Document Detail


Reduced dietary salt for the prevention of cardiovascular disease: a meta-analysis of randomized controlled trials (Cochrane review).
MedLine Citation:
PMID:  21731062     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although meta-analyses of randomized controlled trials (RCTs) of salt reduction report a reduction in the level of blood pressure (BP), the effect of reduced dietary salt on cardiovascular disease (CVD) events remains unclear.
METHODS: We searched for RCTs with follow-up of at least 6 months that compared dietary salt reduction (restricted salt dietary intervention or advice to reduce salt intake) to control/no intervention in adults, and reported mortality or CVD morbidity data. Outcomes were pooled at end of trial or longest follow-up point.
RESULTS: Seven studies were identified: three in normotensives, two in hypertensives, one in a mixed population of normo- and hypertensives and one in heart failure. Salt reduction was associated with reductions in urinary salt excretion of between 27 and 39 mmol/24 h and reductions in systolic BP between 1 and 4 mm Hg. Relative risks (RRs) for all-cause mortality in normotensives (longest follow-up-RR: 0.90, 95% confidence interval (CI): 0.58-1.40, 79 deaths) and hypertensives (longest follow-up RR 0.96, 0.83-1.11, 565 deaths) showed no strong evidence of any effect of salt reduction CVD morbidity in people with normal BP (longest follow-up: RR 0.71, 0.42-1.20, 200 events) and raised BP at baseline (end of trial: RR 0.84, 0.57-1.23, 93 events) also showed no strong evidence of benefit. Salt restriction increased the risk of all-cause mortality in those with heart failure (end of trial RR 2.59, 1.04-6.44, 21 deaths).We found no information on participant's health-related quality of life.
CONCLUSIONS: Despite collating more event data than previous systematic reviews of RCTs (665 deaths in some 6,250 participants) there is still insufficient power to exclude clinically important effects of reduced dietary salt on mortality or CVD morbidity. Our estimates of benefits from dietary salt restriction are consistent with the predicted small effects on clinical events attributable to the small BP reduction achieved.
Authors:
Rod S Taylor; Kate E Ashton; Tiffany Moxham; Lee Hooper; Shah Ebrahim
Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2011-07-06
Journal Detail:
Title:  American journal of hypertension     Volume:  24     ISSN:  1941-7225     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-18     Completed Date:  2011-11-21     Revised Date:  2012-09-24    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  843-53     Citation Subset:  IM    
Affiliation:
Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, UK. rod.taylor@pms.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure / drug effects
Cardiovascular Diseases / epidemiology,  mortality,  prevention & control*
Diet, Sodium-Restricted*
Follow-Up Studies
Humans
Hypertension / physiopathology,  prevention & control*
Morbidity
Randomized Controlled Trials as Topic
Sodium Chloride / urine
Chemical
Reg. No./Substance:
7647-14-5/Sodium Chloride
Comments/Corrections
Comment In:
Am J Hypertens. 2012 Jan;25(1):18; author reply 20   [PMID:  22170073 ]
Nat Rev Cardiol. 2011 Sep;8(9):479   [PMID:  21788960 ]
Am J Hypertens. 2012 Jan;25(1):17; author reply 20   [PMID:  22170072 ]
Am J Hypertens. 2012 Jan;25(1):19; author reply 20   [PMID:  22170074 ]
Am J Hypertens. 2011 Aug;24(8):854-6   [PMID:  21731063 ]
Am J Hypertens. 2011 Aug;24(8):859-60   [PMID:  21765433 ]
Intern Emerg Med. 2012 Aug;7(4):371-3   [PMID:  22467092 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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