High Dietary Sodium, Measured Using Spot Urine Samples, is Associated with Higher Blood Pressure among Young Adults in Haiti
Adrienne Clermont,
Vanessa Rouzier,
Jean Lookens Pierre,
Rodney Sufra,
Eliezer Dade,
Fabyola Preval,
Stephano St-Preux,
Marie Marcelle Deschamps,
Alexandra Apollon,
Kathryn Dupnik,
Miranda Metz,
Yanique Duffus,
Shalom Sabwa,
Lily D. Yan,
Myung Hee Lee,
Lawrence G. Palmer,
Linda M. Gerber,
Mark S. Pecker,
Samuel J. Mann,
Monika M. Safford,
Daniel W. Fitzgerald,
Jean W. Pape,
Margaret L. McNairy
Affiliations
Adrienne Clermont
Center for Global Health, Weill Cornell Medicine, 402 East 67th Street, New York, NY 10065; MD Program, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065
Vanessa Rouzier
Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), 33 Boulevard Harry Truman, Port-au-Prince 6110
Jean Lookens Pierre
Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), 33 Boulevard Harry Truman, Port-au-Prince 6110
Rodney Sufra
Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), 33 Boulevard Harry Truman, Port-au-Prince 6110
Eliezer Dade
Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), 33 Boulevard Harry Truman, Port-au-Prince 6110
Fabyola Preval
Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), 33 Boulevard Harry Truman, Port-au-Prince 6110
Stephano St-Preux
Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), 33 Boulevard Harry Truman, Port-au-Prince 6110
Marie Marcelle Deschamps
Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), 33 Boulevard Harry Truman, Port-au-Prince 6110
Alexandra Apollon
Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), 33 Boulevard Harry Truman, Port-au-Prince 6110
Kathryn Dupnik
Center for Global Health, Weill Cornell Medicine, 402 East 67th Street, New York, NY 10065
Miranda Metz
Center for Global Health, Weill Cornell Medicine, 402 East 67th Street, New York, NY 10065
Yanique Duffus
Center for Global Health, Weill Cornell Medicine, 402 East 67th Street, New York, NY 10065
Shalom Sabwa
Center for Global Health, Weill Cornell Medicine, 402 East 67th Street, New York, NY 10065
Lily D. Yan
Center for Global Health, Weill Cornell Medicine, 402 East 67th Street, New York, NY 10065
Myung Hee Lee
Center for Global Health, Weill Cornell Medicine, 402 East 67th Street, New York, NY 10065
Lawrence G. Palmer
Department of Physiology and Biophysics, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065
Linda M. Gerber
Department of Population Health Sciences, Weill Cornell Medicine, 402 East 67th Street, New York, NY 10065; Department of Medicine, Division of Nephrology and Hypertension, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065
Mark S. Pecker
Department of Medicine, Division of Nephrology and Hypertension, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065
Samuel J. Mann
Department of Medicine, Division of Nephrology and Hypertension, Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065
Monika M. Safford
Center for Global Health, Weill Cornell Medicine, 402 East 67th Street, New York, NY 10065
Daniel W. Fitzgerald
Center for Global Health, Weill Cornell Medicine, 402 East 67th Street, New York, NY 10065
Jean W. Pape
Center for Global Health, Weill Cornell Medicine, 402 East 67th Street, New York, NY 10065, US; Haitian Group for the Study of Kaposi’s Sarcoma and Opportunistic Infections (GHESKIO), 33 Boulevard Harry Truman, Port-au-Prince 6110
Margaret L. McNairy
Center for Global Health, Weill Cornell Medicine, 402 East 67th Street, New York, NY 10065
Background: Hypertension (HTN) is the leading cardiovascular disease (CVD) risk factor in Haiti and is likely driven by poverty-related social and dietary factors. Salt consumption in Haiti is hypothesized to be high but has never been rigorously quantified. Methods: We used spot urine samples from a subset of participants in the population-based Haiti Cardiovascular Disease Cohort to estimate population mean daily sodium intake. We compared three previously validated formulas for estimating dietary sodium intake using urine sodium, urine creatinine, age, sex, height, and weight. We explored the association between dietary sodium intake and blood pressure, stratified by age group. Results: A total of 1,240 participants had spot urine samples. Median age was 38 years (range 18–93), and 48% were female. The mean dietary sodium intake was 3.5–5.0 g/day across the three estimation methods, with 94.2%–97.9% of participants consuming above the World Health Organization (WHO) recommended maximum of 2 g/day of sodium. Among young adults aged 18–29, increasing salt intake from the lowest quartile of consumption (5.88 g/day) was associated with a mean 8.71 mmHg higher systolic blood pressure (SBP) (95% confidence interval: 3.35, 14.07; p = 0.001). An association was not seen in older age groups. Among participants under age 40, those with SBP ≥120 mmHg consumed 0.5 g/day more sodium than those with SBP <120 mmHg (95% confidence interval: 0.08, 0.69; p = 0.012). Conclusions: Nine out of 10 Haitian adults in our study population consumed more than the WHO recommended maximum for daily sodium intake. In young adults, higher sodium consumption was associated with higher SBP. This represents an inflection point for increased HTN risk early in the life course and points to dietary salt intake as a potential modifiable risk factor for primordial and primary CVD prevention in young adults.
