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Throughout the Department out-of Epidemiology, Company out of Medication (Meters.An effective.M., T.G., Yards.M.) and Department regarding Diet and you can Integrative Structure (P.Yards.G.), School of Utah, Salt Lake City; Company of Medication, Nyc School College or university from Medicine (J.M.B.); Welch Cardio for Prevention, Epidemiology and Logical Search, Johns Hopkins University, Baltimore, MD (L.J.A beneficial.); and Department out-of Biostatistical Sciences, Wake Forest School from Treatments, Winston-Salem, NC (J.A great.T.).
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Regarding the Division from Epidemiology, Agency out of Treatments (Meters.An excellent.M., T.Grams., Yards.M.) and Institution from Nourishment and you may Integrative Anatomy (P.Meters.G.), College regarding Utah, Salt River Urban area; Company away from Medication, Nyc College or university College out-of Drug (J.Yards.B.); Welch Cardio to have Reduction, Epidemiology and you may Medical Search, Johns Hopkins University, Baltimore, MD (L.J.An excellent.); and you can Institution regarding Biostatistical Sciences, Aftermath Tree College of Medicine, Winston-Salem, NC (J.A.T.).
Conceptual
Dietary Na recommendations are expressed as absolute amounts (mg/d) rather than as Na density (mg/kcal). Our objective was to determine whether the strength of the relationship of Na intake with blood pressure (BP) varied with energy intake. The DASH (Dietary Approaches to Stop Hypertension)–Sodium trial was a randomized feeding trial comparing 2 diets (DASH and control) and 3 levels of Na density. Participants with pre- or stage 1 hypertension consumed diets for 30 days in random order; energy intake was controlled to maintain body weight. This secondary analysis of 379 non-Hispanic black and white participants used mixed-effects models to assess the association of Na and energy intakes with BP. The relationships between absolute Na and both systolic and diastolic BP varied with energy intake. BP rose more steeply with increasing Na at lower energy intake than at higher energy intake (P interaction<0.001). On the control diet with 2300 mg Na, both systolic and diastolic BP were higher (3.0 mm Hg; 95% confidence interval, 0.2–5.8; and 2.7 mm Hg; 95% confidence interval, 1.0–4.5, respectively) among those with lower energy intake (higher Na density) than among those with higher energy intake (lower Na density). The association of Na with systolic BP was stronger at lower levels of energy intake in both blacks and whites (P<0.001). The association of Na and diastolic BP varied with energy intake only among blacks (P=0.001). Sodium density should be considered as a metric for expressing dietary Na recommendations.