Author(s): Graudal NA, HubeckGraudal T, Jurgens G
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Abstract BACKGROUND: In spite of more than 100 years of investigations the question of reduced sodium intake as a health prophylaxis initiative is still unsolved. OBJECTIVES: To estimate the effects of low sodium versus high sodium intake on systolic and diastolic blood pressure (SBP and DBP), plasma or serum levels of renin, aldosterone, catecholamines, cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglycerides. SEARCH METHODS: PUBMED, EMBASE and Cochrane Central and reference lists of relevant articles were searched from 1950 to July 2011. SELECTION CRITERIA: Studies randomizing persons to low sodium and high sodium diets were included if they evaluated at least one of the above outcome parameters. DATA COLLECTION AND ANALYSIS: Two authors independently collected data, which were analysed with Review Manager 5.1. MAIN RESULTS: A total of 167 studies were included in this 2011 update.The effect of sodium reduction in normotensive Caucasians was SBP -1.27 mmHg (95\% CI: -1.88, -0.66; p=0.0001), DBP -0.05 mmHg (95\% CI: -0.51, 0.42; p=0.85). The effect of sodium reduction in normotensive Blacks was SBP -4.02 mmHg (95\% CI:-7.37, -0.68; p=0.002), DBP -2.01 mmHg (95\% CI:-4.37, 0.35; p=0.09). The effect of sodium reduction in normotensive Asians was SBP -1.27 mmHg (95\% CI: -3.07, 0.54; p=0.17), DBP -1.68 mmHg (95\% CI:-3.29, -0.06; p=0.04). The effect of sodium reduction in hypertensive Caucasians was SBP -5.48 mmHg (95\% CI: -6.53, -4.43; p<0.00001), DBP -2.75 mmHg (95\% CI: -3.34, -2.17; p<0.00001). The effect of sodium reduction in hypertensive Blacks was SBP -6.44 mmHg (95\% CI:-8.85, -4.03; p=0.00001), DBP -2.40 mmHg (95\% CI:-4.68, -0.12; p=0.04). The effect of sodium reduction in hypertensive Asians was SBP -10.21 mmHg (95\% CI:-16.98, -3.44; p=0.003), DBP -2.60 mmHg (95\% CI: -4.03, -1.16; p=0.0004).In plasma or serum there was a significant increase in renin (p<0.00001), aldosterone (p<0.00001), noradrenaline (p<0.00001), adrenaline (p<0.0002), cholesterol (p<0.001) and triglyceride (p<0.0008) with low sodium intake as compared with high sodium intake. In general the results were similar in studies with a duration of at least 2 weeks. AUTHORS' CONCLUSIONS: Sodium reduction resulted in a 1\% decrease in blood pressure in normotensives, a 3.5\% decrease in hypertensives, a significant increase in plasma renin, plasma aldosterone, plasma adrenaline and plasma noradrenaline, a 2.5\% increase in cholesterol, and a 7\% increase in triglyceride. In general, these effects were stable in studies lasting for 2 weeks or more.
This article was published in Cochrane Database Syst Rev
and referenced in Journal of Medical Diagnostic Methods