The Significance of Duration and Amount of Sodium Reduction Intervention in Normotensive and Hypertensive Individuals: A Meta-Analysis
- 1 March 2015
- journal article
- review article
- Published by Elsevier BV in Advances in Nutrition: An International Review Journal
- Vol. 6 (2), 169-177
- https://doi.org/10.3945/an.114.007708
Abstract
The purpose of this meta-analysis was to establish the time for achievement of maximal blood pressure (BP) efficacy of a sodium reduction (SR) intervention and the relation between the amount of SR and the BP response in individuals with hypertension and normal BP. Relevant studies were retrieved from a pool of 167 randomized controlled trials (RCTs) published in the period 1973–2010 and integrated in meta-analyses. Fifteen relevant RCTs were included in the maximal efficacy analysis. After initiation of sodium reduction (range: 55–118 mmol/d), there were no significant differences in systolic blood pressure (SBP) or diastolic blood pressure (DBP) between measurements at weeks 1 and 2 (∆SBP: −0.18 mmHg/∆DBP: 0.12 mmHg), weeks 1 and 4 (∆SBP: −0.50 mmHg/∆DBP: 0.35 mmHg), weeks 2 and 4 (∆SBP: −0.20 mmHg/∆DBP: −0.10 mmHg), weeks 2 and 6 (∆SBP: −0.50 mmHg/∆DBP: −0.42 mmHg), and weeks 4 and 6 (∆SBP: 0.39 mmHg/∆DBP: −0.22 mmHg). Eight relevant RCTs were included in the dose-response analysis, which showed that within the established usual range of sodium intake [P = 0.53; ∆DBP: −0.49 mm Hg (95% CI: −4.0, 3.03), P = 0.79]. In contrast, prehypertensive and hypertensive populations showed a significant dose-response relation (range of sodium reduction: 77–140 mmol/d) [∆SBP: 6.87 mmHg (95% CI: 5.61, 8.12, P < 0.00001); ∆DBP: 3.61 mmHg (95% CI: 2.83, 4.39, P < 0.00001)]. Consequently, the importance of kinetic and dynamic properties of sodium reduction, as well as baseline BP, should probably be considered when establishing a policy of sodium reduction.Keywords
This publication has 47 references indexed in Scilit:
- The Association Between Dietary Sodium Intake, ESRD, and All-Cause Mortality in Patients With Type 1 DiabetesDiabetes Care, 2011
- Dietary Salt Intake and Mortality in Patients With Type 2 DiabetesDiabetes Care, 2011
- Projected Effect of Dietary Salt Reductions on Future Cardiovascular DiseaseNew England Journal of Medicine, 2010
- A randomized trial on sodium reduction in two developing countriesJournal of Human Hypertension, 2004
- Dietary Sodium Restriction Rapidly Improves Large Elastic Artery Compliance in Older Adults With Systolic HypertensionHypertension, 2004
- Effects of moderate sodium restriction on clinic and twenty-four-hour ambulatory blood pressure in elderly hypertensive subjectsJournal Of Hypertension, 1993
- Sodium chloride raises blood pressure in normotensive subjects. The study of sodium and blood pressure.Hypertension, 1991
- Two-way factorial study of alcohol and salt restriction in treated hypertensive men.Hypertension, 1990
- DOUBLE-BLIND RANDOMISED CROSSOVER TRIAL OF MODERATE SODIUM RESTRICTION IN ESSENTIAL HYPERTENSIONThe Lancet, 1982
- Blood pressure, sodium intake, and sodium related hormones in the Yanomamo Indians, a "no-salt" culture.Circulation, 1975