Effect of longer-term modest salt reduction on blood pressure

作者：Feng J. He, Jiafu Li, Graham A. MacGregor · 发表于：Cochrane Database of Systematic Reviews · 年份：2013 · DOI：10.1002/14651858.cd004937.pub2 · 被引用次数：723 · 研究领域：Sodium Intake and Health、Renin-Angiotensin System Studies、Blood Pressure and Hypertension Studies

BACKGROUND: A reduction in salt intake lowers blood pressure (BP) and, thereby, reduces cardiovascular risk. A recent meta-analysis by Graudal implied that salt reduction had adverse effects on hormones and lipids which might mitigate any benefit that occurs with BP reduction. However, Graudal's meta-analysis included a large number of very short-term trials with a large change in salt intake, and such studies are irrelevant to the public health recommendations for a longer-term modest reduction in salt intake. We have updated our Cochrane meta-analysis. OBJECTIVES: To assess (1) the effect of a longer-term modest reduction in salt intake (i.e. of public health relevance) on BP and whether there was a dose-response relationship; (2) the effect on BP by sex and ethnic group; (3) the effect on plasma renin activity, aldosterone, noradrenaline, adrenaline, cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglycerides. SEARCH METHODS: We searched MEDLINE, EMBASE, Cochrane Hypertension Group Specialised Register, Cochrane Central Register of Controlled Trials, and reference list of relevant articles. SELECTION CRITERIA: We included randomised trials with a modest reduction in salt intake and duration of at least 4 weeks. DATA COLLECTION AND ANALYSIS: Data were extracted independently by two reviewers. Random effects meta-analyses, subgroup analyses and meta-regression were performed. MAIN RESULTS: Thirty-four trials (3230 participants) were included....