Show simple item record

dc.contributor.authorHuang, Len_US
dc.contributor.authorTrieu, Ken_US
dc.contributor.authorYoshimura, Sen_US
dc.contributor.authorNeal, Ben_US
dc.contributor.authorWoodward, Men_US
dc.contributor.authorCampbell, NRCen_US
dc.contributor.authorLi, Qen_US
dc.contributor.authorLackland, DTen_US
dc.contributor.authorLeung, AAen_US
dc.contributor.authorAnderson, CAMen_US
dc.contributor.authorMacGregor, GAen_US
dc.contributor.authorHe, FJen_US
dc.description.abstractOBJECTIVE: To examine the dose-response relation between reduction in dietary sodium and blood pressure change and to explore the impact of intervention duration. DESIGN: Systematic review and meta-analysis following PRISMA guidelines. DATA SOURCES: Ovid MEDLINE(R), EMBASE, and Cochrane Central Register of Controlled Trials (Wiley) and reference lists of relevant articles up to 21 January 2019. INCLUSION CRITERIA: Randomised trials comparing different levels of sodium intake undertaken among adult populations with estimates of intake made using 24 hour urinary sodium excretion. DATA EXTRACTION AND ANALYSIS: Two of three reviewers screened the records independently for eligibility. One reviewer extracted all data and the other two reviewed the data for accuracy. Reviewers performed random effects meta-analyses, subgroup analyses, and meta-regression. RESULTS: 133 studies with 12 197 participants were included. The mean reductions (reduced sodium v usual sodium) of 24 hour urinary sodium, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were 130 mmol (95% confidence interval 115 to 145, P<0.001), 4.26 mm Hg (3.62 to 4.89, P<0.001), and 2.07 mm Hg (1.67 to 2.48, P<0.001), respectively. Each 50 mmol reduction in 24 hour sodium excretion was associated with a 1.10 mm Hg (0.66 to 1.54; P<0.001) reduction in SBP and a 0.33 mm Hg (0.04 to 0.63; P=0.03) reduction in DBP. Reductions in blood pressure were observed in diverse population subsets examined, including hypertensive and non-hypertensive individuals. For the same reduction in 24 hour urinary sodium there was greater SBP reduction in older people, non-white populations, and those with higher baseline SBP levels. In trials of less than 15 days' duration, each 50 mmol reduction in 24 hour urinary sodium excretion was associated with a 1.05 mm Hg (0.40 to 1.70; P=0.002) SBP fall, less than half the effect observed in studies of longer duration (2.13 mm Hg; 0.85 to 3.40; P=0.002). Otherwise, there was no association between trial duration and SBP reduction. CONCLUSIONS: The magnitude of blood pressure lowering achieved with sodium reduction showed a dose-response relation and was greater for older populations, non-white populations, and those with higher blood pressure. Short term studies underestimate the effect of sodium reduction on blood pressure. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019140812.en_US
dc.format.extentm315 - ?en_US
dc.rightsCreative Commons Attribution (CC BY 4.0) license
dc.subjectBlood Pressureen_US
dc.subjectBlood Pressure Determinationen_US
dc.subjectDiet, Sodium-Restricteden_US
dc.subjectDose-Response Relationship, Drugen_US
dc.subjectRandomized Controlled Trials as Topicen_US
dc.subjectSodium Chloride, Dietaryen_US
dc.titleEffect of dose and duration of reduction in dietary sodium on blood pressure levels: systematic review and meta-analysis of randomised trials.en_US
pubs.notesNot knownen_US
pubs.publication-statusPublished onlineen_US
rioxxterms.funderDefault funderen_US
rioxxterms.identifier.projectDefault projecten_US

Files in this item


This item appears in the following Collection(s)

Show simple item record

Creative Commons Attribution (CC BY 4.0) license
Except where otherwise noted, this item's license is described as Creative Commons Attribution (CC BY 4.0) license