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    Saturday, August 22, 2009

    PART IV OF IV SODIUM AND HIGH BLOOD PRESSURE.

    Reducing Sodium Intake

    Avoiding the salt shaker isn't the magic bullet for sodium reduction. This is because around 80% of dietary sodium comes from processed, prepared, and restaurant foods. Steering clear of these types of foods is likely to have the most impact on sodium intake. The amount of salt in some restaurant meals can be shocking, at more than four times the recommended daily intake of sodium. Plus, another downside of most processed foods is that they are very low in potassium.

    For people who are trying to reduce dietary sodium, understanding how to read food labels is also important. Foods that contain 5% or less of the Daily Value (DV) of sodium are considered to be "low-salt." However, the percentage of the DV of sodium in the nutrition information portion of the labeling of packaged foods is based on a DV of 2,400 mg. It's not based on the 1,500 mg recommendation that applies to almost 70% of the adult population.

    In addition to food labels, checking medication labels for sodium is a good idea. Some common culprits with a relatively large amount of sodium include antacids, and drugs that are available as effervescent formulations, like Zantac 150 EFFERdose and Alka-Seltzer effervescent products.

    Note that even a small reduction in the amount of sodium your patients consume each day can make a difference.3 It's best to always encourage patients to try to meet these types of goals. Suggest reducing sodium intake gradually. It might be easier for patients to get accustomed to the taste of foods with less salt this way.

    To help combat the problem of excess sodium consumption, groups including the American Heart Association and some federal agencies have been pushing for the food industry to reduce the amount of sodium in the food supply by 50% over a ten-year period. This could help reduce blood pressure in the population as a whole.9 In the U.K., a combination of government regulations, changes in labeling requirements, and consumer awareness has helped achieve a 10% reduction in consumption of salt.3
    Conclusion

    Limiting sodium intake can help reduce blood pressure [Evidence level A; high-quality RCT]. Let your patients know that following a healthy diet (like DASH) and minimizing processed and prepared foods is likely to make the biggest difference.

    Tell most patients to make sure they're getting plenty of dietary potassium as well. Fruits and vegetables are good sources. But watch out for patients with kidney disease, or those taking medicines that can increase potassium levels (e.g., ACE inhibitors, ARBs, eplerenone [Inspra], and potassium-sparing diuretics).

    Also take the opportunity to encourage patients who are able to get at least 30 minutes of physical activity each day. Remind them that smoking cessation and moderating alcohol consumption can also reduce cardiovascular risk.

    Blood pressure-lowering benefits of reduced salt intake. Pharmacist's Letter/Prescriber's Letter 2009;25(6):250605.June 2009



    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    *Tune in tomorrow for WHY DOCS SHOULD HANG UP THEIR WHITE COATS

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