russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLCrussjcardiol-1113Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWПОТРЕБЛЕНИЕ СОЛИ, АРТЕРИАЛЬНАЯ ГИПЕРТЕНЗИЯ И РИСК РАЗВИТИЯ СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЙ (Ч.I)SALT INTAKE, ARTERIAL HYPERTENSION, AND CARDIOVASCULAR RISK. PART IПотешкинаН. Г.PoteshkinaN. G.

д.м.н., профессор, зав. кафедрой общей терапии

nat-pa@yandex.ruРоссийский государственный медицинский университет Росздрава, кафедра общей терапии ФУВ, МоскваRussian Federation201128062011038795Copyright © Потешкина Н.Г., 20112011Потешкина Н.Г.Poteshkina N.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/1113

Статья посвящена проблеме взаимосвязи потребления поваренной соли в мире и риска развития сердечно-сосудистых заболеваний. Представлен анализ мировых рандомизированных, многоцентровых, проспективных, клинико-эпидемиологических исследований, выполненных на рубеже ХХ – ХХI веков. Показано, что уровень потребления соли в мире существенно различается. Доказана прямая взаимосвязь между количеством потребления соли и генезом артериальной гипертензии (АГ). Кроме того, риск развития АГ и рост смертности от сердечно-сосудистых заболеваний связан с повышенным потреблением соли даже при относительно невысоких уровнях артериального давления.

This review is focussed on the link between salt intake and the risk of cardiovascular disease. The results of international multi-centre, randomized, prospective, clinical and epidemiological studies from late 20th and early 21st century are analysed. It is demonstrated that salt intake differs across international populations, and that the amount of salt consumed is directly linked to the risk of arterial hypertension (AH) development. In addition, increased salt intake is associated with elevated AH risk and increased cardiovascular mortality rates even at relatively low levels of blood pressure.

артериальная гипертензияпотребление солириск сердечно-сосудистых заболеванийArterial hypertensionsalt intakecardiovascular riskReferencesВолков В.С., Поселюгина О.Б., Нилова С.А. Артериальная гипертония и потребление поваренной соли в России // Болезни сердца и сосудов 2009; 9: 4: 16-18;Волков В.С., Поселюгина О.Б., Нилова С.А. Артериальная гипертония и потребление поваренной соли в России // Болезни сердца и сосудов 2009; 9: 4: 16-18;Adrogué H.J., Madias N.E. Sodium and Potassium in the Pathogenesis of Hypertension // N Engl J Med 2007; 356: 1966-1978.Adrogué H.J., Madias N.E. Sodium and Potassium in the Pathogenesis of Hypertension // N Engl J Med 2007; 356: 1966-1978.Ambard L. and Beaujard E. Causes de l’hypertension arterialle // Arch Gén Med 1904; 81: 520–533.Ambard L. and Beaujard E. Causes de l’hypertension arterialle // Arch Gén Med 1904; 81: 520–533.Brown IJ, Tzoulaki I, Candeias V, et al. Salt intakes around the world: implications for public health // International Journal of Epidemiology 2009; 38: Issue 3; p. 791-813.Brown IJ, Tzoulaki I, Candeias V, et al. Salt intakes around the world: implications for public health // International Journal of Epidemiology 2009; 38: Issue 3; p. 791-813.Carvalho JJ, Baruzzi RG, Howard PF, et al. Blood pressure in four remote populations in the INTERSALT Study. Hypertension 1989; 14; 238-246.Carvalho JJ, Baruzzi RG, Howard PF, et al. Blood pressure in four remote populations in the INTERSALT Study. Hypertension 1989; 14; 238-246.Cook NR, Cutler JA, Obarzanek E, et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ 2007; 334: 885-893.Cook NR, Cutler JA, Obarzanek E, et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ 2007; 334: 885-893.Corcoran A.C., Taylor R. D., Page I. H. Controlled Observations on the Effect of Low Sodium Dietotherapy in Essential Hypertension // Circulation 1951; 3: 1 – 16.Corcoran A.C., Taylor R. D., Page I. H. Controlled Observations on the Effect of Low Sodium Dietotherapy in Essential Hypertension // Circulation 1951; 3: 1 – 16.Dennis B, Stamler J, Buzzard M, et al. for the INTERMAP Research Group INTERMAP: the dietary data–process and quality control // Journal of Human Hypertension 2003; 17: 609–622.Dennis B, Stamler J, Buzzard M, et al. for the INTERMAP Research Group INTERMAP: the dietary data–process and quality control // Journal of Human Hypertension 2003; 17: 609–622.Dyer AR, Elliott P, Shipley M. for the INTERSALT Cooperative Research Group. Urinary Electrolyte Excretion in 24 Hours and BloodPressure in the INTERSALT Study II. Estimates of Electrolyte-Blood Pressure Associations Corrected for Regression Dilution Bias // American Journal of Epidemiology 1994; 139: 9: 940-951.Dyer AR, Elliott P, Shipley M. for the INTERSALT Cooperative Research Group. Urinary Electrolyte Excretion in 24 Hours and BloodPressure in the INTERSALT Study II. Estimates of Electrolyte-Blood Pressure Associations Corrected for Regression Dilution Bias // American Journal of Epidemiology 1994; 139: 9: 940-951.Elliott P., Stamler J., Nichols R., et al. Intersalt revisited: further analyses of 24 hour sodium excretion and blood pressure within and across populations // BMJ 1996; 312: 7041, 1249-1253.Elliott P., Stamler J., Nichols R., et al. Intersalt revisited: further analyses of 24 hour sodium excretion and blood pressure within and across populations // BMJ 1996; 312: 7041, 1249-1253.Frost CD, Law MR, Wald NJ. By how much does dietary salt reduction lower blood pressure? II-Analysis of observational data within populations // BMJ. 1991; 302: 815–819.Frost CD, Law MR, Wald NJ. By how much does dietary salt reduction lower blood pressure? II-Analysis of observational data within populations // BMJ. 1991; 302: 815–819.Graudal NA, Gallie M, Garred P. Effects of sodium restriction on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride // JAMA. 1998. 279: 1383 –1391.Graudal NA, Gallie M, Garred P. Effects of sodium restriction on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride // JAMA. 1998. 279: 1383 –1391.He J., Ogden L.G., Vupputuri S., et al. Dietary Sodium Intake and Subsequent Risk of Cardiovascular Disease in Overweight Adults. JAMA. 1999; 282 (21): 2027-2034.He J., Ogden L.G., Vupputuri S., et al. Dietary Sodium Intake and Subsequent Risk of Cardiovascular Disease in Overweight Adults. JAMA. 1999; 282 (21): 2027-2034.Holbrook JT, Patterson KY, Bodner JE, et al. Sodium and potassium intake and balance in adults consuming self- selected diets // Am J Clin Nutr 1984; 4: 40: 786-793.Holbrook JT, Patterson KY, Bodner JE, et al. Sodium and potassium intake and balance in adults consuming self- selected diets // Am J Clin Nutr 1984; 4: 40: 786-793.Hsing-Yi Chang, Yu-Whuei Hu, Ching-Syang Jack Yue, et al. Effect of potassium-enriched salt on cardiovascular mortality and medical expenses of elderly men // Am J Clin Nutr 2006; 83: 6: 1289-1296.Hsing-Yi Chang, Yu-Whuei Hu, Ching-Syang Jack Yue, et al. Effect of potassium-enriched salt on cardiovascular mortality and medical expenses of elderly men // Am J Clin Nutr 2006; 83: 6: 1289-1296.Intersalt Cooperative Research Group: Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion // BMJ 1988; 297: 319–328.Intersalt Cooperative Research Group: Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion // BMJ 1988; 297: 319–328.Kempner W. Some effects of the rice diet treatment of kidney disease and hypertension // Bull N Y Acad Med, 1946; 22: 7: 358–370.Kempner W. Some effects of the rice diet treatment of kidney disease and hypertension // Bull N Y Acad Med, 1946; 22: 7: 358–370.Kjelsberg MO, Cutler JA, Dolecek TA. Brief description of the Multiple Risk Factor Intervention Trial // Am J Clin Nutr 1997; 65: 1, 191S-195S.Kjelsberg MO, Cutler JA, Dolecek TA. Brief description of the Multiple Risk Factor Intervention Trial // Am J Clin Nutr 1997; 65: 1, 191S-195S.Law MR, Frost CD, Wald NJ. By how much does dietary salt reduction lower blood pressure? I-Analysis of observational data among populations // BMJ. 1991; 302: 811–815.Law MR, Frost CD, Wald NJ. By how much does dietary salt reduction lower blood pressure? I-Analysis of observational data among populations // BMJ. 1991; 302: 811–815.Lloyd-Jones D, Adams RJ, Brown TM, et al. AHA Statistical Update Heart Disease and Stroke Statistics–2010 Update A Report From the American Heart Association // Circulation 2010; 121: e46-e215.Lloyd-Jones D, Adams RJ, Brown TM, et al. AHA Statistical Update Heart Disease and Stroke Statistics–2010 Update A Report From the American Heart Association // Circulation 2010; 121: e46-e215.Lloyd-Jones DM, Hong Y, Labarthe D. et al. AHA Special Report. Defining and Setting National Goals for Cardiovascular Health Promotion and Disease Reduction. The American Heart Association’s Strategic Impact Goal Through 2020 and Beyond // Circulation. 2010; 121: 586-613.Lloyd-Jones DM, Hong Y, Labarthe D. et al. AHA Special Report. Defining and Setting National Goals for Cardiovascular Health Promotion and Disease Reduction. The American Heart Association’s Strategic Impact Goal Through 2020 and Beyond // Circulation. 2010; 121: 586-613.Luft FC, Fineberg NS, Sloan RS. Estimating dietary sodium intake in individuals receiving a randomly fluctuating intake // Hypertension 1982; 4: 805-808.Luft FC, Fineberg NS, Sloan RS. Estimating dietary sodium intake in individuals receiving a randomly fluctuating intake // Hypertension 1982; 4: 805-808.Meneton P, Jeunemaitre X, de Wardener Hugh E, et al. Links Between Dietary Salt Intake, Renal Salt Handling, Blood Pressure, and Cardiovascular Diseases // Physiol Rev 2005; 85: 679-715.Meneton P, Jeunemaitre X, de Wardener Hugh E, et al. Links Between Dietary Salt Intake, Renal Salt Handling, Blood Pressure, and Cardiovascular Diseases // Physiol Rev 2005; 85: 679-715.Mortality After 16 Years for Participants Randomized to the Multiple Risk Factor Intervention Trial. The Multiple Risk Factor Intervention Trial Research Group // Circulation 1996; 94: 946-951.Mortality After 16 Years for Participants Randomized to the Multiple Risk Factor Intervention Trial. The Multiple Risk Factor Intervention Trial Research Group // Circulation 1996; 94: 946-951.Multiple Risk Factor Intervention Trial Research Group. Mortality after 10 1/2 years for hypertensive participants in the Multiple Risk Factor Intervention Trial // Circulation 1990; 82: 1 616-1628.Multiple Risk Factor Intervention Trial Research Group. Mortality after 10 1/2 years for hypertensive participants in the Multiple Risk Factor Intervention Trial // Circulation 1990; 82: 1 616-1628.Peralez Gunn J, Kuklina EV, Keenan NL. Centers for Disease Control and Prevention (CDC). Sodium intake among adult – United States, 2005-2006. MMWR 2010; 58: 746--749.Peralez Gunn J, Kuklina EV, Keenan NL. Centers for Disease Control and Prevention (CDC). Sodium intake among adult – United States, 2005-2006. MMWR 2010; 58: 746--749.Rose G. Strategy of prevention: lessons from cardiovascular disease // Br Med J (Clin Res Ed). 1981; 282: 1847–1851.Rose G. Strategy of prevention: lessons from cardiovascular disease // Br Med J (Clin Res Ed). 1981; 282: 1847–1851.Sasaki S, Zhang Xin-Hua, Kesteloot Hugo. Dietary Sodium, Potassium, Saturated Fat, Alcohol, and Stroke Mortality // Stroke 1995; 26: 783-789.Sasaki S, Zhang Xin-Hua, Kesteloot Hugo. Dietary Sodium, Potassium, Saturated Fat, Alcohol, and Stroke Mortality // Stroke 1995; 26: 783-789.Stamler J, Caggiula AW, Grandits GA. Relation of body mass and alcohol, nutrient, fiber, and caffeine intakes to blood pressure in the special intervention and usual care groups in the Multiple Risk Factor Intervention Trial // Am J Clin Nutr 1997; 65: 1: 338S-365S.Stamler J, Caggiula AW, Grandits GA. Relation of body mass and alcohol, nutrient, fiber, and caffeine intakes to blood pressure in the special intervention and usual care groups in the Multiple Risk Factor Intervention Trial // Am J Clin Nutr 1997; 65: 1: 338S-365S.Stamler J, Stamler R, Neaton JD. Blood pressure, systolic and diastolic, and cardiovascular risks: US population data // Arch Intern Med. 1993; 153: 598-615.Stamler J, Stamler R, Neaton JD. Blood pressure, systolic and diastolic, and cardiovascular risks: US population data // Arch Intern Med. 1993; 153: 598-615.Stamler J. Assessing diets to improve world health: nutritional research on disease causation in populations // Am J Clin Nutr 1994; 59: 1: 146S-156S.Stamler J. Assessing diets to improve world health: nutritional research on disease causation in populations // Am J Clin Nutr 1994; 59: 1: 146S-156S.Stamler J. The INTERSALT Study: background, methods, findings, and implications // Am J Clin Nutr 1997; 65: 626S-642S.Stamler J. The INTERSALT Study: background, methods, findings, and implications // Am J Clin Nutr 1997; 65: 626S-642S.Stamler J, Elliott P, Appel L, et al. for the INTERMAP Research Group. Higher blood pressure in middle-aged American adults with less education–role of multiple dietary factors: The INTERMAP Study // Journal of Human Hypertension 2003; 17: 655–664.Stamler J, Elliott P, Appel L, et al. for the INTERMAP Research Group. Higher blood pressure in middle-aged American adults with less education–role of multiple dietary factors: The INTERMAP Study // Journal of Human Hypertension 2003; 17: 655–664.Stamler J., Elliott P., Dennis B., et al. for the INTERMAP Research Group INTERMAP: background, aims, design, methods, and descriptive statistics (nondietary) // Journal of Human Hypertension 2003; 17, 591–608.Stamler J., Elliott P., Dennis B., et al. for the INTERMAP Research Group INTERMAP: background, aims, design, methods, and descriptive statistics (nondietary) // Journal of Human Hypertension 2003; 17, 591–608.Tobian L, Hanlon S. High sodium chloride diets injure arteries and raise mortality without changing blood pressure // Hypertension 1990; 15: 900-903.Tobian L, Hanlon S. High sodium chloride diets injure arteries and raise mortality without changing blood pressure // Hypertension 1990; 15: 900-903.Ueshima H, Okayama A, Saitoh S, et al. for the INTERLIPID Research Group. Differences in cardiovascular disease risk factors between Japanese in Japan and Japanese-Americans in Hawaii: the INTERLIPID study // Journal of Human Hypertension 2003; 17: 631–639.Ueshima H, Okayama A, Saitoh S, et al. for the INTERLIPID Research Group. Differences in cardiovascular disease risk factors between Japanese in Japan and Japanese-Americans in Hawaii: the INTERLIPID study // Journal of Human Hypertension 2003; 17: 631–639.Watkin D.M., Froeb H.F., Hatch F.T., et al. Effect of diet in essential hypertension: II. Results with unmodified Kempner rice diet in fifty hospitalized patients // Am. J.Med. 1950; 9: 441-499.Watkin D.M., Froeb H.F., Hatch F.T., et al. Effect of diet in essential hypertension: II. Results with unmodified Kempner rice diet in fifty hospitalized patients // Am. J.Med. 1950; 9: 441-499.Weinberger MH, Fineberg NS. Sodium and volume sensitivity of blood pressure. Age and pressure change over time // Hypertension 1991; 18; 67-71.Weinberger MH, Fineberg NS. Sodium and volume sensitivity of blood pressure. Age and pressure change over time // Hypertension 1991; 18; 67-71.World Health Organization. Reducing salt intake in populations: report of a WHO forum and technical meeting, 5--7 October 2006, Paris, France. Geneva, Switzerland: World Health Organization; 2007.World Health Organization. Reducing salt intake in populations: report of a WHO forum and technical meeting, 5--7 October 2006, Paris, France. Geneva, Switzerland: World Health Organization; 2007.Zhou BF, Stamler J, Dennis B, et al. for the INTERMAP Research Group. Nutrient intakes of middle-aged men and women in China, Japan, United Kingdom, and United States in the late 1990s: The INTERMAP Study // Journal of Human Hypertension 2003; 17: 623–630.Zhou BF, Stamler J, Dennis B, et al. for the INTERMAP Research Group. Nutrient intakes of middle-aged men and women in China, Japan, United Kingdom, and United States in the late 1990s: The INTERMAP Study // Journal of Human Hypertension 2003; 17: 623–630.

The authors declare that there are no conflicts of interest present.