Salt and potassium in cardiovascular diseases

Salt (sodium)

Diet also plays an important role in the prevention and treatment of high blood pressure. Numerous studies document that a diet rich in salt is associated with an increase in cardiovascular mortality.

The available evidence indicates that people who consume more fruits and vegetables have a lower prevalence of hypertension and other cardiovascular risk factors such as obesity and type 2 diabetes. The DASH study has shown that a modification of the eating pattern, increasing the intake of fruits , vegetables, blue fish, whole grains and nuts, and by reducing fat, red meat and sweets, it is able to lower blood pressure in normotensive patients and in a similar way to that achieved with medication. The health benefits of this DASH-type diet could be attributed to its richness in calcium, potassium and also to the high content of phytochemical compounds (flavonoids, beta-carotenes, lycopene, phytosterols, etc.) provided by its richness in fruits and vegetables.

Decreasing the intake of salt (sodium) in the diet improves blood pressure levels in hypertensive people, reduces the use of medication in hypertensive people, and prevents the onset of hypertension in people at high risk of presenting it. Removing the salt shaker from the table can lower blood pressure by 2-8 mmHg. There is genetic variability in the response to dietary salt that causes approximately 50% of the population to respond to salt restriction, while the other part of the population respond worse or not.

The sources of sodium come from common salt (salt shaker), from foods to which salt has been added (salted fish, brines, olives), from sparkling mineral waters, from some medications, and from food additives added by the industry food. During food processing, ingredients (additives) can be added to improve its taste and help preserve it. Additives are found in precooked foods ready for immediate consumption, concentrated soups and cubes to prepare broth, but also in other foods apparently little related to an additional contribution of sodium to the diet such as candies, pastries, ice cream, gum. chew, nougat, cookies and marzipan.

The recommendations in hypertensive individuals and in non-hypertensive individuals but at risk of having it as diabetics and obese are the following:

• Moderation of salt in all hypertensive patients undergoing treatment with pills for hypertension because, in general, the drugs lose some of their effectiveness when the patient ingests an excess of salt.
• Limit the amount of salt added in cooking processes.
• Avoid or limit foods with a high amount of sodium: salted fish, brines, preserves, olives, salty snacks, precooked foods, carbonated waters, cured cheeses, cold cuts, etc.
• Read the labels of packaged foods. Low sodium are those that contain less than 140 mg of sodium (6 mEq) per serving.
• Use other flavor enhancers as substitutes for salt in food preparation: vinegar, lemon, garlic, onions, spices or aromatic herbs.
• Do not drink sparkling mineral waters and monitor the composition of the others.

Potassium salts can be used, but they should also be used with caution because, although they contain 50% less sodium, they still provide sodium and should not be used when the patient is being treated with potassium-sparing diuretic drugs and drugs. angiotensin converting enzyme (ACE) inhibitors.

The benefits derived from these measures will depend on their long-term compliance. Very severe restrictions are rarely observed, so, as a general rule, do not restrict but moderate the consumption of salt.

Potassium

As discussed earlier when discussing the DASH-type diet, consuming potassium lowers blood pressure. Therefore, other measures aimed at regulating blood pressure control are the increase in ingested potassium, although the preferable strategy is to increase the consumption of foods rich in potassium (fruits and vegetables) and not the use of potassium supplements.