Effects of low-sodium bread on dietary compliance and fecal cultivable bacteria in a randomized controlled pilot trial in hypertensive subjects.

High salt intake and compliance to low-sodium (LS) diets are critical in hypertension. Salt reduction in processed foods can help to achieve the target sodium intake. To verify the hypothesis that an innovative LS formulation of a traditional bread could result in a reduction of sodium intake and blood pressure, we performed a 6-month randomized controlled pilot trial on hypertensive patients. We additionally explored the effects of sodium restriction on blood pressure and fecal cultivable bacteria.Fifty-seven patients were randomized in three groups. Group A (n = 19) followed a free diet using standard bread (750 mg Na/100 g), group B (n = 18) followed a LS diet (2300 mg Na/die) using standard bread, group C (n = 20) followed a LS diet (2300 mg Na/die) using LS bread (280 mg Na/100 g). We measured 24-h urinary sodium, blood pressure, routine parameters, fecal microbial counts (26 patients).After 6 months, as compared to group A, group C showed a reduction of 24-h urinary sodium excretion (-908 mg/24 h), diastolic pressure (-9 mmHg) and microbial counts of Bacteroides, Porphyromonas, Prevotella, Enterobacteriaceae, Staphylococcus, Micrococcus. These results suggest that LS bread could increase the adherence to a LS diet, reducing sodium excretion, diastolic pressure and abundance of some fecal cultivable bacteria.Trial registration Registration nr. NCT03127553, on 25/04/2017.

Hypertension in the elderly.

Hypertension is a common problem in the elderly. Its prevalence is currently 60%-80%, but it is estimated that it will increase with the projected population growth of older people aged more than 65 years. Hypertension is a major cardiovascular risk factor due to the well-known continuous relationship between high blood pressure, stroke and cardiovascular (CV) mortality in all age groups. Because of the expected increasing proportion of older people, a further increase in CV and renal complications of hypertension in the next few decades can be predicted. In the elderly, systolic blood pressure increases because of arterial stiffness produced by structural alterations of arterial wall occurring with aging. On the other hand, in people aged 60 years and over, diastolic blood pressure remains unchanged or decreases. Isolated systolic hypertension and high pulse pressure are thus prevalent, and are important risk factors for stroke, coronary heart disease and all-cause mortality in the elderly and very elderly. The efficacy of therapy in older patients with systolic and diastolic hypertension or with isolated systolic hypertension, in terms of reduction of cardiovascular morbility and mortality, have been widely confirmed by many controlled and randomized clinical trials.