Sodium in effervescent, dispersible, soluble drugs linked to hypertension and heart risk.

Excess dietary sodium is a major and global health problem. The National Salt Reduction Initiative (NSRI) established in 2010, still hopes to reduce dietary sodium consumption in the U. by 20 percent in five years. Cutting sodium intake to the recommended 2.3 g/day (100 mmol/L or one teaspoonful) could prevent 11 million cases of hypertension.

When it comes to concern about sodium intake levels, the most publicized problem is high-salt diets. However, a group of researchers were concerned about the level of sodium in some common fizzy meds and their health impact especially for people with high blood pressure.

In their study, they found a link between the amount of sodium in certain drugs and the risk of cardiovascular problems, including hypertension and stroke. Moreover, the normal use of some of these meds can expose patients to sodium levels well above the recommended maximum.

They said that many effervescent, dispersible and soluble medicines contain very high levels of sodium usually in the form of sodium bicarbonate which makes them fizz. Some levels are so high they can raise a person’s risk of developing a range of serious health conditions. For example, the maximum recommended dose of dispersible paracetamol delivers almost 1.5 times an adult’s recommended sodium intake. Sodium is added to medicines for several reasons, such as to aid absorption into the body, to make them fizz, to aid their dispersal, or to help them dissolve in water. This means these medicines can contain very high quantities of sodium, even though sodium is not one of their active medical ingredients.

The study authors said that taking these drugs in addition to a typical “Western” diet, could result in high sodium intake. “Curiously, unlike foods, pharmaceutical manufacturers are not placed under any restrictions or obligations with regards to sodium content or labelling of these sodium-containing formulations.”

The researchers tracked more than 1.2 million patients for seven years, and compared the risk of cardiovascular events – non-fatal heart attack, non-fatal stoke, or vascular death – in those taking sodium-containing effervescent, dispersible and soluble medications with those taking non-sodium versions of the same drugs. They found that patients taking the sodium-containing drugs had a 16 percent increased risk of a heart attack, stroke or vascular death compared with those taking sodium-free versions of the same medications.

The patients who took sodium-containing drugs were seven times more likely to develop high blood pressure. Their death rate was also 28 percent higher than that of the non-sodium patients, a number the researchers said was driven by the increased risk of hypertension and stroke.

Lead author Dr. Jacob George, Senior Clinical Lecturer and Honorary Consultant in Clinical Pharmacology at the University of Dundee, said a problem with many medicines’ sodium content is not just the quantity of it, but the fact that people just don’t know about it. “These medications contain quite a lot more sodium than a lot of people are aware. In fact, if you take the full dose of certain medications, you’re elevating your risk of sodium-related health problems even before you take into account dietary factors.”

Dr. George emphasized that the elevated risks shown in the study were attributable to normal doses of sodium-containing medicines, not excessive use.

The authors conclude that sodium-containing medications should be prescribed with caution only if the perceived benefits outweigh these risks. They also say that their sodium-content should be labelled to warn hypertensives and other people at risk.


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