Association of drinking water salinity with elevated blood pressure and risk of hypertension among coastal and other populations: a systematic review and meta-analysis of observational studies

作者：Rajat Das Gupta, Setor K. Kunutsor, David Eliecer López-Salamanca, Fariha Tahsin Mercy, Nafisa Nawal, Carlos Espinal Tejada, Kunihiro Matsushita, Silvana Luciani, Anselm Hennis, Rajiv Chowdhury · 发表于：BMJ Global Health · 年份：2025 · DOI：10.1136/bmjgh-2024-018543 · 被引用次数：2 · 研究领域：Sodium Intake and Health、Renal function and acid-base balance、Thermoregulation and physiological responses

BACKGROUND: The link between drinking water salinity and increased blood pressure and hypertension risk among coastal and other populations remains unclear. To investigate this, we performed a systematic review and meta-analysis of observational studies on drinking water salinity and cardiovascular outcomes. METHODS: We systematically searched MEDLINE, Embase and Web of Science for relevant studies published until 10 May 2025. Observational studies reporting on the association between sodium in drinking water and systolic/diastolic blood pressure (SBP/DBP), hypertension, coronary heart disease (CHD), stroke and composite cardiovascular outcomes were prespecified to be included. We assessed study quality using the Newcastle-Ottawa Scale and performed random effects meta-analysis. RESULTS: We identified 27 observational studies (involving 74 063 unique participants from 7 countries), 15 of which included coastal populations. Comparing higher versus lower drinking water salinity, the mean differences were 3.22 mm Hg (95% CI 1.11 to 5.33) for SBP and 2.82 mm Hg (95% CI 1.44 to 4.20) for DBP. The pooled OR for hypertension, comparing higher versus lower water salinity, was 1.26 (95% CI 1.07 to 1.48). These associations were generally consistent across subgroups but were statistically significant for studies conducted in coastal populations and for those published after 2000. However, we found an insufficient number of studies with reliable data on CHD or stroke outcomes. CONCLUSIO...