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Aktuelle Ernährungsmedizin 2006; 31(3): 110-114
DOI: 10.1055/s-2006-932595
Originalbeitrag
© Georg Thieme Verlag KG Stuttgart · New York

A Salty Matter

One More Contribution to the Debate on the Optimum Level of Salt ConsumptionEine salzige AngelegenheitNoch ein Beitrag zur Diskussion über die generelle Empfehlung einer Einschränkung der KochsalzzufuhrG.  Mayer1
  • 1Division of Nephrology, Department of Internal Medicine, Medical University of Innsbruck, Austria
Manuskript nach einem Vortrag bei dem 23. Gemeinsamen Kongress von GESKES, AKE und DGEM nutrition 2005 in Genf vom 2. - 4.6.2005
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Publication History

Publication Date:
15 May 2006 (online)

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Zusammenfassung

Ein Zusammenhang zwischen dem Kochsalzkonsum und dem Blutdruck wird seit vielen Jahren postuliert. Gesundheitsbehörden, aber auch viele Fachgesellschaften fordern von der Bevölkerung im Sinne einer Primär- aber auch Sekundärprävention eine generelle Reduktion der Kochsalzzufuhr, obwohl es für diese Empfehlungen kaum eine wissenschaftliche Grundlage gibt. Am besten ist noch der epidemiologische Zusammenhang zwischen dem Anstieg des Blutdrucks im Alter und der Natriumzufuhr in einer Population abgesichert. Prospektive, randomisierte Interventionsstudien zur blutdrucksenkenden Wirkung der Einschränkung der Salzzufuhr in einer unselektionierten Bevölkerung hingegen verliefen weitgehend enttäuschend, ein Eindruck, der auch von kürzlich publizierten Metaanalysen bestätigt wird. Zwar gibt es Individuen, die mit einer deutlichen Blutdruckreduktion reagieren (z. B. ältere Menschen), allerdings gibt es auch paradoxe Reaktionen im Sinn eines Blutdruckanstieges bzw. manchmal auch unerwünschte metabole Nebenwirkungen. Objektiv betrachtet muss man feststellen, dass bevor eine generelle Empfehlung abgegeben wird, eigentlich auch für „nicht pharmakologische” Maßnahmen die gleichen Kriterien der strengen Überprüfung des Nutzen-Risiko-Profils anzulegen sind, wie man dies für pharmakologische Eingriffe längst verlangt. Es wäre auch eher überraschend, wenn die Kochsalzrestriktion (und wahrscheinlich alle anderen „Lebensstilmodifikationen”), im Gegensatz zu allen anderen bekannten antihypertensiven Maßnahmen in der Lage wäre, bei allen Individuen nur positive Effekte hervorzurufen.

Abstract

An association between salt consumption and blood pressure has been postulated for many years. Health care officials and many expert panels are demanding a general reduction of sodium consumption as a primary and secondary prevention measure. However, these recommendation are not based on large evidence. To the best the correlation between the increase in blood pressure with aging and salt consumption within a population has been establishd. Prospective interventional studies on the blood pressure lowering effect of salt restriction in an unselected population, however, have provided mostly dissapointing data and this impression has recently been also confirmed in several large meta analyses. Even though some individuals (e. g. elderly subjects) clearly show a reduction of blood pressure after sodium restriction, others experience even an increase or some adverse metabolic side effects. To date it seems that a general recommendation to reduce salt intake cannot be defended by research data. It also is unlikely that a change in any life style factor will lower blood pressure in every hypertensive subject without any side effects. These notes of caution, which are accepted for medical intervention for a long-time, should probably also be acknowledged for „non pharmacological” interventions.

Schlüsselwörter

Salzzufuhr - Salzeinschränkung - Blutdruck

Key words

Salt consumption - salt restriction - blood pressure

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Univ.-Prof. Dr. Gert Mayer

Division of Nephrology · Department of Internal Medicine · Medical University of Innsbruck

Anichstraße 35

6020 Innsbruck · Austria

Phone: 0043/512/5045855

Fax: 0043/512/5045857

Email: gert.mayer@uibk.ac.at

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