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Reducing food salt content - a neglected approach to the hypertension prevention and control

Introduction: High blood pressure is a major cause of cardiovascular disease, responsible for 62% of stroke and 49% of coronary heart disease. There is overwhelming evidence that dietary salt is the major cause of high blood pressure and that a reduction in salt intake lowers blood pressure, thereby, reducing blood pressure-related diseases. Despite that, the large proportion of population still does not take much care about their dietary salt intake. The aim of this study was to identify the amount of dietary salt intake among hypertensive and normo-tensive adult patients from Eastern Croatia, to determine is there difference in dietary salt intake between these two groups and to evaluate the prevalence of uncontrolled blood pressure among hypertensive patients and role of dietary salt intake in that sense. Materials and methods: During June 2010 all together 100 patients that had been cured for hypertension by their chosen family physician were asked to participate in this study on voluntary basis. Response rate was 89.0% (89/100). The main age of this group of patient was 57.5±10.6 (range 38 to 78) years. The control group of patients consist of 71 patients cured for some other reasons in the same family physician office. Response rate for controls was 71.0% (71/100), and their mean age was 53.4±9.4 (range 38 to 77) years. Each participant who agreed to participate in study on voluntary basis had been asked to fill out the specially designed questionnaire that contained questions on gender, age, work status, average monthly income of household, number of members of the household, place of residence, anamnestic data concerning the chronic illnesses and daily used medicines, monthly consumption of salt in household, daily consumption of bread, various bakery products and salty snacks in the household and practice to put extra amount of table salt in the meal before eating. The weight and height of each participant as well as blood pressure were measured. In the Institute of Public Health of Osijek-Baranja County the values of salt content in 23 breads and 42 bakery products from bakery shops in Osijek area were established. Besides that the value of salt content in 31 different salty snacks available in Croatian market was also established. The amount of salt consumed daily through the cooking, consumption of bread, bakery products and salty snacks as well as the overall daily salt consumption for each participant has been calculated. Results: Average daily dietary salt intake among hypertensive adult patients from Eastern Croatia was 8.8±3.4 (range 3.3 to 18.1) grams and among normo-tensive ones 10.2±4.5 (range 4.0 to 24.7) grams. Among hypertensive patients there were 44.9% (40/89) of them with well controlled blood pressure and 55.1% (49/89) of them with uncontrolled blood pressure. The average daily salt intake among hypertensive patients with well controlled blood pressure was 8.3±3.3 (range 3.3 to 16.5) grams and among hypertensive patients with uncontrolled blood pressure was 9.1±3.5 (range 4.1 to 18.1) grams. Discussion and conclusion: The study revealed that average daily salt intake among hypertensive and normo-tensive adult patients from Eastern Croatia is much higher then maximum recommended intake of 6 grams of salt daily. In the milieu of increasing cardiovascular disease worldwide, particularly in low- and middle-income countries, salt reduction is one of the most cost-effective strategies to combat the epidemic of high blood pressure, associated cardiovascular disease and to improve population health in general.

adult population; salt intake; hypertension; prevention; Osijek; Croatia

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