Hypertensives Savor Salt More

SAN FRANCISCO—Hypertensive individuals prefer more salt in their food than do normotensive individuals, but adding other seasonings to food can tame that craving, according to new data presented at the 28th Annual Scientific Meeting of the American Society of Hypertension.

The study included 44 subjects—28 hypertensives and 16 normotensives—with a mean age of 75 years.

Researchers gave French bread with three different concentrations of added salt (421.2, 648.0, and 874.8 mg sodium/100g) to subjects in the first part of the study. The subjects tasted the same types of French bread 15 days later with seasoning added in the same concentrations in all samples of salted bread.

In the first taste test, 68% of hypertensive subjects said they preferred the bread with the highest concentration of salt compared with 31% of normotensive subjects. In the second taste test added seasonings, 14% of hypertensive subjects preferred the bread with the highest salt content compared with none of the normotensive subjects.

According to the investigators, the findings suggest that hypertensive patients prefer a higher salt content, but use of other seasonings diminished the preference for salt. 

“These studies have immediate applicability to possible benefits for hypertensive individuals,” said investigator Patricia Villela, MS, a clinical researcher at the University of São Paulo in Brazil.  “We were not surprised by the finding of hypertensive patients having greater appetite for salt than normotensive.  However, we were surprised by the fact seasonings added [to the bread] may have changed the preference of the elderly, decreasing [their] appetite for salt. It would be important to demonstrate that changes in habits can be maintained in the long term.”

All the subjects completed questionnaires and evaluated each sample using a hedonic scale of flavor.  The investigators examined body mass index (BMI) and blood pressure levels.  They also determined 24-hour urinary sodium excretion on the two days of sensory analysis.

Additionally, the researchers found that the 24-hour urinary sodium excretion was greater in hypertensive than normotensive group (177 vs. 141 mEq). The two groups were similar with respect to body mass index. “The main message is that we can invest in dietary strategies to facilitate adherence of hypertensive individuals to lower salt intake,” Villela said.

Considerable debate is now underway in the U.S. about how to lower salt intake on a population-wide level.  In national studies in Finland and Great Britain, instituting a national salt-reduction program led to decreased sodium intake, according to a report in the New England Journal of Medicine (2013;368:1229-1237). In Finland, the resulting decrease in systolic and diastolic pressures corresponded to a significant decrease in death due to stroke and coronary heart disease.

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