THE CLINIC: Hypertension Concerns

Thu, 13 Sept. 2012 - 1:09 a.m. MT
Credit: ARA Staff - American Running Association

QUESTION:
I am a 53-year-old female with 25 years of running under my belt. I currently run about 35 miles a week, as I’m training for a marathon. I am 5’ 5” and 120 lbs. I run a 5K in 24:30 and a marathon in about 4:15. I do tempo runs, long runs, and speedwork.
 
I consume an enormous amount of salt, and it concerns me. I do not particularly like salt, but find, most often in the summer, that I crave it. I do sweat profusely. I have a history of hypertension in the family. At 120 over 75, my blood pressure is still good, if slightly higher than the 110 over 60 from 10 years ago. Recently two of my running buddies, who happen to be very strong athletes, have developed hypertension; this surprises and worries me. Without a lot of salt, my training schedule makes me very lethargic. Can my sodium intake be harmful? How often should I check my blood pressure? I am a bit of a type-A personality and have had trouble sleeping, plus hot flashes associated with menopause. I really wish to avoid developing hypertension.
 
Sue Fenimore
Baltimore, MD
 
ANSWER:
With a blood pressure of 120 over 75 and clearly a salty sweater, you are doing the right thing and should not worry unless you actually develop hypertension.
 
Athletes sweating in the summer sun should not abide by the dietary guidelines established for sedentary adults: 2,300 milligrams of sodium daily. This equates to a teaspoon of table salt a day. As internist for the Oklahoma Sooners, I have found some OU football players, during two-a-day workouts, to lose five teaspoons of salt a day. Heat cramping and exhaustion result from lack of sodium. Never drink more than you sweat. Overdrinking, even fluids with sodium, can dilute blood sodium. If you gain weight during a long run, drink less next time. 
 
If you see salt on your skin or clothing or sweat burns your eyes, you may need more salt than most people during a workout in the sun. Foods with lots of sodium include tomato juice, canned soup, pickles, pretzels, and pizza.
 
Randy Eichner, MD
Oklahoma City, OK
 
ANSWER:
As noted above, your desire for salt seems like your body’s appropriate response to your exercise regimen. You might obtain a home blood pressure monitor at your local pharmacy and monitor it twice a week. Keep a diary of these readings to be sure you’re on the right dietary track. While excess sodium does carry the risk of hypertension, the dangers of hyponatremia—dangerously low blood sodium—are worth reading up on as well.
 
Lloyd Lense, MD 
East Setauket, NY

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(RUNNING & FITNEWS® April/March 2006 • Volume 24, Number 2)




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