Sodium intake and high blood pressure among adults on caloric restriction: a multi-year cross-sectional analysis of the U.S. Population, 2007-2018

Abstract

Aim: Small studies have shown reduced sodium sensitivity of blood pressure in obese adolescents on caloric restriction. However, no study at the population level has studied such an effect. We aimed to explore the association between mean daily sodium intake and prevalent hypertension among a nationally representative sample of U.S. adults on caloric restriction who participated in the National Health Examination and Nutrition Survey over the last twelve years. Methods and Results: We used a design-based regression model to explore the association between sodium intake and prevalent hypertension. We also conducted sensitivity analyses using multiple imputation chained equations and propensity score matching. We also measured the effect of a binary exposure derived from two widely recommended thresholds of sodium intake: 2.3 and 5.0 grams per day. Among 5,756 individuals, we did not detect any significant association between increased sodium and the odds of hypertension (OR: 0.97; CI 95%: 0.90; 1.05). All our sensitivity analyses are consistent with our main findings. Conclusion: Our findings suggest that people on caloric restriction, a component of healthy weight loss, would see no benefit in reducing sodium intake to lower blood pressure. These results highlight the need to explore new population-specific strategies for sodium intake reduction, including new dietary prescription approaches to improve dietary adherence and reduce the risk associated with sodium-deficient diets.