The Association between Dietary Sodium, Salt, and Elevated Blood Pressure among Hispanic Adults in El Paso, Texas

Introduction: High blood pressure (hypertension) is the leading cause of cardiovascular disease (CVD) which represents a worldwide public health concern, and continues to be the number one cause of death among both men and women affecting 1 out of 3 adults in the United States. Furthermore, there is evidence suggesting that high levels of dietary sodium and salt consumption intake can not only increase an individual\u27s blood pressure level, but also their risk for CVD, heart attack, or stroke. Objective: To conduct a secondary data analysis to assess the association between sodium and salt intake and blood pressure among Hispanic adults participating in a culturally appropriate large-scale lifestyle intervention, a component of the community based participatory research, the H.E.A.R.T. (Health Education Awareness Research Team) project, conducted in El Paso, Texas from 2009 to 2014. Specific Aims: 1) To identify blood pressure levels of participants by age and gender; 2) to examine dietary sodium and salt intake by gender and age groups (\u3c40, 40 - 60, and \u3e 60 years), and; 3) to explore if there was an association between high dietary sodium and salt intake and elevated blood pressure. Methods: Secondary data analysis was performed using information collected at baseline from participants in the lifestyle intervention program of the H.E.A.R.T. project. Data collected included demographic, anthropometric and blood pressure measures. Dietary sodium and salt intake was self-reported using My Habits food eating pattern questionnaire which reported low and high sodium and salt intake. Sodium and salt intake were then categorized in two groups of either low or high intake scores. Results: There were a total of 741 project participants, ages 44.6 years (SD ± 13.3) with the majority being female (83.5%). The mean systolic and diastolic blood pressure among men was 132 mm Hg (SD ±10) and 80 mm Hg (SD ±10) respectively, which according to American Heart Association blood pressure categories, is consistent with prehypertension. The mean systolic blood pressure among women was 125 mm Hg (SD ±18) indicating prehypertension, however the diastolic blood pressure was within normal range (less than 80) at 76 mm Hg (SD ± 9). Odd\u27s Ratio was conducted in order to explore any association between dietary sodium and salt intake and blood pressure among all participants. Results for the Odd\u27s Ratio revealed no statistical difference between high and low sodium and salt intake groups: (OR=.8 [95%CI: 0.54-1.1]). Tests were then conducted among all participants using body mass index (BMI) as a covariate. The results for the Odd\u27s Ratio among normal weight individuals (OR=.64 [95%CI: 0.27-1.5]), and overweight/obese individuals (OR=.88 [95%CI: 0.63-1.22]) did not yield a statistically significant difference between either of the groups. Additional tests were conducted by gender and by groups. A statistical difference between high and low sodium and salt intake groups was observed in overweight/obese males (OR=2.13 [95% CI: 0.81-5.56]) and within age groups; \u3c40 (OR=3.14 [95% CI: 0.76-12.95]) and 40-60 (OR=3.1 [95% CI: 0.55-17.6]). No statistical difference was observed in low and high sodium and salt intake groups among females. Discussion: Elevated blood pressure was observed among men who reported high sodium and salt intake, but only when accounting for overweight and obesity. Contrary to what previous literature has reported, data from this study was not indicative of statistically significant associations between high dietary sodium and salt intake and elevated blood pressure for both genders. Limitations in the study that could potentially be a source of bias is that dietary sodium and salt intake was reported as a score, and was not quantified in milligrams of sodium and salt intake. Moreover, a more exact method such as urinary sodium excretion was not conducted for the purpose of this study. These results will, however, have implications for increasing awareness of the association of blood pressure and high sodium and salt intake among Hispanic populations, especially in overweight and obese males