Verma S , Gupta M , Holmes DT , Xu L , Teoh H , Gupta S , Yusuf S , Lonn EM. Plasma renin activity predicts cardiovascular mortality in the Heart Outcomes Prevention Evaluation HOPE study. Eur Heart J ; 32 : — Stolarz-Skrzypek K , Kuznetsova T , Thijs L , Tikhonoff V , Seidlerová J , Richart T , Jin Y , Olszanecka A , Malyutina S , Casiglia E , Filipovský J , Kawecka-Jaszcz K , Nikitin Y , Staessen JA ; European Project on Genes in Hypertension EPOGH Investigators.

Fatal and nonfatal outcomes, incidence of hypertension, and blood pressure changes in relation to urinary sodium excretion. Systematic review of dietary salt reduction policies: evidence for an effectiveness hierarchy? PLoS One ; 12 : e Li Y , Huang Z , Jin C , Xing A , Liu Y , Huangfu C , Lichtenstein AH , Tucker KL , Wu S , Gao X.

Longitudinal change of perceived salt intake and stroke risk in a Chinese population. Stroke ; 49 : — Mente A , Irvine EJ , Honey RJ , Logan AG. Urinary potassium is a clinically useful test to detect a poor quality diet.

J Nutr ; : — Effect of potassium-enriched salt on cardiovascular mortality and medical expenses of elderly men. Am J Clin Nutr ; 83 : — Rationale, design, and baseline characteristics of the Salt Substitute and Stroke Study SSaSS —a large-scale cluster randomized controlled trial.

Am Heart J ; : — Versi E. BMJ ; : McLean RM. Measuring population sodium intake: a review of methods. Nutrients ; 6 : — Mozaffarian D , Fahimi S , Singh GM , Micha R , Khatibzadeh S , Engell RE , Lim S , Danaei G , Ezzati M , Powles J ; Global Burden of Diseases Nutrition and Chronic Diseases Expert Group.

Global sodium consumption and death from cardiovascular causes. Mills KT , Chen J , Yang W , Appel LJ , Kusek JW , Alper A , Delafontaine P , Keane MG , Mohler E , Ojo A , Rahman M , Ricardo AC , Soliman EZ , Steigerwalt S , Townsend R , He J ; Chronic Renal Insufficiency Cohort CRIC Study Investigators.

Sodium excretion and the risk of cardiovascular disease in patients with chronic kidney disease. Kieneker LM , Eisenga MF , Gansevoort RT , de Boer RA , Navis G , Dullaart RPF , Joosten MM , Bakker SJL. Association of low urinary sodium excretion with increased risk of stroke.

Mayo Clin Proc ; 93 : — Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide.

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Department of Medicine, National Center of Cardiovascular Disease. Hongye Zhang , Hongye Zhang. Department of Medicine, Beijing Hypertension League Institute. Patricio Lopez-Jaramillo. Department of Medicine, Instituto de Investigaciones MASIRA, Universidad de Santander.

Albertino Damasceno. Faculty of Medicine, Eduardo Mondlane University. Peter Langhorne. Department of Medicine, Glasgow Royal Infirmary, University of Glasgow. Annika Rosengren. Department of Molecular and Clinical Medicine, University of Gothenburg and Region Västra Götaland, Sahlgrenska University Hospital.

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Okechukwu S Ogah. Department of Medicine, University College Hospital. Adesola Ogunniyi. Helle K Iversen. Department of Neurology, Rigshospitalet, University of Copenhagen.

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Disclosures: The authors report no relevant financial disclosures. Read more about salt. low-sodium diet. potassium chloride. Facebook Twitter LinkedIn Email Print Comment. Related Content. Please refresh your browser and try again. If this error persists, please contact ITSupport wyanokegroup.

com for assistance. You can avoid having a stroke by seeking and following professional medical advice and maintaining a healthy lifestyle and diet. If you have had a stroke before, these measures might help in preventing a recurrence. Meanwhile, the same preventive measures for heart disease are the ones for stroke.

The essential things you can do to reduce stroke risks are:. The treatment for heart disease is the same for stroke. There are medications used to treat stroke. Some of them include:. You might have had different misconceptions about salt like:.

Foods that contain plenty of salt are salty, but sometimes some other things may be mixed with the food, which will mask the salty taste even though the salt content of the food is high. Therefore, always ensure you check food labels to know the sodium or salt quantity. Please reduce salt intake in your diet by maintaining a minimal dietary salt intake and a healthy lifestyle.

There are ways you can minimize your salt intake. You might find it hard at first if you are a high dietary salt taker, but you will soon get used to taking a minimal amount of dietary salt, which is good for your heart, kidney, and body as a whole.

Ways to reduce salt sodium consumption are:. Your health is vital, and you should always monitor and take care of your health properly. Maintain a healthy lifestyle, consume food low in sodium, and avoid making your meals with too much salt.

It is important to seek medical help if you notice any early signs of stroke or recurrence. We perform ultrasounds, such as echocardiograms as well as venous insufficiency testing in our office.

We also perform stress testing in our office. In the hospitals, we perform cardiac catheterizations as well as implant permanent pacemakers and implantable cardioverter defibrillators ICD. Smoking: if you are the type that smokes a lot, you increase your chances of having a stroke.

For nonsmokers, if you are always around smokers, especially when they are smoking, it is also detrimental to your health and puts you at risk of getting a stroke. High cholesterol: unhealthy diets and eating food high in cholesterol and fats can result in a stroke.

Diabetes: excess blood sugar can also put you at risk of having a stroke. Cardiovascular disease: these are diseases that affect the heart and blood vessels. Anyone who has suffered a heart disease has a chance of getting a stroke. Age: as you become older, there is a tendency to have a stroke if you do not adequately take good care of your health.

Family history: if there is a history of stroke in the family, your chances of getting a stroke are high, so you have to take proper regular care of your health to prevent it. Sodium intake and stroke However, our primary focus is on sodium as a risk factor for stroke.

There are symptoms to look out for in high blood pressure, which are: Shortness of breath Nausea Blurred vision Pulsation in the head or neck Dizziness Headache According to the World Health Organization , the recommended amount of salt to consume per day is 5 grams, about one teaspoon.

In the Americas, salt intake is double that: nearly 11 grams per day in most of the region's countries.

One option that consumers can take is to avoid these processed foods and instead focus on foods that are fresh, natural, and free of added salt. Policy changes and multi-sector action are also important to shape the environment in ways that facilitate healthy eating.

Legislative bodies can adopt laws to protect the health of their populations, and governments can strengthen the work of their regulatory authorities and promote incentives to create healthy environments in schools.

Dining halls and cafeterias in companies and government institutions can offer food with less sodium, and the food industry has the responsibility of reformulating products to reduce salt," said Orduñez.

He added that the role of civil society is equally important in advocating for healthy public policies and monitoring compliance with established regulations. This year's World Health Day 7 April was dedicated to hypertension. WHO issued a call to intensify efforts to prevent and control high blood pressure, which is the main risk factor for cardiovascular deaths and is estimated to affect more than 1 in 3 adults worldwide, or some 1 billion people.

Univariate and multivariate logistic regression analysis was used to measure the associations of salt type used with hypertension and stroke and co-variables were respectively adjusted in different models. After adjusting age and gender, other salt intake was associated with 1.

After the adjustment of age and gender, the risk of hypertension and stroke was 3. Other salt intake or no table salt were associated with a higher risk of hypertension or hypertension and stroke. Peer Review reports. Hypertension is reported to be a major cause of premature deaths and a heavy burden of cardiovascular morbidity and mortality, which resulted in approximately 7.

Hypertension is widely validated to increase the risk of developing cardiovascular diseases CVD such as coronary heart disease CHD and stroke [ 2 , 3 ]. Hypertension has strong associations with atherosclerosis deposits blocking and narrowing brain arteries, which has become a major risk factor for the occurrence of stroke [ 4 , 5 ].

Stroke is reported to be the leading cause of death in China and the second leading cause of death all through the world [ 6 ]. Stroke is also the main reason of long-term neurological disability in adults, which leads to a substantial economic burden to the society and a decreased quality of life in patients [ 7 ].

Considering the considerable amount of economic burden to the family and society, more effective health care planning and prevention of hypertension and stroke are necessary. Currently, some researches proposed that lifestyle changes may have significant effects on blood pressure control [ 8 ].

As high salt intake was reported to be associated with the risk of hypertension and cardiovascular events, restricting dietary salt has been proposed to be a method for hypertension prevention [ 9 , 10 ].

Salt reduction was considered to be an important dietary target for to reduce the mortality of main noncommunicable diseases by the World Health Organization WHO [ 11 ]. In recent years, low-salt diet or event no-salt diet was advocated to improve health and prevent some diseases [ 12 ].

For some people, to control salt use in daily life indicated low salt or no salt indicate adding low or no salt at table, and some other people added lite salt or salt substitute at table. Lite salt or salt substitute refer to sodium chloride in traditional salt is partially replaced with potassium chloride or magnesium sulfate, which are considered as a strategy under consideration by several countries for lowing blood pressure [ 14 ].

At present, various studies have explored the associations between sodium intake and the risk of hypertension or stroke [ 3 , 15 ]. High sodium intake was associated with increased risk of hypertension or stroke.

People was advocated to reduced salt use. But for common people, monitoring the salt contributions of specific foods and food groups, differentiating the inherent and processing-added sodium content of foods or other dietary sources were difficult [ 13 ]. It is easier for controlling the discretionary salt use including table salt and salt added while cooking to achieve the sodium intake reduction.

Previous studies were focused on the volume of salt intake with the risk of hypertension and stroke, whether the different types of salt used just at table or during cooking were associated with the risk of hypertension or stroke were still unclear.

In the current study, the associations of different salt types added at table or no table salt with the occurrence of hypertension and stroke were assessed based on the data from National Health and Nutrition Examination Survey NHANES database.

The NHANES database included a multifaceted health examination on a nationally representative sample of the civilian, non-institutionalized population in the United States based on complex multistage stratified probability sampling methods [ 16 ].

NHANES data is publicly available and the data collection and data release were approved by the National Center for Health Statistics NCHS Ethics Review Board [ 17 ].

After excluding participants without data on salt intake, and baseline characteristics including poverty income ratio PIR , history of diabetes, body mass index BMI , sodium and marital status, 15, subjects were involved in.

The detailed screen process was shown in Fig. In NHANES database, health questionnaires were collected from all subjects in their home, and physical, laboratory and anthropometric examinations were performed in Mobile Examination Centers MEC by well-trained health technicians following standardized procedures.

People with hypertension, stroke, or hypertension and stroke were measured as outcome variables. Data from the Medical Conditions Questionnaire MCQf were applied to identify stroke diagnosis.

Those who replied to have difficulties causing by stroke problems based on the Physical Functioning Questionnaire PFQ AE were also defined to have stroke [ 20 ]. Hypertension and stroke was defined according to the self-reported physician diagnosis of both hypertension and stroke.

No table salt referred to no salt used or added at the table and in food preparation in household. Ordinary salt includes regular iodized salt, sea salt and seasoning salts made with regular salt, indicating using or adding these kinds of salt at the table or while cooking.

Other salt indicated the lite salt or salt substitute at the table or while cooking. Potassium intake were calculated from the in-person h dietary recall interview which was administered by trained interviewers using the USDA automated multiple-pass method [ 21 , 22 ].

All subjects were asked to list all food and beverages consumed in the h period from midnight to midnight on the day before the interview. The FNDDS uses food composition data from the USDA National Nutrient Database or Standard Reference [ 24 ]. At the end of the dietary recall, participants were asked questions about discretionary salt use.

The questions are:. What type of salt do you usually add to food at the table? How often do you add ordinary salt to food at the table? How often is ordinary salt or seasoned salt added in cooking or preparing foods in your household? Another variable including the data on salt use from the NHANES was DR2SKY with the questions of salt used at table yesterday?

Salt includes ordinary or seasoned salt, lite salt, or a salt substitute. and what type of salt was it? Was it ordinary or seasoned salt, lite salt, or a salt substitute? All statistical tests were conducted by two-sided test. The sample data were subjected to a weighted manner to all analyses to account for the cluster sample design, oversampling, poststratification, survey nonresponse and sampling frame, and the weights were taken from sdmvstra, sdmvpsu and wtmec2yr variables in the NHANES database [ 25 ].

The mobile examination center MEC exam weight wtmec2yr variables was applied for weighting. The variable name for the masked variance unit pseudo-stratum was sdmvstra and the variable name for the masked variance unit pseudo-primary sampling units PSUs was sdmvpsu.

The weight of the survey enabled it to be extended to the civilian noninstitutionalized US population. Sampling errors were calculated to determining their statistical reliability [ 26 ].

The non-normal distributed data were expressed by M Q 1 , Q 3 , and differences between groups were compared by the Mann—Whitney U rank sum test. Logistic regression analysis was used to measure the associations of salt types with hypertension and stroke.

The odds ratios ORs and confidence intervals CIs were employed for evaluating the reliability of an estimate.

As for different types of salt intake, three models were established: Crude model: the model without adjustment; Model 1: adjusted for age and gender; Model 2: adjusted for age, gender, race, BMI and PIR. SAS 9. The svydesign and svyglm function in R package survey 4. The detailed data analysis process was presented in Supplementary Fig.

In total, 22, subjects from NHANES between and were involved in this study. Among them, people were aged 20—39 years, accounting for There were The median PIR of all participants was 2. In the study population, There were patients with hypertension, accounting for As for salt used, people used ordinary salt, accounting for Compared with people consuming ordinary salt, the risk of hypertension was 2.

Compared with those with ordinary salt at table, the risk of stroke in ordinary salt group or no table salt group was not statistically different Fig. Forest plot of multivariable analysis of the associations between salt types and hypertension, stroke or hypertension companied with stroke.

In comparison with people with ordinary salt at table, the risk of hypertension and stroke was 4. Post adjusting age and gender, the risk of hypertension and stroke was 3. In the present study, the data of 15, participants were collected from the NHANES database to analyze the associations of salt types added at table with hypertension and stroke.

The result delineated that other salt intake or no table salt might be associated with an increased risk of hypertension. Other salt intake or no table salt might be also associated with an increased risk of hypertension and stroke.

The findings of our study might give a reference for the use of salt at table in preventing the occurrence of hypertension and stroke and improving the prognosis of patients with hypertension or hypertension and stroke.

Several meta-analyses involving randomized controlled trials RCTs revealed that salt substitutes application decreased the systolic blood pressure and diastolic blood pressure in patients with hypertension [ 27 ].

Salt substitute might be an accessible and effective method for reducing the risk of death caused by stroke in patients with hypertension [ 28 ]. In this study, patients with other salt intake lite salt or salt substitute were associated with a higher risk of hypertension or hypertension and stroke.

Some studies have indicated that people may prefer the taste of ordinary salt to salt substitutes and some people do not accept the taste of salt substitutes, so when they use salt substitutes, they might use more amount of salt, which actually resulted in a high sodium intake [ 29 ].

In addition, we found for people with more salt substitutes at table, the potassium intake was lower than those with ordinary salt intake Supplementary Fig. Previous studies have revealed that potassium is an essential nutrient and the addition of a high potassium diet could reduce the blood pressure in people [ 30 , 31 ].

Also, some randomized controlled trials indicated that higher potassium intake could lower the blood pressure in those with hypertension [ 32 ]. Therefore, adequate potassium supplement was recommended in people especially hypertension people. As for people do not add salt product at the table, excessive low salt diet might cause salt-sensitivity hypertension, as long-term low sodium intake might result in the high sensitivity to salt in human body and increased sodium intake might stimulate the secretions of hormones such as epinephrine and angiotensin, which led to hypertension [ 33 ].

Salt-sensitivity hypertension was a potential area requiring validation for further research, as some other researchers indicated that although a high-salt diet might increase the accumulation of sodium, the expansion of volume, and the adjustment of cardiac outputs, the autoregulation might maintain the flow via increasing the systemic vascular resistance, and causing the kidneys to excrete more salt and water, and therefore reducing systems to normal and minimizing the changes in blood pressure [ 34 ].

Another study also depicted that sodium reduction only decreased the blood pressure in participants with a blood pressure in the highest 25th percentile of all population and the author also suggested to reframe the policy of lowering dietary sodium intake in the general population and hypertension patients [ 35 ].

Sodium is main extracellular cation in the body to maintain intravascular volume, which is required in human body and salt restriction in humans may cause some adverse effects [ 36 ]. A previous study also reported that salt-deficient diet promoted cystogenesis in ARPKD via epithelial sodium channel [ 37 ].

Besides, people might intake more sodium rather than eat at table. Nowadays, commercial products infiltrate sodium insensibly into our nutrition and the involuntary sodium intake was high in daily life [ 38 ].

People who used other salt or do not add salt at table might prefer other commercial products with high sodium. The findings of our study suggested that adding ordinary salt at table with appropriate volume is recommended for the prevention of hypertension.

Minus Related Pages. Your body needs a small amount of sodium to work properly, but too much sodium is bad for your health. While sodium has many forms, most sodium we consume is from salt. Most Americans consume too much sodium.

Most sodium comes from processed and restaurant foods. How to Reduce Sodium Intake. Sodium, Potassium and Health. Health Professional Resources.

Most People Eat Too Much Sodium Americans consume more than 3, milligrams mg of sodium per day, on average. Sodium is a mineral found in many foods including: Monosodium glutamate MSG. Sodium bicarbonate baking soda. Sodium nitrate a preservative. View Larger.