The association of estimated salt intake with blood pressure in a Viet Nam national survey

• Published in: PloS one 2018-01, Vol.13 (1), p.e0191437-e0191437
• Main Authors: Jensen, Paul N, Bao, Tran Quoc, Huong, Tran Thi Thanh, Heckbert, Susan R, Fitzpatrick, Annette L, LoGerfo, James P, Ngoc, Truong Le Van, Mokdad, Ali H
• Format: Article
• Language: English
• Subjects: Adult; Adults; Age; Aged; Alcohol use; Alcoholic beverages; Antihypertensives; Biology and Life Sciences; Blood; Blood pressure; Blood Pressure - drug effects; Developing countries; Diabetes; Epidemiology; Female; Health aspects; Humans; Hypertension; LDCs; Male; Medicine and Health Sciences; Middle Aged; Migration; People and Places; Physical Sciences; Physiological aspects; Pregnancy; Prevention; Preventive medicine; Risk factors; Rural areas; Rural populations; Rural urban migration; Salt (Food); Salts; Smoking; Sodium; Sodium Chloride, Dietary - administration & dosage; Statistical models; Studies; Subgroups; Surveys and Questionnaires; Urban areas; Urine; Vietnam
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0191437

To evaluate the association of salt consumption with blood pressure in Viet Nam, a developing country with a high level of salt consumption. Analysis of a nationally representative sample of Vietnamese adults 25-65 years of age who were surveyed using the World Health Organization STEPwise approach to Surveillance protocol. Participants who reported acute illness, pregnancy, or current use of antihypertensive medications were excluded. Daily salt consumption was estimated from fasting mid-morning spot urine samples. Associations of salt consumption with systolic blood pressure and prevalent hypertension were assessed using adjusted linear and generalized linear models. Interaction terms were tested to assess differences by age, smoking, alcohol consumption, and rural/urban status. The analysis included 2,333 participants (mean age: 37 years, 46% male, 33% urban). The average estimated salt consumption was 10g/day. No associations of salt consumption with blood pressure or prevalent hypertension were observed at a national scale in men or women. The associations did not differ in subgroups defined by age, smoking, or alcohol consumption; however, associations differed between urban and rural participants (p-value for interaction of urban/rural status with salt consumption, p = 0.02), suggesting that higher salt consumption may be associated with higher systolic blood pressure in urban residents but lower systolic blood pressure in rural residents. Although there was no evidence of an association at a national level, associations of salt consumption with blood pressure differed between urban and rural residents in Viet Nam. The reasons for this differential association are not clear, and given the large rate of rural to urban migration experienced in Viet Nam, this topic warrants further investigation.