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Excess dietary sodium and inadequate potassium intake by hypertensive patients in Italy: results of the MINISAL-SIIA study program

Galletti, Ferruccioa; Agabiti-Rosei, Enricob; Bernini, Giampaoloc; Boero, Robertod; Desideri, Giovambattistae; Fallo, Francescof; Mallamaci, Francescag; Morganti, Albertoh; Castellano, Mauriziob; Nazzaro, Pietroi; Trimarco, Brunoj; Strazzullo, Pasqualea

doi: 10.1097/HJH.0000000000000010

Introduction: The aim of the study was to assess the age-specific, sex-specific, and region-specific average sodium and potassium intake and its association with anthropometric characteristics in a sample of the Italian adult hypertensive population.

Methods: A total of 1232 hypertensive patients were recruited consecutively by 47 centers recognized by the Italian Society of Hypertension. The enrolled participants were on stable antihypertensive treatment. Anthropometric indices, blood pressure, 24-h urinary sodium, and potassium excretion were measured and used as proxy for the average daily sodium and potassium intake.

Results: The average sodium intake was 172 mmol (or 10.1 g of salt/day) among men and 138 (or 8.1) among women, with no difference among geographical areas. Over 90% of men and 81% of women had a consumption higher than the recommended standard dietary intake of 5 g/day. The average potassium intake was 63 and 56 mmol, respectively in men and women, again without geographical differences, nearly 92% of men and 95% of women having an intake lower than the recommended intake (100 mmol/day or 3.9 g/day). There was a significant trend to a gradual decrease in sodium intake with age in both sexes (P <0.001). There was also a direct association between BMI and sodium intake in both sexes, this association being independent of age (P < 0.001).

Conclusion: In this national sample of the Italian hypertensive population, dietary sodium intake was largely higher and potassium intake much lower than the recommended intakes, and this was true for all geographical areas. Overweight and obese hypertensive patients had particularly high sodium intakes.

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aDepartment of Clinical Medicine and Surgery, Federico II University of Naples Medical School, Naples

bDepartment of Medical and Surgical Sciences, University of Brescia, Brescia

cDepartment of Internal Medicine, University of Pisa, Pisa

dS.C. Nephrology and Dialysis, Ospedale Martini, Torino, Torino

eDepartment of Life, Health, and Environmental Sciences, University of L’Aquila, L’Aquila

fDepartment of Medicine, Clinica Medica 3, University of Padova, Padova

gNephrology, Dialysis and Transplantation Unit and CNR-IBIM, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension, Reggio Calabria

hDepartment of Internal Medicine and Hypertension Center, San Giuseppe Hospital, University of Milan, Milan

iDepartment of Neurological and Psychiatric Sciences, Neurophysiopathology, Hypertension, University of Bari, Bari

jDepartment of Clinical Medicine, Cardiovascular and Immunological Sciences, Federico II University of Naples, Naples, Italy

Correspondence to Ferruccio Galletti, Department of Clinical Medicine and Surgery, ‘Federico II’ University of Naples Medical School, via S. Pansini, 5, 80131 Naples, Italy. E-mail: or

Abbreviations: BP, blood pressure; CVD, cardiovascular disease; GIRCSI, Working Group for Reduction of Salt Intake

Received 22 April, 2013

Revised 2 August, 2013

Accepted 27 August, 2013

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