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Salzkonsum und kardiovaskuläres Risiko

Plädoyer für eine Salzreduktion

Salt consumption and cardiovascular risk

A plea for salt reduction

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Zusammenfassung

Ein langfristig erhöhter Salzkonsum erhöht die Inzidenz der arteriellen – insbesondere systolischen – Hypertonie mit allen bekannten kardiovaskulären Folgen, wie z. B. Schlaganfall, Herz- und Niereninsuffizienz. Er beschleunigt als vaskulärer Risikofaktor die Entwicklung der (aortalen) Gefäßsteifigkeit. Die verminderte Compliance führt zur Augmentation des zentralen Blutdrucks, erhöht die Last des linken Ventrikels und vermindert die diastolische Perfusion. Hierdurch kann die Entwicklung einer Herzinsuffizienz begünstigt werden. Eine Blutdrucksenkung durch Salzreduktion ist durch zahlreiche kontrollierte Studien sehr gut belegt. In Langzeitstudien konnte auch eine Reduktion der kardiovaskulären Morbidität und Mortalität gezeigt werden. Die Empfehlung zur Salzreduktion sollte von der Empfehlung zur Erhöhung der Kaliumaufnahme begleitet werden.

Abstract

High salt intake over long term is associated with increased incidence of arterial, predominantly systolic, hypertension and increased risk of cardiovascular diseases, e.g., stroke, heart failure, and renal insufficiency. High salt consumption is a vascular risk factor generating aortic stiffness and decreased vascular compliance leading to central blood pressure augmentation, higher cardiac load, and diminished diastolic perfusion. The development of heart failure can be a consequence of this sequelae. Randomized trials show a reduction in blood pressure with lower sodium intake. In long-term clinical trials, a reduction in cardiovascular morbidity and mortality has been demonstrated. Recommendations should emphasize the simultaneous reduction in sodium intake and increase in potassium intake.

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Middeke, M. Salzkonsum und kardiovaskuläres Risiko. Internist 53, 14–19 (2012). https://doi.org/10.1007/s00108-011-2888-2

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