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Advice to reduce dietary salt for prevention of cardiovascular disease

Creator:

Hooper, L., Bartlett, C., Davey Smith, G. and Ebrahim, S.

Subject Keywords: Salt, Food, Death, Cardiovascular disease, Blood pressure, Adults
Topic: Cardiovascular Health (Draft)
Burden
Causes
Chronic Conditions
Conditions
Coronary Heart Disease (CHD)
Hypertension
Management
Prevention
Stroke
Chronic Conditions
Type: Article
Region: International (other)
Description:

Restricting sodium intake in hypertensive patients over short periods of time reduces blood pressure. Long term effects (on mortality, morbidity or blood pressure) of advice to reduce salt in patients with elevated or normal blood pressure are unclear. Objectives To assess in adults the long term effects (mortality, cardiovascular events, blood pressure, quality of life, weight, urinary sodium excretion, other nutrients and use of anti-hypertensive medications) of advice to restrict dietary sodium using all relevant randomised controlled trials. Inclusion decisions were independently duplicated and based on the following criteria: 1) randomisation was adequate; 2) there was a usual or control diet group; 3) the intervention aimed to reduce sodium intake; 4) the intervention was not multifactorial; 5) the participants were not children, acutely ill, pregnant or institutionalised; 6) follow-up was at least 26 weeks; 7) data on any of the outcomes of interest were available. Three trials in normotensives (n=2326), five in untreated hypertensives (n=387) and three in treated hypertensives (n=801) were included, with follow up from six months to seven years. The large, high quality (and therefore most informative) studies used intensive behavioural interventions. Deaths and cardiovascular events were inconsistently defined and reported; only 17 deaths equally distributed between intervention and control groups occurred. Systolic and diastolic blood pressures were reduced at 13 to 60 months in those given low sodium advice as compared with controls (systolic by 1.1 mm Hg, 95% CI 1.8 to 0.4, diastolic by 0.6 mm hg, 95% CI 1.5 to -0.3), as was urinary 24 hour sodium excretion (by 35.5 mmol/ 24 hours, 95% CI 47.2 to 23.9). Degree of reduction in sodium intake and change in blood pressure were not related. People on anti-hypertensive medications were able to stop their medication more often on a reduced sodium diet as compared with controls, while maintaining similar blood pressure control.

Date:

26/01/2004

Rights: © The Cochrane Collaboration
Suggested citation:

Hooper, L., Bartlett, C., Davey Smith, G. and Ebrahim, S.. (2004) Advice to reduce dietary salt for prevention of cardiovascular disease [Online]. Available from: http://publichealthwell.ie/node/4350 [Accessed: 12th November 2019].

  

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