Low-Salt and Minimal Sugar-Sweetened Beverage Intake May Not Improve Hypertension Control

Objective: Sugar-sweetened beverage (SSB) (high fructose corn syrup and sucrose) consumption positively associates with obesity, cardiovascular disease, and hypertension (HTN). High fructose intake may aggravate HTN, an effect enhanced by greater sodium intake. Thus, high SSB may increase difficult-to-control BP (BPD). Methods: SSB consumption in the Systolic Blood Pressure Intervention Trial (SPRINT) was evaluated in 61 subjects with a validated instrument and converted to grams of fructose per day. Demographics and 24-hour sodium excretion were collected. The BPD group had SBP >140 mmHg or >120 mmHg for intensive group participants, or BP at “goal” for the trial group and more than median number of agents in each group in study as a whole. The “BP Easy” group (BPE; n=25) group comprised the remainder of subjects. Mean BP from two visits before SPRINT termination established the study BP; descriptive variables were summarized; and a Wilcoxon rank sum test was used to compare SSB consumption between groups. Results: Cohort characteristics are shown in Table 1. BPD and BPE median fructose intakes were 11.25 g/d (IQR, 5.5 to 17.92) and 11.9 g/day (IQR 2.9 to 36.71; P =0.577), respectively. BPD and BPE median 24hr urine sodium excretion were 108.4 mmol (IQR 89.5-152.5) and 121.1 (102-137; P=0.16), respectively. Conclusions: A highly selected group of older subjects had low SSB (fructose) intake, yet a proportion that consumed less sodium and fructose manifested difficult to control BP. Further study of this sub-population is critical to better understanding difficult to control BP.