Fluid intake and blood pressure in children: the Salus per Aquam project
Sodium intake is known to contribute to the development of hypertension, thus intake reduction is a cornerstone in the prevention and management of hypertension. The increase in renal sodium excretion might represent a further potential preventive and/or therapeutic opportunity.
To explore the working hypothesis that an increased fluid intake can improve renal sodium handling towards a decrease in blood pressure.
The SPA Project is a multicenter, observational, cross-sectional, cohort study investigating healthy children, aged 5–8 years as to sodium and fluid intake by means of urinary sodium and creatinine from multiple samples taken in different days in order to characterize them in lower/higher sodium and lower/higher fluid intake. Both SBP and DBP (by multiple office blood pressure measurements) were used as outcome measures.
Three hundred and thirty-nine healthy, nonoverweight children (51.6% boys) with a median age of 5.7 years old (IQR: 5.3–6.2) participated in the study but only 223 could be analyzed. Among children with higher sodium intake, those introducing more fluids, showed a significantly lower blood pressure (both systolic and diastolic) compared with those with lower fluid intake: systolic 86.0 ± 8.5 vs. 90.0 ± 8.1 mmHg; P = 0.014 and diastolic: 53.8 ± 4.9 vs. 58.6 ± 6.6 mmHg; P < 0.0001.
An increased fluid intake is associated with a reduced blood pressure possibly by increasing renal sodium excretion. We speculate that this simple, highly acceptable, inexpensive, and harmless measure might have a role in preventing and/or minimizing the epidemics of hypertension and of its related morbidities both in children and in adults.
Keywords: blood pressure; children; excretion; fluid; intake; sodium
Document Type: Research Article
Affiliations: 1: Pediatric Nephrology, Dialysis and Transplantation Unit 2: Neonatology and Neonatal Intensive Care Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico 3: Department of Pediatric Cardiology, Vittore Buzzi Children's Hospital 4: Pediatric Cardiology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico 5: Department of Pediatrics, Vittore Buzzi Children's Hospital 6: Pediatric Practitioner, Milan, Italy 7: Department of Medicine, Imperial College, London, UK 8: UO Cardiologia ad Indirizzo Pediatrico, Polo Materno-Infantile, Varese 9: UOC Pediatria Medica, Ospedale di Pescara, Pescara 10: Pediatric Cardiology Unit, Parma General and University Hospital, Parma 11: UO Cardiologia Riabilitativa e Prevenzione Patologie Cardiovascolari, USL Umbria1, Perugia 12: UOS Cardiologia Pediatrica, Policlinico Universitario, Messina 13: Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan 14: Freelance Clinical Epidemiologist, Bergamo, Italy
Publication date: January 25, 2022
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