Salt and BP; Are Studies Using Statistics Right?

No they are not! And here is why.

Some of you may be concerned about salt increase in your diet because you have heard about the increase of BP. I decided to do a literature research on that and have written my article (still in progress for corrections) but the key part–meaning BP increase as a result of salt increase is already set in stone. I decided to copy-paste here for you selected parts of my summary so you can see how meaningless the studies have been and where the statistical errors stand–number in parentheses are references from the original article as I am working on it:

“…studies show that the increase in systolic BP as a result of increased dietary sodium is from 1.5 mm HG to 4.18 mm HG is healthy participants(16) and up to 5.8 mm Hg in hypertensive patients measured in urine(8)…it is evident that normal daily variations of BP move in a significantly larger range. For healthy individuals the daily variation may encompass a nearly ten times increase in BP just from living than the increase we see in BP from eating more salt. [for reference the normal range is 100-139 mm Hg in systolic that is written elsewhere in the paper.]

While it is understandable that BP increase is of concern, the size of the increase must also be significant for it to be true real concern. It is well understood that increased salt increases blood volume(17)… It is also understood that decreased levels of dietary salt reduces BP by about the same amount as increased dietary salt increases BP. There is a direct relation between salt intake and blood pressure, which is shown with the statistical power test in all studies(18). The change is minor in both directions.

We must therefore ask: is the slight reduction worth the trade-of people experience an increase in their triglycerides by a much 7%(6,8,19,20)? Is it a fair and safe exchange to suggest that a hypertensive patient should decrease dietary salt to end up increasing triglyceride levels by 7% but only reducing BP by less than 4%? As shown above, the reduction of dietary salt culminates in a 1.5 mm Hg to 5.8 mm Hg reduction in BP based on patient condition by many studies. Assuming an individual with hypertension of 150/90 BP, the systolic decrease is maximum 5.8 mm Hg (or 3.8%) from reduced salt diet, but which remains a high BP. At the same time, triglyceride increases by 7% so if that patient had normal triglycerides of 145 mg/dL(21), with the 7% increase as a result of reduced dietary salt it jumps to an unhealthy 155.15 mg/dL. The trade-off is not a good one because higher than normal triglycerides may lead to serious diseases(21).”

As you can see:
1) The article snippet here shows that increased salt increases BP quite insignificantly and reduced salt reduces BP also quite insignificantly as well.
2) Decreased dietary salt increases triglycerides, which is the bad particle component of LDL, the bad cholesterol, by 7%–a significant increase.

Thus should you be concerned about increasing your salt? Not a chance! Enjoy your salted meals! The citation numbers are not starting at 1 since I copy-pasted from an article I am writing.

Sources:

  1. Graudal NA, Hubeck-Graudal T, Jürgens G. Effects of Low-Sodium Diet vs. High-Sodium Diet on Blood Pressure, Renin, Aldosterone, Catecholamines, Cholesterol, and Triglyceride (Cochrane Review). American Journal of Hypertension. 2012;25(1):1-15.
  1. He FJ, Li J, MacGregor GA. Effect of longer term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials. BMJ. 2013;346.
  1. FH MSB. Dietary salt reduction; further lowering of target lowers blood pressure but may increase risk. Evidence Based Medicine. 2014;19(1):22.
  2. Mange K, Matsuura D, Cizman B, et al. Language Guiding Therapy: The Case of Dehydration versus Volume Depletion. Annals of Internal Medicine. 1997;127(9):848-853.
  3. Texas Uo. Power of a Statistical Procedure. 2012. https://www.ma.utexas.edu/users/mks/statmistakes/power.html. Accessed 12/07/2015.
  4. Albert GNT, Hubeck-Graudal; Gesche, Jurgens;. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Cochrane Database of Systematic Reviews. 2011;11.
  5. Jurgens G, Graudal NA. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride. 2004.
  6. MedlinePlus N. Triglyceride level. In: Chen AM, ed. MedlienPlus Encyclopedia. internet2014.

Comments are welcome as always!

Angela

 

 

About Be Healthy

Angela A Stanton, PhD, is a Neuroeconomist who evaluates changes in behavior, chronic pain, decision-making, as a result of hormonal variations in the brain. She lives in Southern California. Her current research is focused on migraine cause, prevention and treatment without the use of medicines. As a migraineur, her discovery was helped by experimenting on herself. She found the cause of migraine to be at the ionic level, associated with disruption of the electrolyte homeostasis, resulting from genetic mutations of insulin and glucose transporters, and voltage gated sodium and calcium channel mutations. Such mutations cause major shifts in a migraine brain, unlike that of a non-migraine brain. A non-migraineur can handle electrolyte changes on autopilot. A migraineur must always be on manual guard for such changes to maintain electrolyte homeostasis. The book Fighting The Migraine Epidemic: How To Treat and Prevent Migraines Without Medicines - An Insider's View explains why we have migraines, how to prevent them and how to stay migraine (and medicine) free for life. As a result of the success of the first edition of her book and new research and findings, she is now finishing the 2nd edition. The 2nd edition is the “holy grail” of migraines, incorporating all there is to know at the moment and also some hypotheses. It includes an academic research section with suggestions for further research. The book is full of citations to authenticate the statements she makes to be followed up by those interested and to spark further research interest. While working on the 2nd edition of the book she also published academic articles: "Migraine Cause and Treatment" Mental Health in family Medicine, November 23, 2015, open access "Functional Prodrome in Migraines" Journal of Neurological Disorders, January 22, 2016, open access "Are Statistics Misleading Sodium Reduction Benefits?", Journal of Medical Diagnostic Method, February 3, 2016, open access “A Comment on Severe Headache or Migraine History Is Inversely Correlated With Dietary Sodium Intake: NHANES 1999-2004” Angela A Stanton PhD, 19 July 2016 DOI: 10.1111/head.12861 not open access, subscription is required to read it. Dr. Stanton received her BSc at UCLA in Mathematics, MBA at UCR, MS in Management Science and Engineering at Stanford University, PhD in NeuroEconomics at Claremont Graduate University, and fMRI certification at Harvard University Medical School at the Martinos Center for Neuroimaging for experimenting with neurotransmitters on human volunteers. For relaxation Dr. Stanton paints and photographs. Follow her on Twitter at: @MigraineBook
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6 Responses to Salt and BP; Are Studies Using Statistics Right?

  1. Roald Michel says:

    This is from a study published in the Lancet (20 May 2016): “These data suggest that lowering sodium intake is best targeted at populations with hypertension who consume high sodium diets.”

    It was a study among 133118 individuals in 49 countries. Amazing, don’t you think. And what an eye opening result. Who would have thought? Wow. Breaking news, I tell you.

    Um…….I wonder how much money and time this breathtaking study has consumed.

    Oh, and if you want to get the full flavor of this exiting story, you have to pay the Lancet US$ 31.50

    Liked by 1 person

    • Be Healthy says:

      Yep. That is why when I sent it to them I was told “it is not a priority”… of course not.. they have not yet got their Nobel Prize for totally writing wrong information first and now starting to back off but still not right. 🙂

      Making the news is all about making statements everyone already knows and can associate with.

      Don’t you agree? People like to have their knowledge (from previous such misleading garbage) confirmed. I suppose if I want to catch any attention with any article I would have to also show a 2-point increase from BP–perhaps I can do that after say… hmmmm… eating a candy? I may be able to beat that 2 points ten-fold. Much more worthy of a news but my heart tells me I don’t want to hurt people. Eventually when they killed off everyone… well.. the truth will then come out. In fact, on BBC1 there was a film last night in the UK that some of my UK migraineurs have told me about that is awesome and points totally in the direction my work is heading–except for the sugar.

      It showed up on YouTube 4 hours after it aired. I am considering writing up an article about it now. In fact, I will. 😀 Let them smart peeps read and watch some real worthy stuff!

      Like

  2. Roald Michel says:

    After you had shown to me the treasures shared by the electrifying Salt Queen, the ever seductively dancing water goddesses (Tiamat is my favorite), as well as the deceitful personality of the sweet talking Sugar King, I eagerly sprinkled more delicious salt on my steaks, my re-heated organic potatoes, and my lettuce, while telling my honey, my maple syrup, and my snow whites to hit the road and never come back again. And you know what? My BP lowered and stays now at levels I had when I was 20 years old (115/70; 125/72).

    Liked by 1 person

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