Previous research has shown daily salt intakes in Turkey to be far above the recommended limits. Knowing the sources of dietary salt could form a basis for preventive strategies aimed towards salt reduction. This study aimed to investigate dietary sources of salt in Turkey. A sub-group (n = 657) was selected from the PatenT2 study population, which represented the urban and rural areas of 4 major cities (Ankara, Istanbul, Izmir, and Konya). A questionnaire inquiring about sociodemographic characteristics, medical histories, detailed histories of diet, and salt consumption was completed. Participants were asked to collect a 24-h urine sample and to record their food intake (dietary recall) on the same day. Of 925 participants selected, 657 (71%) provided accurate 24-h urine collections, based on creatinine excretion data. The mean daily 24-h urinary sodium excretion was 252.0 ± 92.2 mmol/day, equal to daily salt intake of 14.8 ± 5.4 g. Of the 657 participants with accurate 24-h urine collections, 464 (70%) provided fully completed dietary recalls. Among these 464 participants, there was a significant difference between the 24-h urinary sodium excretion-based salt intake estimation (14.5 ± 5.1 g/day) and the dietary recall-based salt intake estimation (12.0 ± 7.0 g/day) (p < 0.001). On the other hand, a positive correlation was obtained between the dietary recall-based daily salt intake and 24-h urinary sodium excretion-based daily salt intake (r = 0.277, p < 0.001). Bread was the main source of salt (34%) followed by salt added during cooking and preparing food before serving (30%), salt from various processed foods (21%), and salt added at the table during food consumption (11%). Conclusively, this study confirmed a very high salt intake of the adult population in four major cities in Turkey. The present findings support the emerging salt reduction strategy in Turkey by promoting lower salt content in baked bread, and less salt use in habitual food preparation and during food consumption in the home.

The validation and accuracy of sphygmomanometers are important issues in the home sphygmomanometer market and in clinical practice. The aims of this study are to assess the frequency of validated home sphygmomanometers and to evaluate the relationship between the validation and accuracy of the devices. Eight hundred and ninety-six home sphygmomanometers were brought by individuals to the University Hospital Hypertension Clinic for this study, and 870 (97%) of the devices were in adequate working condition and suitable for analysis. The relationship between accuracy and validation was investigated only in automated sphygmomanometers (n = 554). Both the manufacturer and model were known in 500 devices (90%), and these devices were eligible for evaluation of validation. We found 74 devices listed in the dabl Educational Trust website. Twenty-two of the 74 (30%) devices were validated. Four hundred (72%) of the 554 automated sphygmomanometers were inaccurate. The frequency of accuracy was higher among validated devices compared with nonvalidated devices (68 vs. 15%) (P<0.01). Our study showed that the frequency of accurate devices was higher among validated sphygmomanometers compared with nonvalidated sphygmomanometers. To our knowledge, our study is the first to demonstrate the relationship between accuracy and validation of home sphygmomanometers. The frequency of device-related errors can be decreased by training patients and supervising the blood pressure device market. Nonprofit organizations can help patients to overcome some of the problems in the blood pressure device market.

Home blood pressure monitoring requires a precise blood pressure measurement technique and an accurate sphygmomanometer. The oscillometric sphygmomanometers have some drawbacks including inaccuracy. The aims of this study were to assess the inaccuracy of home sphygmomanometers using a method first proposed in 2009 and to compare validated devices with other devices. Three hundred and eighty-two home sphygmomanometers that had been brought by individuals to the University Hospital were included in this study. This method has three stages (general evaluation, quick screening, final assessment) and sequential measurement of blood pressure is used for assessment. The devices were categorized into two groups for comparisons: validated and ‘others’. One hundred and fourteen (30%) of the 382 devices were validated. Final assessment showed 91 (24%) of the 382 devices to be inaccurate. Inaccuracy among the ‘others’ and wrist devices were more common than for the validated and upper arm devices (P<0.0001 for both comparisons). The categorization of upper arm devices into validated and ‘others’ showed that the validated devices were more accurate than the ‘others’ (94 vs. 79%) (P=0.002). The frequency of inaccurate and very inaccurate devices was 3% (three of 114) and 4% (four of 114) for the validated devices, respectively. Validated and upper arm devices were more accurate than the ‘others’ and wrist devices. Validation did not guarantee individual accuracy. Active involvement of hypertension centers is required to improve the quality and reliability of home blood pressure monitoring.