Intersalt revisited: further analyses of 24 hour sodium excretion and blood pressure within and across populations
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Why the study?
Does higher 24-hour urinary sodium excretion associate with higher blood pressure and greater age-related blood pressure increases in adults?
Population
10,074 men and women aged 20-59 (median age 40) from 52 population samples in 32 countries.
Comparison
Higher 24-hour urinary sodium excretion vs Lower 24-hour urinary sodium excretion
Design
Cross-sectional
Authors
Discussion
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Overview
Should not yet change practice; leaves open causal effects of sodium reduction on BP trajectories.
Structured PICO
Does higher 24-hour urinary sodium excretion associate with higher blood pressure and greater age-related blood pressure increases in adults?
P
Population
10,074 men and women aged 20-59 (median age 40) from 52 population samples in 32 countries.
I
Intervention
Higher 24-hour urinary sodium excretion (evaluated per 100 mmol/day higher excretion)
C
Comparator
Lower 24-hour urinary sodium excretion
O
Outcome
Association of 24-hour urinary sodium excretion with systolic and diastolic blood pressure, and difference in blood pressure with agesurrogate
Higher urinary sodium excretion is strongly associated with higher blood pressure and a substantially greater increase in blood pressure from young adulthood to middle age, supporting population-wide salt reduction.
Limitations
- Cross-sectional design limits causal inference
- Regression dilution bias due to day-to-day variance in sodium excretion
- Potential overadjustment when including BMI in models
Cite This Study
Elliott et al. (1996) studied this question.
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