Blood Pressure Stability and Plasma Aldosterone Reduction: The Effects of a Sodium and Bicarbonate-Rich Water - A Randomized Controlled Intervention Study

Blood Press. 2024 Dec;33(1):2291411. doi: 10.1080/08037051.2023.2291411. Epub 2023 Dec 21.

Abstract

Objective: Hypertension is a recognized risk factor for cardiovascular disease (CVD), and dietary sodium intake has been linked to its development. However, mineral water high in bicarbonate and sodium does not appear to have adverse effects on blood pressure.This study examines the effects of consuming a mineral water high in bicarbonate and sodium (HBS) compared to a low bicarbonate and sodium (LBS) mineral water on blood pressure and related factors.Methods: A randomized controlled intervention was conducted with 94 healthy participants, consuming 1,500 - 2,000 mL daily of either mineral water high in bicarbonate and sodium (HBS water, n = 49) or low in bicarbonate and sodium (LBS water, n = 45). Blood pressure, anthropometrics, and urinary calcium and sodium excretion were assessed at baseline and after 28 days. 3-day food protocols were assessed to evaluate possible dietary changes.Results: Blood pressure changes did not differ between the groups. Both normotensive and hypertensive subjects showed similar changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) in response to the different test waters. Serum aldosterone decreased significantly in both groups, with a greater reduction in the HBS group. Urinary calcium excretion significantly decreased (p = 0.002) and sodium excretion increased in the HBS group. Multiple linear regression analyses indicated no association between urinary sodium excretion and systolic blood pressure increase in the HBS group (B = 0.046, p = 0.170). Changes in urinary sodium excretion did not correlate with changes in serum aldosterone in the same group (r=-0.146, p = 0.350).Conclusions: The study revealed no significant differences in blood pressure changes between individuals consuming HBS water and LBS water. Notably, the additional sodium intake from the test water was effectively excreted.Trial registration: This trial was registered in the German Clinical Trials Register (DRKS00025341, https://drks.de/search/en).

Keywords: Bicarbonate; aldosterone; blood pressure; mineral water; sodium.

Plain language summary

What is the context? High blood pressure is a risk factor for heart diseases, one of the leading causes of illness and death worldwide. Too much sodium in the diet has been linked to the development of high blood pressure. However, some high-sodium mineral waters appear to have a different effect on blood pressure. Researchers have demonstrated that mineral waters high in both sodium and bicarbonate may not have harmful effects on blood pressure.What is the study about? In this study, 94 healthy participants between the ages 30 to 65 were divided into two groups. One group drank high-bicarbonate, high-sodium mineral water, and the other group drank low-bicarbonate, low-sodium mineral water for four weeks. Blood pressure was measured before and at the end of the study. The participants were asked not to change their usual diet and physical activity during the study.What are the results? Blood pressure did not change differently between the two groups. Consumption of high-sodium, high-bicarbonate mineral water increased sodium intake, but sodium was effectively excreted in the urine. Moreover, aldosterone, a blood pressure regulating hormone, decreased with mineral water consumption. Its reduction is good for maintaining stable blood pressure.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aldosterone
  • Bicarbonates / pharmacology
  • Blood Pressure / physiology
  • Calcium
  • Humans
  • Hypertension*
  • Mineral Waters*
  • Sodium / pharmacology

Substances

  • Sodium
  • Bicarbonates
  • Aldosterone
  • Calcium
  • Mineral Waters