rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2015-11-2-190-195rpcardio-149Research ArticlePOINT OF VIEWТОЧКА ЗРЕНИЯLOW SODIUM DIET: PROS AND CONSДИЕТА С НИЗКИМ СОДЕРЖАНИЕМ ПОВАРЕННОЙ СОЛИ: ЗА И ПРОТИВДрапкинаО. М.DrapkinaO. M.

д.м.н., профессор кафедры пропедевтики внутренних болезней лечебного факультета, зав. отделением кардиологии УКБ№2

119991, Москва, ул. Трубецкая, 8, стр. 2

Trubetskaya ul. 8-2, Moscow, 119991 Russia

drapkina@bk.ruШепельР. Н.Shepel'R. N.

аспирант той же кафедры, врач-кардиолог того же отделения

119991, Москва, ул. Трубецкая, 8, стр. 2

Trubetskaya ul. 8-2, Moscow, 119991 Russia

Первый Московский государственный медицинский университет им. И.М. СеченоваРоссияI.M. Sechenov First Moscow State Medical UniversityRussian Federation201523092015112190195Copyright © Drapkina O.M., Shepel' R.N., 20152015Драпкина О.М., Шепель Р.Н.Drapkina O.M., Shepel' R.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/149

Currently, there is rather contradictory evidence on the effectiveness of a low sodium diet for the prevention of various diseases. At that, it is a generally accepted fact, that it is necessary to reduce salt intake in order to reduce high blood pressure. An internist should remember that the degree of blood pressure reduction is individual and not always depends on the level of salt intake. Moreover, the low-sodium diet helps to reduce the rate of telomere shortening, thereby slowing down the aging process.

В настоящее время существуют достаточно противоречивые данные по эффективности низкосолевой диеты с целью профилактики различного рода заболеваний. При этом общепризнанным является факт, что снижение потребления соли необходимо для коррекции высоких цифр артериального давления. Врачу не стоит забывать о том, что степень снижения артериального давления индивидуальна, и не всегда зависит от уровня потребления соли. Кроме того, низкосолевая диета способствует сни-жению скорости укорочения теломер, тем самым замедляя процессы старения.

теломерыстарениесердечно-сосудистая системафактор рискасольtelomeresagingcardiovascular systemrisk factorsaltReferencesEaston B.S., Konner M. Paleolithic nutrition: A consideration of its nature and current implications. NEJM 1985: (312):283-9.Easton B.S., Konner M. Paleolithic nutrition: A consideration of its nature and current implications. NEJM 1985: (312):283-9.McCarron D.A., Geerling J.C., Kazacs A.C. et al. Can dietary sodium intake be modified by public policy? Clin J Am Soc Nephrol 2009 (4): 1878-82.McCarron D.A., Geerling J.C., Kazacs A.C. et al. Can dietary sodium intake be modified by public policy? Clin J Am Soc Nephrol 2009 (4): 1878-82.Intersalt Cooperative Research Group: Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. BMJ 1988; 297: 319-28.Intersalt Cooperative Research Group: Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. BMJ 1988; 297: 319-28.Brown I.J., Tzoulaki I., Candeias V. et al. Salt intakes around the world: implications for public health. Int J Epidemiol 2009; 38: 791-813.Brown I.J., Tzoulaki I., Candeias V. et al. Salt intakes around the world: implications for public health. Int J Epidemiol 2009; 38: 791-813.Beloglazova IP, Mogutova PA, Poteshkina NG. Salt intake and heart remodeling in patients with arterial hypertension. Vestnik RGMU 2013; (1): 20-4. Russian (Белоглазова И.П., Могутова П.А., По-тешкина Н.Г. Потребление соли и ремоделирование сердца у больных артериальной гипертен-зией. Вестник РГМУ 2013; (1): 20-4).Beloglazova IP, Mogutova PA, Poteshkina NG. Salt intake and heart remodeling in patients with arterial hypertension. Vestnik RGMU 2013; (1): 20-4. Russian (Белоглазова И.П., Могутова П.А., По-тешкина Н.Г. Потребление соли и ремоделирование сердца у больных артериальной гипертен-зией. Вестник РГМУ 2013; (1): 20-4).Volkov VS, Poselyugina OB, Nilova SA. Arterial hypertension and salt intake in Russia. Bolezni Serdtsa i Sosudov 2009; 9 (4): 16-8. Russian (Волков В.С., Поселюгина О.Б., Нилова С.А. Артериальная гипертония и потребление поваренной соли в России. Болезни Сердца и Сосудов 2009; 9 (4): 16-8).Volkov VS, Poselyugina OB, Nilova SA. Arterial hypertension and salt intake in Russia. Bolezni Serdtsa i Sosudov 2009; 9 (4): 16-8. Russian (Волков В.С., Поселюгина О.Б., Нилова С.А. Артериальная гипертония и потребление поваренной соли в России. Болезни Сердца и Сосудов 2009; 9 (4): 16-8).Jacobson M.F. Salt The Forgotten Killer. Washington, D.C.: Center for Science in the Public Interest; 2005.Jacobson M.F. Salt The Forgotten Killer. Washington, D.C.: Center for Science in the Public Interest; 2005.He F.J., MacGregor G.A. Salt intake and cardiovascular disease. Nephrol Dial Transplant 2008; 23 (11): 3382-5.He F.J., MacGregor G.A. Salt intake and cardiovascular disease. Nephrol Dial Transplant 2008; 23 (11): 3382-5.Farley T. Cut the salt. Get the facts: The National Salt Reduction Initiative. New York (NY): New York City Department of Mental Health and Hygiene. Available: www.nyc.gov/html/doh/downloads/pdf/cardio/cardiosalt-nsri-faq.pdf (accessed by 22.10.2014).Farley T. Cut the salt. Get the facts: The National Salt Reduction Initiative. New York (NY): New York City Department of Mental Health and Hygiene. Available: www.nyc.gov/html/doh/downloads/pdf/cardio/cardiosalt-nsri-faq.pdf (accessed by 22.10.2014).Krieger J.N., Sherrad D.J. Practical fluid and electrolytes. Norwalk, CT: Appleton and Lange, 1991.Krieger J.N., Sherrad D.J. Practical fluid and electrolytes. Norwalk, CT: Appleton and Lange, 1991.Djadyk A.I., Bagrij A.Je., Vorob'eva A.S. et al. Faces of Ukraine 2008; (5): 40-2.Djadyk A.I., Bagrij A.Je., Vorob'eva A.S. et al. Faces of Ukraine 2008; (5): 40-2.Lawes C.M.M., Bennett D.A., Feigin V.L., Rodgers A. Blood pressure and stroke: an overview of published reviews. Stroke 2004; 35: 776-85.Lawes C.M.M., Bennett D.A., Feigin V.L., Rodgers A. Blood pressure and stroke: an overview of published reviews. Stroke 2004; 35: 776-85.Effects of treatment on morbidity in hypertension, II: results in patients with diastolic blood pressure averaging 90 through 114 mm Hg. JAMA 1970;213 (7):1143-52.Effects of treatment on morbidity in hypertension, II: results in patients with diastolic blood pressure averaging 90 through 114 mm Hg. JAMA 1970;213 (7):1143-52.Kostis JB, Davis BR, Cutler J, et al. Prevention of heart failure by antihypertensive drug treatment in older persons with isolated systolic hypertension. SHEP Cooperative Research Group. JAMA 1997;278(3):212-6.Kostis JB, Davis BR, Cutler J, et al. Prevention of heart failure by antihypertensive drug treatment in older persons with isolated systolic hypertension. SHEP Cooperative Research Group. JAMA 1997;278(3):212-6.Collins R, MacMahon S. Blood pressure, antihypertensive drug treatment and the risk of stroke and of coronary heart disease. Br Med Bull 1994;50:272-98.Collins R, MacMahon S. Blood pressure, antihypertensive drug treatment and the risk of stroke and of coronary heart disease. Br Med Bull 1994;50:272-98.Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospective designed overviews of randomised trials. Lancet 2000;356:1955-64.Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospective designed overviews of randomised trials. Lancet 2000;356:1955-64.Kempner W. Treatment of kidney desease and hypertensive vascular disease with the rise diet. Noth Caroline Medical Journal 1944(5): 125-133.Kempner W. Treatment of kidney desease and hypertensive vascular disease with the rise diet. Noth Caroline Medical Journal 1944(5): 125-133.Denton D., Weisinger R., Mundy N.I., et al. The effect of increased salt intake on blood pressure of chimpanzees. Nat Med 1995;1:1009-16.Denton D., Weisinger R., Mundy N.I., et al. The effect of increased salt intake on blood pressure of chimpanzees. Nat Med 1995;1:1009-16.Cook NR, Cutler JA, Obarzanek E, et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ 2007; 334: 885-93.Cook NR, Cutler JA, Obarzanek E, et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ 2007; 334: 885-93.Midgley J.P., Matthew A.G., Greenwood C.M., Logan A.G. Effect of reduced dietary sodium on blood pressure: a meta-analysis of randomized controlled trials. JAMA 1999,275(20):1590-7.Midgley J.P., Matthew A.G., Greenwood C.M., Logan A.G. Effect of reduced dietary sodium on blood pressure: a meta-analysis of randomized controlled trials. JAMA 1999,275(20):1590-7.Graudal N.A., Galloe A.M., Garred P. Effects of sodium restriction on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride: a meta-analysis. JAMA 1998; 279(17):1383-91.Graudal N.A., Galloe A.M., Garred P. Effects of sodium restriction on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride: a meta-analysis. JAMA 1998; 279(17):1383-91.Kagan A., Popper J.S., Rhoads G.G., Yano K. Dietary and other risk factors for stroke in Hawaiian Japanese men. Stroke 1985; 16: 390-6.Kagan A., Popper J.S., Rhoads G.G., Yano K. Dietary and other risk factors for stroke in Hawaiian Japanese men. Stroke 1985; 16: 390-6.Alderman M.H., Madhavan S., Cohen H., et al. Low urinary sodium is associated with greater risk of myocardial infarction among treated hypertensive men. Hypertension 1995 (5):1144-52.Alderman M.H., Madhavan S., Cohen H., et al. Low urinary sodium is associated with greater risk of myocardial infarction among treated hypertensive men. Hypertension 1995 (5):1144-52.Cutler J.R., Presented May 30, 1997, at American Society of Hypertension annual meeting, San Francisco, CA (unpublished).Cutler J.R., Presented May 30, 1997, at American Society of Hypertension annual meeting, San Francisco, CA (unpublished).Tunstall-Pedoe H., Woodward M., Tavendale R, et al. Comparison of the prediction by 27 different factors of coronary heart disease and death in men and women of the Scottish heart health study: cohort study. BMJ 1997; 315: 722-9.Tunstall-Pedoe H., Woodward M., Tavendale R, et al. Comparison of the prediction by 27 different factors of coronary heart disease and death in men and women of the Scottish heart health study: cohort study. BMJ 1997; 315: 722-9.Alderman MH, Cohen H, Madhavan S. Dietary sodium intake and mortality: the National Health and Nutrition Examination Survey (NHANES I). Lancet 1998; 351:781-5.Alderman MH, Cohen H, Madhavan S. Dietary sodium intake and mortality: the National Health and Nutrition Examination Survey (NHANES I). Lancet 1998; 351:781-5.Cohen HW, Hailpern SM, Fang J, Alderman MH. Sodium intake and mortality in the NHANES II follow-up study. Am J Med 2006;119(3):275.e7-14.Cohen HW, Hailpern SM, Fang J, Alderman MH. Sodium intake and mortality in the NHANES II follow-up study. Am J Med 2006;119(3):275.e7-14.Geleijnse JM, Witteman JC, Stijnen T, et al. Sodium and potassium intake and risk of cardiovascular events and all-cause mortality: the Rotterdam Study. Eur J Epidemiol 2007;22(11):763-70.Geleijnse JM, Witteman JC, Stijnen T, et al. Sodium and potassium intake and risk of cardiovascular events and all-cause mortality: the Rotterdam Study. Eur J Epidemiol 2007;22(11):763-70.Larsson S.C., Virtanen M.J., Mars M., et al. Magnesium, Calcium, Potassium, and Sodium Intakes and Risk of Stroke in Male Smokers. Arch Intern Med 2008;168(5):459-65.Larsson S.C., Virtanen M.J., Mars M., et al. Magnesium, Calcium, Potassium, and Sodium Intakes and Risk of Stroke in Male Smokers. Arch Intern Med 2008;168(5):459-65.Olovnikov AM. A theory of marginotomy. The incomplete copying of template margin in enzymic synthesis of polynucleotides and biological significance of the phenomenon. J Theor Biol 1973;41:181-90.Olovnikov AM. A theory of marginotomy. The incomplete copying of template margin in enzymic synthesis of polynucleotides and biological significance of the phenomenon. J Theor Biol 1973;41:181-90.Drapkina OM, Shepel RN. Modern views on the role of telomeres and telomerase in the pathogenesis of hypertension. Arterial'naya Gipertenziya 2013; (19) 4: 290-28. Russian (Драпкина О.М., Шепель Р.Н. Современные представления о роли теломер и теломеразы в патогенезе гипер-тонической болезни. Артериальная Гипертензия 2013; (19)4: 290-28).Drapkina OM, Shepel RN. Modern views on the role of telomeres and telomerase in the pathogenesis of hypertension. Arterial'naya Gipertenziya 2013; (19) 4: 290-28. Russian (Драпкина О.М., Шепель Р.Н. Современные представления о роли теломер и теломеразы в патогенезе гипер-тонической болезни. Артериальная Гипертензия 2013; (19)4: 290-28).Cappuccio F.P., D’Elia L., Strazzullo P., Miller M.A. Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care 2010; 33: 414-20.Cappuccio F.P., D’Elia L., Strazzullo P., Miller M.A. Quantity and quality of sleep and incidence of type 2 diabetes: a systematic review and meta-analysis. Diabetes Care 2010; 33: 414-20.Cappuccio F.P., Taggart F.M., Kandala N.B., et al. Meta-analysis of short sleep duration and obesity in children, adolescents and adults. Sleep 2008; 31: 619-26.Cappuccio F.P., Taggart F.M., Kandala N.B., et al. Meta-analysis of short sleep duration and obesity in children, adolescents and adults. Sleep 2008; 31: 619-26.Ikehara S.,Iso H., Date C., et al. Association of sleep duration with mortality from cardiovascular disease and other causes for Japanese men and women: the JACC study. Sleep 2009; 32(3): 259-301.Ikehara S.,Iso H., Date C., et al. Association of sleep duration with mortality from cardiovascular disease and other causes for Japanese men and women: the JACC study. Sleep 2009; 32(3): 259-301.Willeit Р., Willeit J., Mayr A., et al. Telomere length and risk of incident cancer and cancer mortality. JAMA 2010; 304: 69-75.Willeit Р., Willeit J., Mayr A., et al. Telomere length and risk of incident cancer and cancer mortality. JAMA 2010; 304: 69-75.Drapkina OM, Shepel RN. Telomeres and chronic heart failure. Kardiologiya 2014; 54 (4): 60-7. Russian (Драпкина О.М., Шепель Р.Н. Теломеры и хроническая сердечная недостаточность. Кардиология 2014; 54(4): 60-7).Drapkina OM, Shepel RN. Telomeres and chronic heart failure. Kardiologiya 2014; 54 (4): 60-7. Russian (Драпкина О.М., Шепель Р.Н. Теломеры и хроническая сердечная недостаточность. Кардиология 2014; 54(4): 60-7).Ogami M., Ikura Y., Ohsawa M., et al. Telomere shortening in human coronary artery diseases. Arterioscler Tromb Vasc Diol 2004; 24: 546-50.Ogami M., Ikura Y., Ohsawa M., et al. Telomere shortening in human coronary artery diseases. Arterioscler Tromb Vasc Diol 2004; 24: 546-50.Zhu H. Abstract MP64: High sodium intake is associated with short leukocyte telomere length in overweight and obese adolescents. Circulation 2014; 129: AMP64.Zhu H. Abstract MP64: High sodium intake is associated with short leukocyte telomere length in overweight and obese adolescents. Circulation 2014; 129: AMP64.World Health Organization. Reducing salt intake in populations: report of a WHO forum and technical meeting, 5-7 October 2006, Paris, France. Geneva, Switzerland: World Health Organization; 2007.World Health Organization. Reducing salt intake in populations: report of a WHO forum and technical meeting, 5-7 October 2006, Paris, France. Geneva, Switzerland: World Health Organization; 2007.

The authors declare that there are no conflicts of interest present.