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Effects of a low-salt diet on flow-mediated dilatation in humans^1,2,3

¹ From CSIRO Human Nutrition, Adelaide, South Australia, Australia (KMD, JBK, and PMC), and the Department of Nutrition & Dietetics, Flinders University, South Australia, Australia (KMD).

² Supported by CSIRO–Human Nutrition.

³ Reprints not available. Address correspondence to JB Keogh, CSIRO–Human Nutrition, PO Box 10041 BC, Adelaide, South Australia 5000. E-mail: jennifer.keogh{at}csiro.au.

ABSTRACT

Background: The effect of salt reduction on vascular function, assessed by brachial artery flow-mediated-dilatation (FMD), is unknown.

Objective: Our aim was to compare the effects of a low-salt (LS; 50 mmol Na/d) with those of a usual-salt (US; 150 mmol Na/d) diet on FMD.

Design: This was a randomized crossover design in which 29 overweight and obese normotensive men and women followed an LS diet (50 mmol Na/d) and a US diet (150 mmol Na/d) for 2 wk. Both diets had similar potassium and saturated fat contents and were designed to ensure weight stability. After each intervention, FMD, pulse wave velocity, augmentation index, and blood pressure were measured.

Results: FMD was significantly greater (P = 0.001) with the LS diet (4.89 ± 2.42%) than with the US diet (3.37 ± 2.10%), systolic blood pressure was significantly (P = 0.02) lower with the LS diet (112 ± 11 mm Hg) than with the US diet (117 ± 13 mm Hg), and 24-h sodium excretion was significantly lower (P = 0.0001) with the LS diet (64.1 ± 41.3 mmol) than with the US diet (156.3 ± 56.7 mmol). There was no correlation between change in FMD and change in 24-h sodium excretion or change in blood pressure. No significant changes in augmentation index or pulse wave velocity were observed.

Conclusions: Salt reduction improves endothelium-dependant vasodilation in normotensive subjects independently of the changes in measured resting clinic blood pressure. These findings suggest additional cardioprotective effects of salt reduction beyond blood pressure reduction. The trial is registered with the Australian and New Zealand Clinical Trials Registry (unique identifier: ANZCTR12607000381482; http://www.anzctr.org.au/trial_view.aspx?ID=82159).

Received for publication August 20, 2008. Accepted for publication November 14, 2008.

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