Academic journal article Journal of Health Population and Nutrition

Sodium and Potassium Intake of Urban Dwellers: Nothing Changed in Yazd, Iran

Academic journal article Journal of Health Population and Nutrition

Sodium and Potassium Intake of Urban Dwellers: Nothing Changed in Yazd, Iran

Article excerpt


High blood pressure is one of the major established risk factors of cardiovascular and cerebrovascular diseases, including coronary heart disease and stroke. Sodium ion from salt (NaCl) has been proven to be a major determinant of high blood pressure (1).

Genetical susceptibility, dietary habits, environment, and lifestyle are the most important predictors of sodium intake (2). There is a strong body of evidence that supports the association between daily sodium intake in the form of salt consumption and hypertension (1,3,4). Furthermore, high sodium intake increases left ventricular muscle mass, wall thickness of vessels and increases the rate of stroke and heart failure, independent of hypertension (4).

The Intersalt Study investigated the relationship between sodium and hypertension in 52 people in 32 countries. The study showed a strong positive relationship between systolic and diastolic blood pressure and urinary sodium excretion (5).

Primary prevention is a vital long-term goal of public health. There are substantial benefits from even modest reductions of blood pressure from reducing salt intake (6). Dietary intervention trials demonstrated a significant result from reducing salt intake and increasing consumption of fruit and vegetables and non-dairy products. Additionally, a pilot programme in Nigeria has shown that good adherence to reducing sodium correlated with modest lowering of blood pressure despite the low baseline level (7).

Moreover, multiple interventional studies have demonstrated that reducing daily salt intake can reduce blood pressure (8). Evidence from randomized controlled trials, such as the DASH study, showed that reduction in sodium intake can decrease blood pressure in hypertensive individuals and, to a lesser extent, in normotensives. Limiting sodium intake to 67 mmol/day can reduce systolic and diastolic blood pressure by 5.8 and 2.5 mmHg respectively (3).

Reduction in sodium intake can be an effective public health intervention at the population level. A 2 mmHg reduction of mean blood pressure in general population can reduce mortality from cardiovascular diseases by 17% (9). Evidence shows that a 3 g/day decrease in the daily salt intake resulted in 13% decline in stroke-related mortality and 10% decline in ischaemic heart disease-related mortality (10).

Although the relationship between salt intake and blood pressure is linear, i.e. the lesser the intake the better, a general recommendation is to limit salt intake to 4.5-6 g/day (10). Eating more fresh fruits and vegetables and homemade foods instead of canned foods and fast foods are the core recommendations to reduce sodium intake (11).

The prevalence of hypertension according to the new criteria (>140/90 mmHg) varies across different regions of Iran between 15% and 35% in urban adult populations (12-14). This is similar to the prevalence of disease in other parts of Asia (15).

Recent hospital-based studies from Iran reported high consumption of salty food by almost 25% of patients with ischaemic heart disease in urban areas (16). After the study published by Page et al. in 1981 (17), little is known about the sodium and potassium intake in central Iran at the population level based on the objective method of 24-hour urine collection. This study aims to assess the daily salt intake by people aged 20-74 years according to the 24-hour urinary sodium execration in urban population of Yazd in central Iran.


This observational study was a substudy of Yazd Healthy Heart Project. From autumn 2004 to summer 2005, two thousand people from the urban population of Yazd city, aged 20-74 years, were enrolled in the main study based on cluster random sampling. Sample frame was the household numbers according to the database of Yazd City Health Services.

Yazd is located in central Iran, with over one million population. …

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