Yea but…. 500 mg Na is not sustainable in the ‘real world’. Great proof of concept paper but impracticable at present time
Lowering salt (one teaspoon) in the diet among middle-aged and older adults was as good an effect for reducing BP as a first-line anti-hypertensive drug, independent of severity of HTN or meds, in ~75% of people, from a randomized trial
jamanetwork.com/journals/jam… @JAMA_current
Not sure they hate research. Rather, no protected time, financial or staff support not included in teams
“The problem is, most primary care people hate doing research…”
The fact that <1% of research dollars go to primary care research will require more interest, advocacy and power. @NASEM_Health Primary Health Care conference
Let me see if I got this right:
SCOTUS says states have no regulatory authority over carrying weapons BUT can regulate women’s’ choice over abortions. Is it just me or is this crazy?
If I’m reading correctly… difference between groups is around 400 mg or about 17 mm/d. Not enough difference to anticipate an effect. Also control Gp consuming around 90 mmol Na/d-on grand scheme of dietary Na..not unreasonable
Medical dogma is that people with heart failure need to adhere to a low salt diet. The largest randomized trial reported today failed to show any benefit for reducing clinical events
thelancet.com/journals/lance… @TheLancet #ACC22
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Along with Neal study-NEJM 385 1067-strong case for small increases in dietary K
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I struggle a bit re where drugs work esp cyclosilicate. Orig paper in NEJM shows effects in first 30 min. Doesn’t this suggest upper small bowel secretory mech?
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NEJM paper was outstanding. FDA recommendations long overdue. Wish the FDA had gone a bit further and recommended small increases in dietary K as well per NEJM paper
Thrilled @US_FDA setting dietary sodium targets
Our 2010 @NEJM paper found even modest reductions➡️substantial health & economic benefits nejm.org/doi/full/10.1056/ne…
▶️All segments of US population benefit
▶️cost-saving
▶️magnitude of benefits on par w other public health targets
Old small interventional studies: on fixed Na diet, increasing dietary or pharm K causes natriuresis
“Study of the year”, well known simple and cheap nutrition intervention showing drastic 13% reduction in RCT but industry in US wud never let any such thing implemented. Can mediation analysis tease out if it is lowering of Na or addition of K as @hswapnil pointed out?
Outstanding review. Wish they would have emphasized the importance of dietary K a bit more. Increases in K associated with decreases in BP and prevent Na effects on BP.
Confused about sodium?
Here's a great resource explaining why sodium reduction is the most neglected, high-impact health intervention in the world.
Sometimes scientific controversy arises because of true uncertainty. Sometimes because of error.
bit.ly/2NAbMEj
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With great sadness, we announce the passing of Dr. Robert W. Schrier; Chairman of Dept of Medicine '76-'02 & Head of the Division of Nephrology '72-'92, transforming it into one of the leading Nephrology Divisions in the country. We thank him for his contributions to science.
