Coronary heart disease salt intake

Fluid overload occurs commonly in patients with renal failure, often in the absence of associated heart disease. If salt and water intake is not controlled in the patient who is oliguric or anaemic, plasma volume and symptoms of congestive heart failure ensue. Hypertension and coronary heart disease with increasing age contributes to the congestive heart failure. Diuretics like loop-diuretics or metolazone may be of value. Digitalis should be used with caution in patients on dialysis as cardiac arrhythmias may ensue in patients receiving dialysis in the presence of hypokalemia. 

The UK Committee On Medical Aspects (COMA) of food policy reports of 1984 and 1994, in pointing out that coronary heart disease and cerebral vascular disease (stroke) account for more than one-third of the deaths in the UK and that one in two adults i.e. 20 million) in the UK are clinically overweight, suggest dietary changes. The main recommendations are that blood cholesterol levels are kept below 5.2 units (a figure currently exceeded by 70% of the UK adult population) and that more starchy foods, vegetables, fruit, and oily fish are eaten to replace reduced intakes of salt and of fatty and sugary foods. 

The recommendation to eat less salt is based on evidence from animal studies and from observations in Japan that a high intake of salt leads to a high blood pressure, and in man a high blood pressure increases the risk of coronary heart disease. An increase in blood pressure is one of the characteristics of ageing. 

CHD can be prevented to some extent by controlling risk factors. Hypertension and plasma cholesterol are both affected by the diet. Advice to patients with a family history of coronary heart disease would include suggesting a cholesterol check, and, depending on the results, reducing saturated fat intake to around 8—10 per cent of the diet. Omega-3 poljomsaturated FAs (found in seafoods and rapeseed oils) should be increased in the diet since they lower LDL-cholesterol. Monounsaturated fats (in olive oil) should also be increased, but total fat should not exceed 30 per cent of the dietary intake. Hjrpertension can be reduced by restricting salt intake (19). 

See also Antioxidants Diet and Antioxidant Defense Observationai Studies Intervention Studies. Coronary Heart Disease Lipid Theory. Dietary Fiber Role in Nutritional Management of Disease. Fatty Acids Monounsaturated Omega-3 Polyunsaturated Omega-6 Polyunsaturated Saturated. Fish. Folic Acid. Potassium. Sodium Physiology Salt Intake and Health. Vegetarian Diets. 

Stroke, coronary heart disease, and heart failure. Excess salt intake also seem to promote the development of osteoporosis, gastric cancer, and bronchial reactivity. The relationship of salt intake to these conditions will be described and the options for limiting intakes will be outlined. 

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