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Determination of discretionary salt intake in an iodine deficient area of East Java-Indonesia using three different methods.

As salt is a potential vehicle for delivering iodine to a population, study on salt intake is important. Many methods have been used to measure iodised-salt intake, but the methods were suspected to be inaccurate. A new method, called a lithium-marker technique, has been considered as suitable and safe; hence it has been proposed as a gold standard for measuring the actual salt intake of an individual. We conducted a study to determine discretionary salt intake using the lithium marker technique. The study shows that the total salt intake for children (N = 15) and mothers (N = 15) were 5.4+/-2.1 g/d and 5.8+/-1.7 g/d respectively in which 48.5+/-17.1% and 50.5?17.3% were discretionary salt. The discretionary salt intake measured using lithium marker (2.53 +/- 1.2 g/d for children and 2.99 +/- 1.5 g/d for mother) were significantly lower than using 24-hour salt recall (7.01+/-2.44 g/cap/d) and salt weighing (6.00+/-1.8 g/cap/d) (p<0.001). In conclusion, the discretionary salt intake by 24-hour salt recall and salt weighing were over estimated as compared to the lithium-labelled salt measurement. It is recommended that the level of iodine fortification in salt be increased up to 80-100 ppm of KIO3 to provide iodine intake of 150 microg/d.

Adult↗

Chronic dietary salt loading: resetting of tubuloglomerular feedback control of renal hemodynamics by an adrenal hormone.

Experiments were performed in chronically salt loaded rats (4 g% NaCl diet for 2 weeks) to determine whether the resetting of tubuloglomerular feedback (TGF) by a humoral inhibitor in tubular fluid is caused by a humoral factor from the adrenal glands. TGF response was assessed by measuring NGFR in the absence of loop of Henle perfusion and during perfusion at 40 nl/min with tubular fluid from normal or salt loaded rats and expressed as NGFR40/NGFR0. (1) Loop of Henle perfusion with tubular fluid from normal rats elicited a TGF response of 50.3% +/- 7.9% (mean +/- SEM) in normal rats and 57.2% +/- 7.9% in salt loaded rats. With tubular fluid from high salt rats, TGF response in normal rats was 97.4% +/- 6.3% and in salt loaded rats 98.0% +/- 1.6%. Participation of adrenal steroids in the inhibition is suggested by the following results: (2) Acute adrenalectomy (ADX) in high salt rats abolished the TGF inhibitory potency of high salt tubular fluid. TGF response in salt loaded rats with high salt tubular fluid from high salt ADX rats was 62.3% +/- 3.0%. Substitution of high salt ADX rats with matching adrenal venous blood from high salt rats restored TGF inhibition. (3) With cross over experiments the effect of heterologous adrenal venous blood substitution on TGF inhibitory activity was studied. The TGF response in high salt rats with high salt tubular fluid and tubular fluid from normal ADX rats substituted with adrenal venous blood collected from high salt rats was 88.9% +/- 5.5% and 91.7% +/- 6.0%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Cortex Hormones↗

[A study on the relationship of taste-sensitivity to salt-restriction in adults].

A survey of the extent of the practice of salt-restriction, duration of such salt restriction, and the ability to discriminate between different degrees of salt content, was performed in a town located in Tottori prefecture Subjects were 20 families (55 persons) where both parents and their adult children had a previous history of hypertension, 38 families (111 persons) where either or both parents had a previous history of hypertension, and 33 families (99 persons) where both parents and their adult children had no history of hypertension. Sensitivity to salt-taste and the relation between the practice of salt-restriction and sensitivity to salt-taste were analyzed. The results are summarized as follows: 1. For persons with histories of hypertension current practice of salt-restriction was significantly greater degree of preference for salt-taste was lower, and the duration of salt-restriction period was longer than those persons without a history of hypertension. 2. Families where both parents and their adult children had histories of hypertension had the highest percentage of these practicing salt-restriction and the largest representation of those who practiced it for a long duration. 3. Those who restricted salt use for a long time also showed a low preference for salt-taste. 4. The sensitivity to salt-taste was much higher in persons who had histories of hypertension than others. 5. Sensitivity to salt-taste was much higher in families where both parents and their adult children had histories of hypertension than others. 6. In families where both parents and adult children had histories of hypertension, significant relationship were observed between parents and their adult children and between husbands and wives in sensitivity to salt-taste.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Correlation of left ventricular hypertrophy and its regression by lisinopril with salt-induced hypertension.

The interaction of salt with hypertension-induced left ventricular hypertrophy and its reversal by inhibition of angiotensin converting enzyme were studied in salt sensitive and salt resistant Dahl rats. Eight-week-old rats were fed either a low or high salt diet for three weeks. The colonies were then further divided and either treated with lisinopril or given no treatment for 11 weeks. Untreated salt sensitive rats had higher blood pressures than salt resistant animals. Left ventricular weight and wall thickness in both untreated salt sensitive groups was higher than in the resistant groups. Therapy lowered blood pressures in all groups but those of the high salt group remained higher than the low salt group. Reduction of left ventricular weight and wall thickness took place in either strain only when salt intake was low. Right ventricular and atrial weights were largely unaffected either by salt intake or drug therapy. Plasma renin activity increased and aldosterone levels decreased with lisinopril therapy in all groups except the salt sensitive, high salt group where both remained unchanged at low levels. Lisinopril was effective in reducing blood pressure and left ventricular hypertrophy, but both effects were severely impaired by high salt intake. The major determinant of left ventricular hypertrophy appeared to be afterload, as shown by a good correlation between left ventricular mass and systolic blood pressure, but there was some indication of a possible independent hypertrophic action of salt.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiotensin-Converting Enzyme Inhibitors↗

Evaluation of protein and peptide hydrolases in DOCA-salt hypertensive rat treated with chlorthalidone.

We have reported that chlorthalidone (Chlor) prevents the development of heart hypertrophy in deoxycorticosterone acetate (DOCA)-salt hypertensive rats. The present study was carried out to determine whether Chlor (8 mg/day per animal, added to the food, for 20 days) affects kidney and heart hypertrophy in DOCA-salt (8 mg/kg, sc, twice a week) rats by causing alterations in protein and peptide hydrolysis. Heart (left ventricle) and kidney enzyme activities were measured in tissue homogenates from normal-control, salt-control, DOCA-salt and DOCA-salt-Chlor male Wistar rats (N = 6 for each group), using azocasein as the substrate for proteolytic enzymes and specific peptides for prolylendopeptidase (PEP) and multicatalytic proteinase (MCP). The tissue weight/body weight ratio increased in parallel to elevation of blood pressure. The left ventricular muscle hypertrophy (26%, P < 0.05) present in the DOCA-salt hypertensive group was completely prevented by simultaneous Chlor treatment. Chlor treatment did not change the kidney hypertrophy (+79%, P < 0.;05) observed in the salt-control (+57%, P < 0.05) and DOCA-salt (+74%, P < 0.05) groups. The hydrolysis of peptides by PEP and MCP was similar in the normal and salt-control groups. The heart PEP activity was 24% higher (P < 0.01) in DOCA-salt rats, whereas MCP activity was not different when compared to control groups. DOCA-salt treatment increased MCP activity in the kidney by 44% while PEP activity did not differ from that of control groups. The hydrolysis of proteins by heart enzymes was increased by salt by 47%. Chlor treatment restored the reduction in protein hydrolysis induced by DOCA-salt (a 21% decrease, P < 0.05) to a level similar to that of the normal-control group. Similarly, Chlor coadministration prevented the 30% reduction in renal proteolytic activity elicited by DOCA-salt treatment. Although Chlor treatment prevented the DOCA-salt-induced reduction in protein hydrolysis, this response did not interfere with kidney hypertrophy. The mechanism by which hypertension produces hypertrophy is unclear, but our results suggest that this structural modification is not related to the activities of some peptidases, e.g. protein and peptide hydrolases.

Animals↗

The influence of kosmotropic and chaotropic salts on the functional properties of Mucuna pruriens protein isolate.

The influence of chaotropic and kosmotropic salts on Mucuna pruriens protein isolates was investigated. Protein solubility profile indicated that solubility was minimal at the isoelectric point of the protein isolate (4.0) while the solubility was maximal at pH 10.0 in all salt solutions. Chaotropes (I(-), ClO(4)(-) and SCN(-)) exhibit better protein solubility than the kosmotropes (SO(4)(2-), Cl(-) and Br(-)). Increase in protein solubility follows the Hofmeister series: NaSO(4)<NaCl<NaBr<NaI<NaClO(4)<NaSCN. Maximal water absorption capacity was recorded at low concentration of all the salts (0.1M). The water absorption capacity reduced as the concentration of the salts was increased to 2.0M. Kosmotropic salts exhibited better water absorption capacity than chaotropic salts. Both foaming capacity and stability were better in chaotropic salts compared with kosmotopic salts. Maximal foam capacities and stability were observed in protein solutions at 0.1M concentration. However the foam capacity and stability decreased as the concentration was increased further to 2.0M. The result indicates that emulsion activity index (EAI) and emulsion stability index (ESI) was reduced as the concentration of salts in each protein solution was increased. Protein solutions which contained NaSCN exhibited the highest emulsifying properties while those in Na(2)SO(4) recorded the lowest emulsifying properties. In addition, chaotropic salts had better emulsifying properties compared with kosmotropic salts. Increase in emulsifying activity follows the Hofmeister series. The least gelation concentration increased as the concentration of the salts increased. However chaotropic salts exhibited better gelation properties than kosmotropic salts.

Emulsions↗

Neural circuits mediating latent learning and conditioning for salt in the rat.

Male Long-Evans rats alternately drank a salt solution in one distinctive compartment of a conditioned cue preference (CCP) apparatus and water in a different compartment over 8 days (training trials) and were then given a choice between the two compartments with no solutions present (test trial). Rats that were water deprived during training, then salt+water deprived during testing, spent more time in their salt-paired compartments, a salt latent cue preference (LCP). Rats that were water-only deprived during training and testing spent more time in their water-paired compartments, a water CCP. Rats that were salt+water deprived during both training and testing spent more time in their salt-paired compartments, a salt CCP. Bilateral, pre-training lesions of the lateral amygdala impaired the water and salt CCPs but not the salt LCP, reflecting the role of the amygdala in Pavlovian conditioning. Lesions of the dorsal or ventral hippocampus impaired the salt LCP and the water and salt CCPs, possibly reflecting the role of the hippocampus in contextual learning. Lesions of the fimbria-fornix impaired the water and salt CCPs but not the salt LCP, while lesions of the entorhinal cortex impaired the salt LCP but not the CCPs. This suggests that the LCP depends on a circuit that includes dorsal and ventral hippocampus and entorhinal cortex, a major conduit of sensory information from the cortex. In contrast, the CCPs depend on the amygdala and a circuit that includes the hippocampus and fimbria-fornix, possibly as a conduit of motivational information from subcortical structures.

Amygdala↗

Cardiovascular effects of dietary salts and isosorbide-5-mononitrate in spontaneously hypertensive rats.

The influence of isosorbide-5-mononitrate (IS-5-MN) on the cardiovascular effects of high dietary salt intake (NaCl, 6.6% of dry weight of food) and that of a potassium, magnesium and l-lysine-enriched salt alternative (Pansalt 10.5%, producing a 6.6% content of NaCl) was studied in spontaneously hypertensive rats in an 8-week experiment. Common salt produced a marked rise in blood pressure and induced cardiac and renal hypertrophy, while the salt alternative, although containing the same amount of NaCl, neither increased blood pressure nor caused any significant cardiac hypertrophy. IS-5-MN treatment at a daily dose of approximately 60-70 mg/kg (mixed with food) attenuated the rise in blood pressure induced by common salt, but did not prevent the cardiac or renal hypertrophy. IS-5-MN did not offer any additional benefit to the use of the salt alternative diet alone in treatment of high blood pressure. Mesenteric arterial responses in vitro were examined at the end of the study. IS-5-MN treatment during the moderately low-salt (NaCl 0.7%) control diet tended to decrease the contractile response to noradrenaline and increase the relaxation to acetylcholine. Common salt, but not the salt alternative, induced a 50% increase in the 24-h urinary excretion of cyclic GMP. Both salt supplements induced an 8-9-fold increase in the excretion of calcium, and about a 2-fold increase in the excretion of phosphorus. Common salt also increased the excretion of magnesium by 50%. IS-5-MN treatment had no significant effect on the excretion of the mineral elements. Our findings show that increased intake of potassium and magnesium reduces the harmful effects of common salt. Pressure-independent mechanisms are involved in salt-induced left ventricular and renal hypertrophy, since they remained unaffected despite the prevention of the salt-induced rise in blood pressure by IS-5-MN treatment.

Animals↗

Taurocholate is more potent than cholate in suppression of bile salt synthesis in the rat.

Synthesis of bile salts is regulated through negative feedback inhibition by bile salts returning to the liver. Individual bile salts have not been distinguished with regard to inhibitory potential. We assessed inhibition of bile salt synthesis by either cholate or its taurine conjugate in bile fistula rats. After allowing synthesis to maximize, baseline synthesis was determined by measuring bile salt output in four consecutive 6-hr periods. Next, sodium cholate (+[(14)C]cholate) or taurocholate (+[(14)C]taurocholate) was infused into the jugular vein for 36 hr and bile was collected in 6-hr aliquots. Hepatic flux of exogenous bile salt was determined by measuring output of radioactivity in bile divided by specific activity of the infusate. Synthesis was determined during the last four 6-hr periods of infusion by subtracting exogenous bile salt secretion from the total bile salt output. Thirteen studies using cholate and 13 using taurocholate were performed. Hepatic flux of infused bile salt varied from 1 to 12 micro mol/100 g per rat per hr. Percent suppression of synthesis varied directly with hepatic flux of exogenous bile salt for both cholate and taurocholate in a linear fashion (r = 0.66, P < 0.01 and r = 0.87, P < 0.0005, respectively). Slope of the taurocholate line was 7.82 (% suppression/ micro mol per 100 g per hr), while slope of the cholate line was 3.66 (P < 0.05), indicating that taurocholate was approximately twice as potent as cholate in suppression of synthesis. At fluxes of 10-12 micro mol/100 g per hr, taurocholate suppressed synthesis 84 +/- 8 (SEM) % while cholate suppressed synthesis only 42 +/- 12% (P < 0.02). The x-intercept of the taurocholate line was 0.65 ( micro mol/100 g per hr), while that of the cholate line was -1.01 (NS) suggesting that the threshold for initial suppression of synthesis did not differ for these two bile salts. We conclude that taurocholate is a more effective inhibitor of hepatic bile salt synthesis than cholate, and that intestinal deconjugation of bile salts may play a role in the regulation of synthesis.-Pries, J. M., A. Gustafson, D. Wiegand, and W. C. Duane. Taurocholate is more potent than cholate in suppression of bile salt synthesis in the rat.

Animals↗

The hydrophobic-hydrophilic balance of bile salts. Inverse correlation between reverse-phase high performance liquid chromatographic mobilities and micellar cholesterol-solubilizing capacities.

To examine quantitatively the hydrophobic-hydrophilic properties of bile salts, we determined the reverse-phase high performance liquid chromatographic (HPLC) mobilities of monomeric bile salt solutions and the equilibrium cholesterol-solubilizing capacities of 100 mM micellar solutions. Studies with the common bile salts (ursodeoxycholate, UDC, cholate, C, chenodeoxycholate, CDC, and deoxycholate, DC) demonstrated that HPLC mobility, which correlates with hydrophilicity, was markedly influenced by both position and orientation, in addition to number, of hydroxyl functions, in that mobility decreased in the order UDC > C > CDC > DC. Conjugation of the bile salt was also important, in that the HPLC mobility of the taurine (T)-conjugates was greater than the glycine (G)-conjugates which in turn was greater than that of the free bile salts. Equilibrium micellar cholesterol solubilities were also influenced by bile salt structure and correlated inversely with hydrophilicity, in that solubility decreased in the order DC > CDC > C > UDC with free bile salts > G-conjugates > T conjugates. For each bile salt series, double logarithmic plots of the cholesterol-solubilizing capacities expressed in mole fraction units versus the HPLC retention factors (k') gave linear relationships. Linear regression equations were employed to predict the equilibrium cholesterol-solubilizing capacities of a number of less common bile salts from their HPLC retention factors. Each theoretical value agreed closely with that derived entirely by experiment. A comparison of the HPLC mobilities of the less common bile salts with the more common species revealed that not only were sulfate and oxo substituents more hydrophilic than alpha-oriented hydroxyl functions, but, in the dihydroxy species, a single equatorial hydroxyl function such as in UDC (3alpha,7beta) and in hyodeoxycholate (3alpha,6alpha) was more hydrophilic than two or three hydroxyl functions at 3, 7, and/or 12alpha (axial) positions. These studies taken together suggest that reverse-phase HPLC mobility and equilibrium cholesterol-solubilizing capacities are inverse functions of each other and correlate closely with the hydrophilicity of bile salt molecules. In addition, the evidence here deduced further strengthens our recent deductions based on an evaluation of a number of other physical-chemical properties (Carey, M. C., J-C. Montet, M. C. Phillips, M. J. Armstrong, and N. A. Mazer, 1981. Biochemistry. 20: 3637-3648.) that cholesterol may be solubilized in micellar bile salt solutions by both hydrophobic and hydrophilic association with the external ("hydrophilic") surface of bile salt micelles rather than with the hydrophobic surface of the micelle's interior.-Armstrong, M. J., and M. C. Carey. The hydrophobic-hydrophilic balance of bile salts. Inverse correlation between reverse-phase high performance liquid chromatographic mobilities and micellar cholesterol-solubilizing capacities.

Bile Acids and Salts↗

Distribution of mixtures of bile salt taurine conjugates between lecithin-cholesterol vesicles and aqueous media: an empirical model.

Bile salts are surfactants that partition into phospholipid bilayers. When liposomes or membranes are exposed to mixed solutions of bile salts, the more hydrophobic bile salt species associate preferentially with the lipid bilayer. As a consequence, in the aqueous phase, the free monomeric concentration of bile salt declines and the more hydrophilic species become relatively enriched. Above a critical saturating concentration of lecithin-associated bile salt, a phase transition occurs with loss of membrane integrity and formation of mixed micelles. In this paper we present a quantitative model which, for mixed solutions of bile salt taurine conjugates, predicts the distribution of bile salt monomers between large unilamellar vesicles composed of lecithin and cholesterol and the aqueous phase. The model is based on association isotherms for individual bile salts, determined by an ultrafiltration method with empirical curve fitting, and is critically dependent upon the observation that association coefficients of each bile salt are a function of the total bound bile salt/lecithin mole ratio. Given the concentrations of individual bile salts, lecithin and cholesterol, the model permits calculation of the membrane-bound bile salt/lecithin ratio and the concentration of each bile salt remaining free as soluble monomer in the aqueous phase, as well as the overall hydrophilic-hydrophobic balance (hydrophobicity index) of the bile salts remaining free in aqueous solution. Distribution data determined empirically for a variety of mixtures of bile salt taurine conjugates and large unilamellar vesicles of varying cholesterol:lecithin ratio agree closely with predictions. This model may be of value in predicting the physical, biological and toxic properties of mixed bile salt solutions.

Animals↗

Dietary salt reduction or exclusion for allergic asthma.

BACKGROUND: There is a wide geographical variation in asthma prevalence and one explanation may be in dietary salt consumption. OBJECTIVES: To assess the effect of dietary sodium reduction in patients with asthma. SEARCH STRATEGY: A search was conducted using the Cochrane Airways Group asthma register. Bibliographies of included randomised controlled trials (RCTs) were searched for additional studies. Authors of identified RCTs were contacted for other studies. The most recent search was carried out in February 2004. SELECTION CRITERIA: All studies were to be RCTs that involved dietary salt reduction or increased salt intake in patients with asthma. Studies of other allergic conditions such as hay fever, allergic rhinitis and eczema were considered patients with asthma were separately identified. DATA COLLECTION AND ANALYSIS: Study quality was assessed and data extracted by two reviewers. All data analysis was conducted using the Cochrane Collaboration software (RevMan). MAIN RESULTS: Six RCTs were included in this review. All studies were small size and of short duration. Data from only four studies could be pooled. Low sodium diet was associated with a significantly lower urine sodium excretion than normal or high salt diets. There were no significant differences in any asthma outcome between low salt and normal or high salt diets, however the confidence intervals were wide. FEV(1) with low salt compared to normal diet showed a WMD 0.09 L with a 95% confidence interval (95%CI) -0.19 L to 0.38 L, and compared to a high salt diet WMD 0.18 L; 95%CI -0.11 L to 0.48 L. Daily PEFR was also non-significantly higher with low salt diet compared to normal (WMD 19.52 L/min; 95% CI -21.22 to 60.25) and high salt diet (WMD 7.57 L/min; 95% CI -37.52 to 52.67). Reliever bronchodilator with the low salt diet when compared to both the normal and high salt diets showed WMD -0.07 puffs/day; 95%CI -0.94 to 0.81 & WMD -0.65 puffs/day; 95%CI -1.75 to 0.45, respectively. REVIEWERS' CONCLUSIONS: Based on currently available evidence it is not possible to conclude whether dietary salt reduction has any place in the treatment or management of asthma. The results of this review do indicate an improvement in pulmonary function with low salt diet, however further large scales trials are required before any firm conclusions can be reach.

Asthma↗

Regulation of bile salt sulfotransferase isoenzymes by gonadal hormones.

We studied the regulation of hepatic bile salt sulfotransferase activity by gonadal hormones and the effect of gonadal hormones on two bile salt sulfotransferase isoenzymes. Bile salt sulfotransferase enzyme activity was three times greater in the female than in the male rats. Oophorectomy significantly decreased bile salt sulfotransferase activity in the female, but orchidectomy had no effect on bile salt sulfotransferase activity in the male. Estrogen treatment of intact as well as orchidectomized males markedly stimulated the enzyme activity, while testosterone treatment of intact or oophorectomized females did not effect bile salt sulfotransferase activity. We concluded that the 3-fold greater activity in female rats is due to the striking stimulatory effect of estrogen on bile salt sulfotransferase activity, and the testosterone has little or no role in the sexually related differences in bile salt sulfotransferase activity in mature rats. These sex-related differences in bile salt sulfotransferase activity were investigated further using DEAE-Sephadex A50 ion-exchange chromatography of rat hepatic cytosol. Two bile salt sulfotransferase isoenzymes were identified both with an approximate molecular weight of 130,000. Bile salt sulfotransferase I eluted with 0.05 M NaCl, had an isoelectric point at pH 6.8, was stimulated by estrogen, and was responsible for 90% of total bile salt sulfotransferase activity in the mature female. Bile salt sulfotransferase II eluted with 0.14 M NaCl, had an isoelectric point at pH 5.3, was unresponsive to estrogen, and accounted for 75 to 80% of bile salt sulfotransferase activity in the mature male.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

The Significance of Interfacial Water Structure in Soluble Salt Flotation Systems.

Flotation of soluble salts with dodecyl amine hydrochloride (DAH) and sodium dodecyl sulfate (SDS) collectors has demonstrated that the interfacial water structure and hydration states of soluble salt surfaces together with the precipitation tendency of the corresponding collector salts are of considerable importance in explaining their flotation behavior. In particular, the high concentration of ions in these soluble salt brines and their hydration appear to modify the bulk and interfacial structure of water as revealed by contact angle measurements and this effect is shown to be an important feature in the flotation chemistry of soluble salt minerals including alkali halide and alkali oxyanion salts. Depending on characteristic chemical features (salt type), the salt can serve either as a structure maker, in which intermolecular hydrogen bonding between water molecules is facilitated, or as a structure breaker, in which intermolecular hydrogen bonding between water molecules is disrupted. For structure making salts the brine completely wets the salt surface and no contact angle can be measured. For structure breaking salts the brine does not completely wet the salt surface and a finite contact angle is measured. In this regard it has been found that soluble salt flotation either with the cationic DAH or anionic SDS collector is possible only if the salt is a structure breaker. Copyright 2001 Academic Press.

Journal Article↗

Iodine losses in iodised salt following different storage methods.

Iodine retention in three types of iodised salt viz., powdered salt, white crystal and brown crystal salt was estimated at an interval of 15 days following commonly practised storage methods i.e., glass jar with lid, plastic jar with lid, earthernware pot with lid, cut open salt packet and salt pack as it is. Highest percent retention of iodine irrespective of type of salt was noticed in intact salt packet (97.19%). The iodine retention was above 80% in other methods--88.41% retention in cut open salt packet, 84.72% in glass jar, 82.86% in earthern pot and 80.85% in plastic jar. Powdered salt had maximum iodine retention (91.16%) followed by brown crystal salt (84.24%) and white crystal salt (76.71%). Even though the iodine content was found to decrease during storage, the powdered salt and brown crystal salt had iodine in the recommended level. On the contrary, white crystal salt contained only half (7 ppm) that recommended at the retail level (15 ppm).

Data Collection↗

Effects of enalapril on the hyperinsulinemic response to severe salt restriction in obese young men with mild systemic hypertension.

Hypertension in obese patients is associated with hyperinsulinemia and salt sensitivity. Very low salt diets may exacerbate hyperinsulinemia, perhaps by activating the renin-angiotensin system. Therefore, the effects of a low salt diet alone and with enalapril on blood pressure and the insulin response to an oral glucose tolerance test were studied in 9 obese (body mass index 35 +/- 2 kg/m2) men with mild hypertension. Measurements were first obtained after a 2-week high-salt (20 mEq/day sodium diet+eleven 1 g salt tablets per day) baseline period. The same measurements were repeated after 2 weeks on a low salt diet (20 mEq/day) and after 2 weeks on low salt diet with enalapril in random sequence. The insulin area under the curve increased from 12.8 +/- 3.0 mU-min/dl during high salt to 16.6 +/- 3.2 mU-min/dl (p < 0.001). Plasma renin activity also increased with salt restriction from 1.4 +/- 0.2 to 3.0 +/- 0.5 ng/ml/hour, p = 0.01. With addition of enalapril to the low sodium chloride diet, the insulin area under the curve (14.5 +/- 2.6 mU-min/dl) was not significantly different from that during the high sodium chloride phase. Mean blood pressure in the laboratory was 105 +/- 1 mm Hg with high salt versus 99 +/- 1 mm Hg with low salt, p < 0.05. Addition of enalapril to the low-salt diet reduced mean blood pressure to 87 +/- 1 mm Hg (p < 0.01 vs low salt), largely by reducing total systemic resistance (p < 0.05). Salt restriction decreases laboratory BP while raising insulin levels in obese men with mild hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Age is a major determinant of the divergent blood pressure responses to varying salt intake in essential hypertension.

Blood pressure responses to 1 week of low (20 mmol sodium/day) and high (300 mmol sodium/day) salt intake were investigated in a double-blind, randomized study in 46 white, nonobese subjects with essential hypertension (13 women, 33 men; mean age 45.3 +/- 2.2 years, age range 25 to 80 years). The individuals were classified as salt-sensitive when mean arterial blood pressure rose by at least 5 mm Hg during high salt intake, as salt-resistant when mean arterial blood pressure changed by less than 5 mm Hg, and as "counter-regulators" when mean arterial blood pressure fell by at least 5 mm Hg during the high salt diet. Mean arterial blood pressure of all subjects taken together increased from 101.9 +/- 1.4 mm Hg during salt restriction to 103.7 +/- 1.5 mm Hg (P < .05) during salt loading. Eleven subjects (23.9%) were classified as salt-sensitive, 27 (58.7%) as salt-resistant, and 8 (17.4%) as counter-regulators. Multiple regression analysis revealed that age, but not baseline blood pressure, sex, body mass index, or family history of hypertension contributed significantly to the change in blood pressure following the diets. Ten of the 11 salt-sensitive subjects were older than the median age of 45 years. In salt-sensitive, as compared to salt-resistant, hypertensive subjects, creatinine clearance was lower and plasma renin activity was suppressed at baseline as well as during low and high salt intake. In contrast, plasma concentrations of norepinephrine and atrial natriuretic peptide were elevated in salt-sensitive subjects. These differences between the groups appeared, at least partially, to be age-related.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Assessment of salt sensitivity in essential hypertension by 24-h ambulatory blood pressure monitoring.

We used ambulatory blood pressure monitoring (ABPM) in the assessment of salt sensitivity in 40 essential hypertensive patients, comparing 24-h mean blood pressure during 7 days of low salt (20 mmol NaCl/day) and high salt (260 mmol NaCl/day) intake. Salt sensitivity was diagnosed in 18 essential hypertensive patients (45%), each of them showing a significant increase in mean blood pressure (P < .05) from low to high salt diet. Salt-sensitive patients exhibited a high-salt-dependent increase in all blood pressure parameters including 24-h systolic, mean, diastolic blood pressure, blood pressure load, area under the curve, and awake and asleep blood pressure values. These patients exhibited a nondipper profile on both low-salt and high-salt diets. Salt-resistant patients (55%) showed a decrease in awake, and an increase in asleep blood pressure values after high salt intake, thus tending to flatten the circadian blood pressure profile. We conclude that ABPM is a useful method to assess salt sensitivity. In salt-resistant patients high salt intake induces a significant increase in asleep blood pressure with no significant changes in 24-h blood pressure, promoting a flattened blood pressure curve and tending to transform a dipper into a nondipper profile, which could have important implications in end-organ damage.

Adult↗