BACKGROUND AND OBJECTIVES: Salt-taste threshold can influence salt appetite, and is thought to be another marker of sodium intake. Many studies have found an association between sodium intake and blood pressure. The aim of this study was to compare the salt-taste threshold and salt intake between hypertensive and normotensive groups. SUBJECTS AND METHOD: One hundred twenty volunteers (51 men and 69 women) who did not take antihypertensive medications were evaluated. First, a questionnaire, which included questions regarding demographic information and preference of salty taste, was conducted, and 24-hour ambulatory blood pressure was checked. Then salt taste threshold was measured by assessing the ability of the subjects to discern the taste of salt in graded solutions of saline. Lastly, 24-hour urinary sodium was measured in a 24-hour urine collection. RESULTS: The salt taste threshold and taste preference for salt were slightly higher in hypertensive group. There was slightly higher salt intake measured as 24-hour urinary sodium in the hypertensive group, compared with the normotensive group. However, there were no significant differences in salt taste threshold, preference of salty taste, and salt intake between the normotensive and the hypertensive groups. CONCLUSION: The threshold of salt taste was not related to sodium intake and hypertension status. These results suggest that the development of hypertension depends on the complex interaction of factors such as genes and environmental factors rather than sensory factors like taste threshold and taste preference.
Appetite ; Blood Pressure ; Humans ; Hypertension ; Male ; Sodium ; Sodium Chloride ; Taste Threshold* ; Urine Specimen Collection ; Volunteers

BACKGROUND AND OBJECTIVES: Metabolic syndrome and high sodium intake are associated with frequent cardiovascular events. Few studies have estimated sodium intake in subjects with metabolic syndrome by 24-hour urine sodium excretion. We evaluated sodium intake in individuals with metabolic syndrome. SUBJECTS AND METHODS: Participants were recruited by random selection and through advertisement. Twenty four-hour urine collection, ambulatory blood pressure measurements, and blood test were performed. Sodium intake was estimated by 24-hour urine sodium excretion. Participants receiving antihypertensive medications were excluded from analysis. RESULTS: Among the 463 participants recruited, subjects with metabolic syndrome had higher levels of 24-hour urine sodium excretion than subjects without metabolic syndrome (p=0.0001). There was a significant relationship between the number of metabolic syndrome factors and 24-hour urine sodium excretion (p=0.001). The proportion of subjects with metabolic syndrome was increased across the tertile groups of 24-hour urine sodium excretion (p<0.0001). The association of high sodium intake and metabolic syndrome was significant only among women. Among the factors related to metabolic syndrome, body mass index had an independent association with 24-hour urine sodium excretion (p<0.0001). CONCLUSION: Women with metabolic syndrome exhibited significantly higher sodium intake, suggesting that dietary education to reduce sodium consumption should be emphasized for women with metabolic syndrome.
Blood Pressure ; Body Mass Index ; Education ; Female ; Hematologic Tests ; Humans ; Hypertension ; Sodium* ; Sodium, Dietary ; Urine Specimen Collection

BACKGROUND/OBJECTIVES: The aims of the present study are: 1) to quantify sodium consumption of patients with unstable or uncontrolled hypertension, 2) to investigate if reduced sodium intake can lower BP in these patients, and 3), to assess the acceptability and feasibility of this approach. SUBJECTS/METHODS: This study included 25 adults (age: 50+ years) with frequently elevated BP or patients with uncontrolled, uncomplicated hypertension despite drug treatment in a general practice setting. BP and salt intake (24h urinary excretion and food records) were measured at baseline and after a sodium reduced diet. RESULTS: Mean (+/- SD) systolic (SBP) over diastolic (DBP) blood pressure (mmHg) at baseline was 150.7 (+/- 9.5)/84.149 (+/- 5.6). Mean urinary sodium excretion was 146 mmol/24h. A reduction of 28 mmol sodium excretion decreased SBP/DBP to 135.5 (+/- 13.0)/82.5 (+/- 12.8) (P < 0.001). After one month of no dietary advice, only in 48%, SBP was still < or =140 mmHg. CONCLUSION: Assessment of sodium intake using food records, 24h urine collections and probing questions to identify use of sodium containing supplements or drugs are essential for tailored advice targeted at sodium intake reduction. The results of the present study indicate that reduced sodium intake can lower BP after 4 weeks in unstable or uncontrolled hypertensive patients.
Adult ; Blood Pressure* ; Diet ; General Practice ; Humans ; Hypertension ; Primary Health Care* ; Sodium* ; Urine Specimen Collection

BACKGROUND/OBJECTIVES: The aims of the present study are: 1) to quantify sodium consumption of patients with unstable or uncontrolled hypertension, 2) to investigate if reduced sodium intake can lower BP in these patients, and 3), to assess the acceptability and feasibility of this approach. SUBJECTS/METHODS: This study included 25 adults (age: 50+ years) with frequently elevated BP or patients with uncontrolled, uncomplicated hypertension despite drug treatment in a general practice setting. BP and salt intake (24h urinary excretion and food records) were measured at baseline and after a sodium reduced diet. RESULTS: Mean (+/- SD) systolic (SBP) over diastolic (DBP) blood pressure (mmHg) at baseline was 150.7 (+/- 9.5)/84.149 (+/- 5.6). Mean urinary sodium excretion was 146 mmol/24h. A reduction of 28 mmol sodium excretion decreased SBP/DBP to 135.5 (+/- 13.0)/82.5 (+/- 12.8) (P < 0.001). After one month of no dietary advice, only in 48%, SBP was still < or =140 mmHg. CONCLUSION: Assessment of sodium intake using food records, 24h urine collections and probing questions to identify use of sodium containing supplements or drugs are essential for tailored advice targeted at sodium intake reduction. The results of the present study indicate that reduced sodium intake can lower BP after 4 weeks in unstable or uncontrolled hypertensive patients.
Adult ; Blood Pressure* ; Diet ; General Practice ; Humans ; Hypertension ; Primary Health Care* ; Sodium* ; Urine Specimen Collection

The effect of NaCl plus 3% chitosan on the systolic blood pressure of spontaneously hypertensive rats (SHR) were evaluated and compared with NaCl plus KCl (NaCl, 49.36% + KCl 49.36%) and chitosan or NaCl treatment alone. In SHR, administration of NaCl plus chitosan (44 mM Na/day) for two months significantly decreased the systolic blood pressure greater than of NaCl plus KCl and NaCl alone. NaCl plus chitosan resulted, though not statistically significant, in decreased urinary Na+ excretion and decreased blood urea nitrogen levels. Urinary creatinine of NaCl plus chitosan was slightly decreased compared to 3 treated groups. Serum electrolytes levels, however, remained unchanged. The combination of NaCl and chitosan may be superior to the conventional use of NaCl plus KCl or NaCl alone in the prevention of hypertension. Even though these supplementary diets have demonstrated potential anti-hypertensive effects in the experimental animal model, further research is needed before any recommendations can be made.
Angiotensin I/blood ; Angiotensin II/biosynthesis ; Animals ; Blood Pressure/*drug effects/physiology ; Blood Urea Nitrogen ; Body Weight/drug effects ; Chitosan/*administration & dosage ; Chlorides/blood/urine ; Creatinine/urine ; Heart/physiology ; Histocytochemistry ; Hypertension/*prevention & control ; Kidney/physiology ; Male ; Potassium/blood/urine ; Potassium Chloride/administration & dosage ; Random Allocation ; Rats ; Rats, Inbred SHR ; Sodium/blood/urine ; Sodium Chloride, Dietary/*administration & dosage ; Systole/drug effects/physiology

Excessive dietary salt intake is related to cardiovascular morbidity and mortality. Although dietary salt restriction is essential, it is difficult to achieve because of salt palatability. However, the association between salt perception or salt eating habit and actual salt intake remains uncertain. In this study, we recruited 74 healthy young individuals. We investigated their salt-eating habits by questionnaire and salt taste threshold through a rating scale that used serial dilution of a sodium chloride solution. Predicted 24-hr urinary salt excretions using Kawasaki's and Tanaka's equations estimated dietary salt intake. Participants' mean age was 35 yr, and 59.5% were male. Salt sense threshold did not show any relationship with actual salt intake and a salt-eating habit. However, those eating "salty" foods showed higher blood pressure (P for trend=0.048) and higher body mass index (BMI; P for trend=0.043). Moreover, a salty eating habit was a significant predictor for actual salt intake (regression coefficient [beta] for Kawasaki's equation 1.35, 95% confidence interval [CI] 10-2.69, P=0.048; beta for Tanaka's equation 0.66, 95% CI 0.01-1.31, P=0.047). In conclusion, a self-reported salt-eating habit, not salt taste threshold predicts actual salt intake.
Adult ; Algorithms ; Blood Pressure ; Body Mass Index ; Demography ; Female ; Habits ; Humans ; Linear Models ; Male ; Questionnaires ; Self Report ; Sodium Chloride, Dietary/*urine ; Taste Perception ; Taste Threshold ; Urine Specimen Collection

This study was performed to assess the sodium intakes of Korean adults using a 24-hr urine analysis and dish frequency questionnaire (DFQ) according to each dish group and the regional area. The subjects of this study were comprised of 552 adults (male: 267, female: 285), aged 20-59yr residing in the metropolitan area (N = 200), Chungcheng-Do (N = 117), Jeolla-Do (N = 117), and Gueongsang-Do provinces (N = 118). The subjects were recruited from the residents who once participated or are participating in the various health programs offered by the public health center. The number of subjects who completed the 24-hr urine collection was 205 (male : 110, female : 95).The mean age and BMI of the subjects were 39.0+/-11.7 y and 23.1+/-2.9 kg/m2, respectively. The mean systolic and diastolic blood pressure was 119.5+/-15.4 mmHg, and 77.1+/-11.1 mmHg, respectively. Eighteen percent of the subjects responded that they are currently smoking, 36% drinking and 50.4% exercising. Twenty point six percent of the subjects were assessed as having hypertension according to their systolic or diastolic blood pressure(SBP > or = 140 mmHg or DBP > or = 90 mmHg) measurements in the present study. Salt intake of the subject estimated with 24-hr sodium excretion was 12.7 g/d (male : 13.4 g/d, female : 12.1 g/d) based on the sodium excretion rate as 82%. Salt intake estimated with DFQ was 14.7 g/d (male : 16.2 g/d, female : 13.4 g/d), 2 g more than the salt intake estimated with 24-hr urine analysis. The four dish groups that contributed most to the sodium intake in order were kimchi (I1571.4mg), soup and stew (1260.5 mg), fish and shellfish (706.3 mg) and noodle and ramyeon (644.3mg). Salt intake estimated with DFQ was the highest in the subjects of Gueongsang-Do (17.0 g/d), second highest Chungcheong-Do (16.4 g/d) and the lowest in the metropolitan area (13.0 g/d). Subjects of Gueongsang-Do showed the highest sodium intakes in most of the dish group, whereas subjects of the metropolitan area showed the lowest. Residents of Chuncheong-Do revealed the highest sodium intake with kimchi and ofJeolla-Do the higher sodium intake with the main dish (meat, fish and beans). The highest salt percentage of kimchi (3.0+/-0.8%) and soybean paste (14.5 +/-5.1%) were observed in Gueongsang-Do, whereas individuals of the metropolitan area were observed as having kimchi (1.6 +/-0.5%) and soybean paste (7.4 +/-1.6%) with the lowest salt percentage. Men were observed as having more salty kimchi (2.4 +/-0.1%) than women (2.1 +/-0.1%).
Adult* ; Blood Pressure ; Drinking ; Female ; Humans ; Hypertension ; Male ; Public Health ; Shellfish ; Smoke ; Smoking ; Sodium* ; Soybeans ; Urine Specimen Collection

Gitelman's syndrome is a variant of Bartter's syndrome characterized by hypocalciuria and hypomagnesemia. The administration of thiazide diuretics may induce a subnormal increase of urinary Na+ and Cl- excretion in patients with Gitelman's syndrome, consistent with the hypothesis that less Na+ and Cl- than normal is reabsorbed by the thiazide-inhibitable transporter in Gitelman's syndrome. Specific mutations of NaCl cotransporter, coupled with mutant NaCl cotransporter expression studies clearly demonstrated that many of the characteristics of individuals with Gitelman's syndrome are explained by lack of function of NaCl cotransporter. We recently diagnosed a patient with Gitelman's syndrome by performing the thiazide and furosemide tests, and it is suggested that the clearance studies by diuretic administration may be of diagnostic help in Gitelman's syndrome.
Adolescent ; Bartter Syndrome/*diagnosis/metabolism/physiopathology ; *Benzothiadiazines ; Chlorides/blood/urine ; Diuretics/diagnostic use ; Electrolytes/blood/urine ; Female ; Furosemide/diagnostic use ; Humans ; Kidney/*physiopathology ; Kidney Function Tests ; Sodium/blood/urine ; Sodium Chloride Symporter Inhibitors/*diagnostic use ; Sodium Chloride Symporters ; Symporters/metabolism ; Syndrome

The assessment of sodium intake is complex because of the variety and nature of dietary sodium. This study intended to develop a dish frequency questionnaire (DFQ) for estimating the habitual sodium intake and a short DFQ for screening subjects with high or low sodium intake. For DFQ112, one hundred and twelve dish items were selected based on the information of sodium content of the one serving size and consumption frequency. Frequency of consumption was determined through nine categories ranging from more than 3 times a day to almost never to indicate how often the specified amount of each food item was consumed during the past 6 months. One hundred seventy one adults (male: 78, female: 93) who visited hypertension or health examination clinic participated in the validation study. DFQ55 was developed from DFQ112 by omitting the food items not frequently consumed, selecting the dish items that showed higher sodium content per one portion size and higher consumption frequency. To develop a short DFQs for classifying subjects with low or high sodium intakes, the weighed score according to the sodium content of one protion size was given to each dish item of DFQ25 or DFQ14 and multiplied with the consumption frequency score. A sum index of all the dish items was formed and called sodium index (Na index). For validation study the DFQ112, 2-day diet record and one 24-hour urine collection were analyzed to estimate sodium intakes. The sodium intakes estimated with DFQ112 and 24-h urine analysis showed 65% agreement to be classified into the same quartile and showed significant correlation (r = 0.563 p < 0.05). However, the actual amount of sodium intake estimated with DFQ112 (male: 6221.9 mg, female: 6127.6 mg) showed substantial difference with that of 24-h urine analysis (male: 4556.9 mg, female: 5107.4 mg). The sodium intake estimated with DFQ55 (male: 4848.5 mg, female: 4884.3 mg) showed small difference from that estimated with 24-h urine analysis, higher proportion to be classfied into the same quartile and higher correlation with the sodium intakes estimated with 24-h urine analysis and systolic blood pressure. It seems DFQ55 can be used as a tool for quantitative estimation of sodium intake. Na index25 or Na index14 showed 39~50% agreement to be classified into the same quartile, substantial correlations with the sodium intake estimated with DFQ55 and significant correlations with the sodium intake estimated with 24-h urine analysis. When point 119 for Na index25 was used as a criterion of low sodium intake, sensitivity, specificity and positive predictive value was 62.5%, 81.8% and 53.2%, respectively. When point 102 for Na index14 was used as a criterion of high sodium intake, sensitivity, specificity and positive predictive value were 73.8%, 84.0%, 62.0%, respectively. It seems the short DFQs using Na index14 or Na index25 are simple, easy and proper instruments to classify the low or high sodium intake group.
Adult ; Blood Pressure ; Diet Records ; Female ; Humans ; Hypertension ; Mass Screening ; Portion Size ; Sensitivity and Specificity ; Serving Size ; Sodium* ; Sodium, Dietary ; Urine Specimen Collection

The purpose of this study was to investigate the compliance with low-salt diet in essential hypertension patients, and to identify the related factors of compliance with low-salt diet. The subjects of this study were 177 hypertensive patients who have been followed at Seoul National University Hospital outpatient clinic. The data was collected from August 20, 1998 to September 22, 1998, through survey using a self-report questionnaires and chart review. 24-hour urine sodium excretion was measured for validation of self-reported low-salt diet compliance from 22 patients who agreed for 24-hour urine collection. The questionnaires consist of general characteristics, disease-related characteristics, diet-related characteristics, and 4 scales: (1) Numeric scale (2) Knowledge of low-salt diet (3) Family support for low-salt diet (4) Low-salt diet compliance. The results were as follows: 1) The mean score of low-salt diet compliance was 38.97 +/- 9.26. The mean salt intake converted from 24-hour urine sodium was 16.81g/day, which was much greater than recommendation. The percentage of patients who were taking salt 6-8g/day was only 13.6%, and 8-10g/day was 13.6%. 2) The mean score of knowledge of low-salt diet was 5.12 +/- 1.81. The mean score of family support for low-salt diet was 30.08 +/- 8.81. The patients received emotional, instrumental, evaluative, and informational aspect of family support in sequence of amount. 3) Several factors were found as significant factors which influence low-salt diet compliance. Those were knowledge(p=.015), family support(p=.000), age(p=.039), diastolic pressure(p=.014), previous dietary habit(p= .000), duration of low-salt diet(p=.000), recognition of importance of low-salt diet on hypertension control(p=.000), and recognition of necessity of low-salt diet while antihypertensive drug therapy(p=.030). 4) Four significant predictive factors of low-salt diet compliance were identified: (1) Family support accounted for 24.8% of low-salt diet compliance (2) Previous dietary habit, 14.4% (3) Recognition of importance of low-salt diet on hypertension control, 3.7% (4) Diastolic pressure, 2.1%. Therefore, these factors accounted for 45.0% of low-salt diet compliance. In conclusion, low-salt diet compliance in hypertensive patients was very poor, which call for nursing intervention for enhancing low-salt diet compliance. It is necessary to provide practical knowledge of low-salt diet for hypertensive patients and family members.
Blood Pressure ; Compliance* ; Diet, Sodium-Restricted* ; Food Habits ; Humans ; Hypertension* ; Nursing ; Outpatient Clinics, Hospital ; Seoul ; Sodium ; Urine Specimen Collection ; Weights and Measures ; Surveys and Questionnaires