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Introduction
Hypertension (elevated blood pressure) is a condition that significantly increases the risk of several diseases and is a major cause of premature death worldwide. In the US, recent estimates suggest that about half of the adult population has hypertension.
At a population level, high sodium intake is one of the main dietary risk factors. All population health guidelines recommend keeping sodium intake below certain levels.
While, on average, blood pressure correlates with sodium intake, there is a wide range of responses on an individual level. People who see increasing sodium intake lead to increased blood pressure are termed “salt sensitive”. Others, however, don’t see much change in blood pressure with increased dietary sodium. Such individuals are classed as “salt resistant”.
In this episode, Assistant Professor at Auburn University, Dr. Austin Robinson, is on to discuss whether people who are salt resistant need to keep their sodium intake low or not. And other individual and group differences that exist for hypertension risk and sodium physiology?
Related resources
- Twitter: @AusRob_PhD
- Relevant research:
- Farquhar et al., 2015 – Dietary Sodium and Health: More Than Just Blood Pressure
- Robinson et al., 2019 – The Influence of Dietary Salt Beyond Blood Pressure
- Robinson et al., 2021 – Differential influences of dietary sodium on blood pressure regulation based on race and sex
- Wenner et al., 2018 – Acute NaCl Loading Reveals a Higher Blood Pressure for a Given Serum Sodium Level in African American Compared to Caucasian Adults
- Sigma-related:
- The impact of sodium and blood pressure
- Importance of measurement: 24-hour measures vs. single and spot measures
- Salt sensitivity of blood pressure
- Are salt-resistant people at no risk?
- Effects of sodium beyond blood pressure
- Is sweating during exercise protective against high-salt diets?
- Orthostatic hypotension: Therapeutic use of high-sodium intake
- Racial differences in the blood-pressure response to sodium, and risk of hypertension-related morbidities: Biological and non-biological factors
Guest Information
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Austin Robinson, PhD is an Assistant Professor at Auburn University, where he directs the Neurovascular Physiology (NVP) Laboratory. His research interests focus on the impact of nutrition and physical activity on cardiovascular health and disease. His lab seeks to determine integrative strategies to prevent and treat cardiovascular disease.
Danny Lennon has a master’s degree (MSc.) in Nutritional Sciences from University College Cork, and he is the founder of Sigma Nutrition.
Danny is currently a member of the Advisory Board of the Sports Nutrition Association, the global regulatory body responsible for the standardisation of best practice in the sports nutrition profession.
Introduction to this Episode
Hypertension (elevated blood pressure) is a condition that significantly increases the risk of several diseases and is a major cause of premature death worldwide. In the US, recent estimates suggest that about half of the adult population has hypertension. At a population level, high sodium intake is one of the main dietary risk factors. All population health guidelines recommend keeping sodium intake below certain levels.
While, on average, blood pressure correlates with sodium intake, there is a wide range of responses on an individual level. People who see increasing sodium intake lead to increased blood pressure are termed “salt sensitive”. Others, however, donʼt see much change in blood pressure with increased dietary sodium. Such individuals are classed as “salt resistant”.
In this episode, Assistant Professor at Auburn University, Dr. Austin Robinson, is on to discuss whether people who are salt resistant need to keep their sodium intake low or not. And other individual and group differences that exist for hypertension risk and sodium physiology?
Connection to Previous Episodes
#451: Potassium & Blood Pressure
- Findings of a 2021 study are suggestive that the association between potassium consumption and both systolic blood pressure and CVD risk is sex-specific.
- An inverse relation between potassium intake and SBP was only present in women within the highest tertile of sodium intake
- However, there were some important limitations of this study. For example, only one random spot urine sample was collected for estimation of 24-h excretion of sodium and potassium.
- Potassium can moderate the effect of sodium on BP and CVD, but not abolish an effect
- Stratifying by higher/lower potassium and higher/lower sodium, it seems higher potassium has a large benefit at lower sodium intakes, but at higher sodium intakes, people are still remaining at high risk even when potassium is high
#415: Prof. Bruce Neal – Can Salt Substitutes Reduce Cardiac Events & Death?
- (29.45 – 34.25): Prof. Neal addresses the claims that the BP lowering (and CV) effect is solely down to potassium, and not sodium BP reduction in SSaSS was likely due to a combination of sodium lowering and increasing potassium intake (baseline potassium was low)
- The reductions in CV could be for a variety of mechanisms BUT it still most likely that the majority of benefit is directly due to BP lowering
#316: Michael Grandner, PhD – Societal, Social & Psychological Influences on Sleep
- As discussed towards the end of the conversation with Dr. Robinson, there are many aspects related to social, economic and racial factors that can indireclty influence risk through affecting things like sleep.
- The work of Dr. Michael Grandner was brought up as an example. Dr. Grander was on the podcast in episode 316 where he discussed research looking at how:
- Sleep duration and quality are influenced by factors at the individual level, which is embedded within a social level, which itself is embedded within a societal level
- How racial discrimination influences sleep
- Significant sleep health disparities exist in the population