavior of the residents who were active in WeChat software between 2019 and 2020, 10-day salt-related surveys were conducted in 2019 and 2020 based on the WeChat public platform of China Healthy Lifestyle for All Campaign. Distribution and scores of salt-related knowledge, salt reduction behavior and high-salt intake behavior between 2019 and 2020 were compared. Data of 2109 participants in 2019 and 12,732 participants in 2020 were left for analysis. Overall, 88.2% of participants in 2019 had a willingness to reduce the amount of cooking salt in their households, significantly lower than 90.2% in 2020 (p-value < 0.05). In 2019 and 2020, over 80% of the participants knew fine dried noodles contain salt, but less than 30% knew ice cream contains salt. Over 78% of participants chose 5 g or 6 g for the maximum daily salt intake of healthy adults, and about 98% of participants knew that excessive salt intake would increase the risk of hypertension in both years. The percentage of participants who used salt measuring spoons asked restaurants to use less salt, read the sodium content on the nutrition facts table, chose foods with low sodium content and regularly used low-sodium salt, were 36.1%, 45.0%, 44.1%, 40.3% and 35.8% in 2019, and the percentage increased significantly to 46.4%, 49.2%, 50.8%, 47.1% and 43.4% in 2020 (all p-value < 0.05). The percentage of people regularly eating pickled mustard tubers, salted vegetables and sauce foods or using high-salt condiments also increased from 2019 to 2020. The median of salt-related knowledge scores, salt reduction behavior scores and high-salt intake behavior scores were 11, 2, 5 points in 2019, and 10, 3, 5 points in 2020, respectively. Compared to 2019, the salt-related knowledge score was relatively lower, while the salt reduction behavior score and high-salt intake behavior score were relatively higher in 2020. Besides, the score of salt-related knowledge and behaviors differed in different gender, age and hypertension groups. The COVID-19 epidemic may have influenced the salt-related knowledge and behaviors status of WeChat users in China. Promotion and education of salt-related knowledge and online behavior intervention are still needed, particularly for male and hypertension patients in the future.
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Affiliation(s)
- Yibing Yang
- Office of Non-Communicable Disease and Aging Health Management, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (Y.Y.); (J.W.)
| | - Jinglei Wang
- Office of Non-Communicable Disease and Aging Health Management, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (Y.Y.); (J.W.)
| | - Jixiang Ma
- Shandong Center for Disease Control and Prevention, Jinan 250014, China;
| | - Wenhui Shi
- Office of Non-Communicable Disease and Aging Health Management, Chinese Center for Disease Control and Prevention, Beijing 102206, China; (Y.Y.); (J.W.)
| | - Jing Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
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The Predictors of High Dietary Salt Intake among Hypertensive Patients in Iran. Int J Hypertens 2020; 2020:6748696. [PMID: 32328301 PMCID: PMC7168708 DOI: 10.1155/2020/6748696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 02/03/2020] [Accepted: 03/20/2020] [Indexed: 11/18/2022] Open
Abstract
Background Hypertension and its complications are among the major health problems all over the world, particularly in developing countries. The aims of this study were to show that, weather the hypertensive patients follow the expertise recommendations and differences between men and women in their levels of knowledge and behavior in salt taking. Methods The present cross-sectional study was conducted among all hypertensive patients in rural health centers of Tabriz, Iran, in Feb-May; 2016. Data were collected by an interviewer-administrated questionnaire, along with anthropometric, blood pressure, and 24-hour urinary sodium excretion measurements. Multivariate logistic regression analysis was used to compute adjusted odds ratio (OR). Results In all 205 patients, 62.9% female, 40.5% aged over 60 years, and 53.7% with low or moderate socioeconomic status, 49.3% body mass index (BMI) 30 kg/m2 and above, 10.2% of the patients had systolic/diastolic equal and above (≥) 40/90 mmHg, participated in the study. In total, 16.6% were aware of the daily salt allowance for healthy people with sex difference (P < 0.001). Significant predictors of adding salt beyond the dietary recommendations in food preparation were occupation (unemployed) (OR = 4.05, 95% CI = 1.041-15.78, (P = 0.044)) and blood pressure level (systolic/diastolic ≥140/90) (OR = 2.76, 95% CI = 1.28-5.96 (P = 0.010)), while adding salt at the table correlated with sex (men) (OR = 4.47, 95% CI = 1.21-16.57 (P = 0.025)), age (54-59) (OR = 0.05 95% CI = 0.01-0.39, (P = 0.005)), and knowledge (general) (OR = 1.06, 95% CI = 0.99-1.13 (P = 0.05)). Conclusion The different pattern of salt intake was observed between men and women. In general, the amount of salt taken by hypertensive patients is higher than recommended allowances. Both men and women add extra amount of salt to food, women when preparing food and men at the table. Salt intake level both during preparing and eating food may be associated with occupation (unemployed), blood pressure level (systolic/diastolic ≥140/90), sex (men), age (54-59), and also patient knowledge (general).
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Schütten MT, Kusters YH, Houben AJ, Niessen HE, Op 't Roodt J, Scheijen JL, van de Waardenburg MP, Schalkwijk CG, de Leeuw PW, Stehouwer CDA. Glucocorticoids affect metabolic but not muscle microvascular insulin sensitivity following high versus low salt intake. JCI Insight 2020; 5:127530. [PMID: 32107343 DOI: 10.1172/jci.insight.127530] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 02/20/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUNDSalt-sensitive hypertension is often accompanied by insulin resistance in obese individuals, but the underlying mechanisms are obscure. Microvascular function is known to affect both salt sensitivity of blood pressure and metabolic insulin sensitivity. We hypothesized that excessive salt intake increases blood pressure and decreases insulin-mediated glucose disposal, at least in part by impairing insulin-mediated muscle microvascular recruitment (IMMR).METHODSIn 20 lean and 20 abdominally obese individuals, we assessed mean arterial pressure (MAP; 24-hour ambulatory blood pressure measurements), insulin-mediated whole-body glucose disposal (M/I value; hyperinsulinemic-euglycemic clamp technique), IMMR (contrast-enhanced ultrasound), osmolyte and water balance, and excretion of mineralocorticoids, glucocorticoids, and amino and organic acids after a low- and high-salt diet during 7 days in a randomized, double-blind, crossover design.RESULTSOn a low-, as compared with a high-salt, intake, MAP was lower, M/I value was lower, and IMMR was greater in both lean and abdominally obese individuals. In addition, natural logarithm IMMR was inversely associated with MAP in lean participants on a low-salt diet only. On a high-salt diet, free water clearance decreased, and excretion of glucocorticoids and of amino acids involved in the urea cycle increased.CONCLUSIONOur findings imply that hemodynamic and metabolic changes resulting from alterations in salt intake are not necessarily associated. Moreover, they are consistent with the concept that a high-salt intake increases muscle glucose uptake as a response to high salt-induced, glucocorticoid-driven muscle catabolism to stimulate urea production and thereby renal water conservation.TRIAL REGISTRATIONClinicalTrials.gov, NCT02068781.
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Aburto TC, Gordon‐Larsen P, Poti JM, Howard AG, Adair LS, Avery CL, Popkin BM. Is a Hypertension Diagnosis Associated With Improved Dietary Outcomes Within 2 to 4 Years? A Fixed-Effects Analysis From the China Health and Nutrition Survey. J Am Heart Assoc 2019; 8:e012703. [PMID: 31657282 PMCID: PMC6898848 DOI: 10.1161/jaha.119.012703] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 09/27/2019] [Indexed: 12/20/2022]
Abstract
Background Evidence shows that dietary factors play an important role in blood pressure. However, there is no clear understanding of whether hypertension diagnosis is associated with dietary modifications. The aim of this study is to estimate the longitudinal association between hypertension diagnosis and subsequent changes (within 2-4 years) in dietary sodium, potassium, and sodium-potassium (Na/K) ratio. Methods and Results We included adults (18-75 years, n=16 264) from up to 9 waves (1991-2015) of the China Health and Nutrition Survey. Diet data were collected using three 24-hour dietary recalls and a household food inventory. We used fixed-effects models to estimate the association between newly self-reported diagnosed hypertension and subsequent within-individual changes in sodium, potassium, and Na/K ratio. We also examined changes among couples and at the household level. Results suggest that on average, men who were diagnosed with hypertension decreased their sodium intake by 251 mg/d and their Na/K ratio by 0.19 within 2 to 4 years after diagnosis (P<0.005). Among spouse pairs, sodium intake and Na/K ratio of women decreased when their husbands were diagnosed (P<0.05). Household average sodium density and Na/K ratio decreased, and household average potassium density increased after a man was diagnosed. In contrast, changes were not statistically significant when women were diagnosed. Conclusions Our findings suggest that hypertension diagnosis for a man may result in modest dietary improvements for him, his wife, and other household members. Yet, diagnosis for a woman does not seem to result in dietary changes for her or her household members.
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Affiliation(s)
- Tania C. Aburto
- Department of NutritionGillings School of Global Public HealthUniversity of North Carolina at Chapel HillNC
| | - Penny Gordon‐Larsen
- Department of NutritionGillings School of Global Public HealthUniversity of North Carolina at Chapel HillNC
- Gillings School of Global Public Health and Carolina Population CenterUniversity of North Carolina at Chapel HillNC
| | - Jennifer M. Poti
- Department of NutritionGillings School of Global Public HealthUniversity of North Carolina at Chapel HillNC
| | - Annie G. Howard
- Gillings School of Global Public Health and Carolina Population CenterUniversity of North Carolina at Chapel HillNC
- Department of BiostatisticsGillings School of Global Public HealthUniversity of North Carolina at Chapel HillNC
| | - Linda S. Adair
- Department of NutritionGillings School of Global Public HealthUniversity of North Carolina at Chapel HillNC
- Gillings School of Global Public Health and Carolina Population CenterUniversity of North Carolina at Chapel HillNC
| | - Christy L. Avery
- Gillings School of Global Public Health and Carolina Population CenterUniversity of North Carolina at Chapel HillNC
- Department of EpidemiologyGillings School of Global Public HealthUniversity of North Carolina at Chapel HillNC
| | - Barry M. Popkin
- Department of NutritionGillings School of Global Public HealthUniversity of North Carolina at Chapel HillNC
- Gillings School of Global Public Health and Carolina Population CenterUniversity of North Carolina at Chapel HillNC
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Rhee M, Jo S, Kim J, Kim K, Nah D, Kim S, Gu N, Sung K, Hong K, Cho E, Lee S. Difference in 24‐hour urine sodium excretion between controlled and uncontrolled patients on antihypertensive drug treatment. J Clin Hypertens (Greenwich) 2019; 21:1057-1062. [DOI: 10.1111/jch.13610] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/15/2019] [Accepted: 04/29/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Moo‐Yong Rhee
- Cardiovascular Center Dongguk University Ilsan Hospital Goyang‐si Korea
| | - Sang‐Ho Jo
- Division of Cardiology Hallym University Sacred Heart Hospital/Hallym University College of Medicine Anyang‐si Korea
| | - Ji‐Hyun Kim
- Cardiovascular Center Dongguk University Ilsan Hospital Goyang‐si Korea
| | - Kwang‐Il Kim
- Department of Internal Medicine Seoul National University Bundang Hospital Seongnam‐si Korea
| | - Deuk‐Young Nah
- Division of Cardiology, Department of Internal Medicine Dongguk University Gyeongju Hospital Gyeongju‐si Korea
| | - Sun‐Woong Kim
- Department of Statistics, Survey and Health Policy Research Center Dongguk University Seoul Korea
| | - Namyi Gu
- Department of Clinical Pharmacology and Therapeutics Dongguk University Ilsan Hospital Goyang‐si Korea
| | - Ki‐Chul Sung
- Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul Korea
| | | | - Eun‐Joo Cho
- Division of Cardiology, Department of Internal Medicine, St Paul's Hospital Catholic University Seoul Korea
| | - Sim‐Yeol Lee
- Department of Home Economics Education Dongguk University Seoul Korea
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Ghimire K, Adhikari TB, Rijal A, Kallestrup P, Henry ME, Neupane D. Knowledge, attitudes, and practices related to salt consumption in Nepal: Findings from the community-based management of non-communicable diseases project in Nepal (COBIN). J Clin Hypertens (Greenwich) 2019; 21:739-748. [PMID: 31026125 DOI: 10.1111/jch.13544] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/22/2019] [Accepted: 04/03/2019] [Indexed: 11/29/2022]
Abstract
High salt/sodium intake is associated with an increased risk of hypertension, which is a major risk factor for cardiovascular diseases. This paper aims to examine the association between salt consumption and salt-related knowledge, attitudes, and practices (KAP) in Nepal. The cross-sectional data used in this study were collected as part of the community-based management of non-communicable diseases project (COBIN) to understand the amount and KAP related to salt consumption in Nepal. Multivariate hierarchical logistic regression was performed to assess the association of salt-related KAP and determinants of high salt consumption in Nepal. The mean per capita salt intake was 8.0 (±3.7) g/day, with 81.6% of the population reporting higher intake than the WHO recommendation of <5 g/day. People of upper castes [adjusted odds ratio (aOR) = 0.7; 95% confidence interval (CI): 0.5-0.9], people in large families (aOR = 0.6; 95% CI: 0.5-0.7), respondents who were advised to lower salt intake (aOR = 0.6; 95% CI: 0.4-0.9) and who checked salt/sodium labels in food (aOR = 0.6; 95% CI: 0.4-0.9) were less likely to consume higher amounts of salt. Similarly, people who added extra salt to their food at the table (aOR = 1.4; 95 CI: 1.1-1.9) and who reported consuming high amounts of salt (aOR = 1.5; 95% CI: 1.1-2.3) were more likely to have high salt intake. High salt intake was documented in this population. This study suggests the need for culturally tailored community-based behavior modification through health education and dietary counseling to effectively reduce salt consumption and thereby support a reduction in hypertension and cardiovascular diseases in Nepal.
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Affiliation(s)
| | - Tara Ballav Adhikari
- Nepal Development Society, Chitwan, Nepal.,Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Per Kallestrup
- Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Megan E Henry
- The Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Dinesh Neupane
- Nepal Development Society, Chitwan, Nepal.,The Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Ajayi S, Adebiyi A, Kadiri S. Increased urinary sodium excretion is associated with systolic blood pressure in first degree relatives of hypertensive patients in Ibadan, Southwestern Nigeria. Pan Afr Med J 2018; 31:168. [PMID: 31086621 PMCID: PMC6488237 DOI: 10.11604/pamj.2018.31.168.16611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/24/2018] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Understanding the risk factors of hypertension has led to a better understanding of the pathogenesis, prevention and reduction in morbidity of hypertension. It is well known that offsprings of hypertensive parents have an increased risk of developing hypertension. It is therefore necessary to explore the physiological differences between normotensive patients with and without a positive family history of hypertension with respect to their urinary excretion of sodium. METHODS This study was carried out at the University College Hospital, Ibadan Nigeria, to determine if normotensive patients with a positive family history of hypertension are different with respect to their urinary excretion of electrolytes and blood pressure. It examined the relationship between 24-hour urinary excretion of sodium, chloride and potassium, urea and creatinine and blood pressure in subjects with and without family history of hypertension. It was a case-control study of sixty-two subjects: normotensive patients' first degree relatives of primary hypertensive patients and normotensive patients without positive family history. RESULTS The mean (SD) systolic blood pressures for subjects with and without family history of hypertension were significantly different: 120.0(22.25) and 105.0(17.50) respectively, (p=0.001). The mean arterial blood pressures were significantly different: 86.4(10.2) mmHg and 80.1(8.1) mmHg respectively (p=0.010). The mean (SD) 24-hour urinary excretion of sodium for normotensive patients with and without positive family history of hypertension were 180.5 (45.50) mEq/L, and 156.0(36.25) mEq/L respectively. Systolic blood pressure and 24-hour urinary excretion of sodium was also higher in normotensive subjects with a positive family history of hypertension. CONCLUSION Systolic blood pressure and twenty-four hour urinary excretion of sodium were higher in normotensive subjects with a positive family history of hypertension than in those without a family history of hypertension.
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Affiliation(s)
- Samuel Ajayi
- Nephrology Unit, Department of Medicine, University College Hospital and College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Adewole Adebiyi
- Cardiology Unit, Department of Medicine, University College Hospital and College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Solomon Kadiri
- Nephrology Unit, Department of Medicine, University College Hospital and College of Medicine, University of Ibadan, Ibadan, Nigeria
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McKenzie B, Santos JA, Trieu K, Thout SR, Johnson C, Arcand J, Webster J, McLean R. The Science of Salt: A focused review on salt-related knowledge, attitudes and behaviors, and gender differences. J Clin Hypertens (Greenwich) 2018; 20:850-866. [PMID: 29722131 PMCID: PMC8031068 DOI: 10.1111/jch.13289] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 03/21/2018] [Indexed: 12/20/2022]
Abstract
The aim of the current review was to examine the scope of studies published in the Science of Salt Weekly that contained a measure of self-reported knowledge, attitudes, and behavior (KAB) concerning salt. Specific objectives were to examine how KAB measures are used to evaluate salt reduction intervention studies, the questionnaires used, and whether any gender differences exist in self-reported KAB. Studies were reviewed from the commencement of Science of Salt Weekly, June 2013 to the end of August 2017. Seventy-five studies had relevant measures of KAB and were included in this review, 13 of these were salt-reduction intervention-evaluation studies, with the remainder (62) being descriptive KAB studies. The KAB questionnaires used were specific to the populations studied, without evidence of a best practice measure. 40% of studies used KAB alone as the primary outcome measure; the remaining studies used more quantitative measures of salt intake such as 24-hour urine. Only half of the descriptive studies showed KAB outcomes disaggregated by gender, and of those, 73% showed women had more favorable KAB related to salt. None of the salt intervention-evaluation studies showed disaggregated KAB data. Therefore, it is likely important that evaluation studies disaggregate, and are appropriately powered to disaggregate all outcomes by gender to address potential disparities.
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Affiliation(s)
- Briar McKenzie
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Joseph Alvin Santos
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Kathy Trieu
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- Faculty of Medicine, The University of Sydney, Camperdown, NSW, Australia
| | - Sudhir Raj Thout
- The George Institute for Global Health India, Unit No. 301, Hyderabad, Telangana, India
| | - Claire Johnson
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - JoAnne Arcand
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Jacqui Webster
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- Faculty of Medicine, The University of Sydney, Camperdown, NSW, Australia
| | - Rachael McLean
- Department of Preventive & Social Medicine, University of Otago, Dunedin, New Zealand
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Kamali AR. Scalable fabrication of highly conductive 3D graphene by electrochemical exfoliation of graphite in molten NaCl under Ar/H2 atmosphere. J IND ENG CHEM 2017. [DOI: 10.1016/j.jiec.2017.03.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Fan S, Yang B, Zhi X, He J, Ma P, Yu L, Zheng Q, Sun G. Neck circumference associated with arterial blood pressures and hypertension: A cross-sectional community-based study in northern Han Chinese. Sci Rep 2017; 7:2620. [PMID: 28572586 PMCID: PMC5454030 DOI: 10.1038/s41598-017-02879-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 04/19/2017] [Indexed: 01/18/2023] Open
Abstract
Although several studies have investigated the associations of neck circumference (NC) with arterial blood pressures (BPs) and hypertension, no such studies have been conducted among Northern Chinese population. Between April and June 2015, a total of 2631 subjects aged ≥35 years old were recruited from Northeastern China. NC and arterial BPs were measured by trained personnel. Generalized linear and logistic regression analyses were applied to examine the associations of NC with arterial BPs and hypertension risk. The optimal cut-off points of NC for predicting hypertension were assessed by the receiver operating characteristic analysis. We found that NC was significantly associated with arterial BPs and hypertension risk in the Northeastern Chinese adults, even after adjusting for many covariates including body mass index, waist circumference or waist-to-hip ratio. The optimal cut-off values for NC to predict hypertension differed with sex, age, and body mass index. Our study suggests that NC may play an independent role in predicting hypertension beyond the classical anthropometric indices, and that it could be used as a valuable anthropometric measurement for routine assessment in primary care clinics and future epidemiological studies.
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Affiliation(s)
- Shujun Fan
- Research Center of Environment and Non-Communicable Disease, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Boyi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xueyuan Zhi
- Research Center of Environment and Non-Communicable Disease, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Jing He
- Department of Non-Communicable Disease, Shenhe Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Ping Ma
- Department of Non-Communicable Disease, Shenhe Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Luyang Yu
- Department of Non-Communicable Disease, Shenhe Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Quanmei Zheng
- Research Center of Environment and Non-Communicable Disease, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Guifan Sun
- Research Center of Environment and Non-Communicable Disease, School of Public Health, China Medical University, Shenyang, 110122, China.
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Álvarez Aliaga A, González Aguilera JC, Maceo Gómez LDR. Factors associated to hypertensive heart disease development: a prospective cohort study in Bayamo, Cuba. Medwave 2016; 16:e6492. [PMID: 27571318 DOI: 10.5867/medwave.2016.06.6492] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 06/21/2016] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Among the conditions resulting from target organ damage by arterial hypertension, hypertensive cardiopathy is the one that exhibits the highest morbidity and mortality rates. Its prevention should be a target of all high blood pressure medical care programs. OBJECTIVE To identify risk factors for the development of hypertensive cardiopathy. METHODS A prospective cohort study was carried out in hypertensive patients assisted at the specialized arterial hypertension physicians offices of the Carlos Manuel de Céspedes Specialty Policlinic attached to the General University Hospital, Bayamo Municipality, Granma Province, Cuba, from January 1st, 2000 to December 31st, 2009. RESULTS Multivariate analysis done to estimate the hazard rate (HR) of developing hypertensive cardiopathy, showed significant independent statistic association for most factors. The first place was occupied by lack of blood pressure control (HR=2.022; 95% CI: 1.659-2.465; p<0.005), followed by hypertension stage 2 (HR=2.015; 95% CI: 1.715-2.366; p<0.005). Another factors with significant HRs were microalbuminuria (HR=1.9; 95% CI: 1.6-2.2) and age over 60 years (HR=1.6; 95% CI: 1.4-1.9). CONCLUSIONS Several risk factors must be considered for the prevention of hypertensive heart disease in high blood pressure patients.
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Affiliation(s)
- Alexis Álvarez Aliaga
- Hospital Universitario Carlos Manuel de Céspedes, Bayamo, Granma, Cuba. Address: Carretera Central Km 1, Vía Santiago de Cuba, Bayamo, Granma, Cuba.
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Li S, Kyvik KO, Pang Z, Zhang D, Duan H, Tan Q, Hjelmborg J, Kruse T, Dalgård C. Genetic and Environmental Regulation on Longitudinal Change of Metabolic Phenotypes in Danish and Chinese Adult Twins. PLoS One 2016; 11:e0148396. [PMID: 26862898 PMCID: PMC4749287 DOI: 10.1371/journal.pone.0148396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 01/18/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The rate of change in metabolic phenotypes can be highly indicative of metabolic disorders and disorder-related modifications. We analyzed data from longitudinal twin studies on multiple metabolic phenotypes in Danish and Chinese twins representing two populations of distinct ethnic, cultural, social-economic backgrounds and geographical environments. MATERIALS AND METHODS The study covered a relatively large sample of 502 pairs of Danish adult twins followed up for a long period of 12 years with a mean age at intake of 38 years (range: 18-65) and a total of 181 Chinese adult twin pairs traced for about 7 years with a mean baseline age of 39.5 years (range: 23-64). The classical twin models were fitted to the longitudinal change in each phenotype (Δphenotype) to estimate the genetic and environmental contributions to the variation in Δphenotype. RESULTS Moderate to high contributions by the unique environment were estimated for all phenotypes in both Danish (from 0.51 for low density lipoprotein cholesterol up to 0.72 for triglycerides) and Chinese (from 0.41 for triglycerides up to 0.73 for diastolic blood pressure) twins; low to moderate genetic components were estimated for long-term change in most of the phenotypes in Danish twins except for triglycerides and hip circumference. Compared with Danish twins, the Chinese twins tended to have higher genetic control over the longitudinal changes in lipids (except high density lipoprotein cholesterol) and glucose, higher unique environmental contribution to blood pressure but no genetic contribution to longitudinal change in body mass traits. CONCLUSION Our results emphasize the major contribution of unique environment to the observed intra-individual variation in all metabolic phenotypes in both samples, and meanwhile reveal differential patterns of genetic and common environmental regulation on changes over time in metabolic phenotypes across the two samples.
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Affiliation(s)
- Shuxia Li
- Unit of Human Genetics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- * E-mail:
| | - Kirsten Ohm Kyvik
- Department of Clinical Research, University of Southern Denmark, and Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Zengchang Pang
- Qingdao Center for Disease Control and Prevention, Qingdao, China
| | - Dongfeng Zhang
- Department of Public Health, Qingdao University Medical College, Qingdao, China
| | - Haiping Duan
- Qingdao Center for Disease Control and Prevention, Qingdao, China
| | - Qihua Tan
- Unit of Human Genetics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jacob Hjelmborg
- Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Torben Kruse
- Unit of Human Genetics, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Christine Dalgård
- Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
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