academy of nutrition and dietetics
  • Home
  • Projects
    • Adult Weight Management Guideline
    • Advanced Technology in Food Production
    • Athletic Performance
    • Bariatric Surgery
    • Breastfeeding
    • Celiac Disease Guideline
    • Chronic Kidney Disease Guideline
    • Chronic Obstructive Pulmonary Disease Guideline
    • Critical Illness Guideline
    • Cystic Fibrosis Guideline
    • Diabetes Type 1 (Pediatrics)
    • Diabetes Types1 and 2 Guideline
    • Diabetes Type 2 Prevention Guideline
    • Dietary Approaches and Health Outcomes
    • Dietary Fatty Acids
    • Disorders of Lipid Metabolism Guideline
    • Energy Expenditure Guideline
    • Fiber
    • Fluoride
    • Food and Nutrition for Older Adults Guideline
    • Fruit Juice
    • Gestational Diabetes Guideline
    • Health Disparities
    • Heart Failure Guideline
    • HIV/AIDS Guideline
    • Hydration
    • Hypertension Guideline
    • Malnutrition in Older Adults
    • Malnutrition in Pregnancy
    • Medical Nutrition Therapy
    • Microwave and Home Food Safety
    • Nutrient Supplementation
    • Nutrition Counseling
    • Nutrition Guidance in Healthy Children
    • Nutrition Screening Adults
    • Nutrition Screening Pediatrics
    • Nutritional Genomics
    • Nutritive and Non-Nutritive Sweetener
    • Obesity, Reproduction and Pregnancy
    • Oncology Guideline
    • Pediatric Weight Management Guideline
    • Preterm Infant (VLBW) Enteral Nutrition Guideline
    • Physical Activity and Nutrition Guideline
    • Retail Nutrition
    • Single Serving Portion Sized Meals and Weight Management
    • Sodium
    • Spinal Cord Injury Guideline
    • Telenutrition
    • Transgender Nutrition
    • Umami
    • Unintended Weight Loss in Older Adults Guideline
    • Vegetarian Nutrition Guideline
    • Wound Care
    • Collaborative Guidelines and Joint Position-Consensus Statements
    image description
    Evidence Analysis Library Proven Research When It Matters Most Sign In
    Essential Evidence For continued Success.
  • Policy and Process
    • Overview
    • Evidence-Based Practice
    • EAL Systematic Review Process
    • EAL Guideline Development Process
    • EAL Policies and Procedures
    • Evidence Analysis Manual
    • Guideline Practitioner Guides
    image description
    Evidence Analysis Library Proven Research When It Matters Most Sign In
    Essential Evidence For continued Success.
  • Resources
    • Resources
    • EAC Orientation Tutorial
    • Presentations
    • Nutrition Care Process
    • Research Gaps
    • Shop EAL Products
    • Guideline Implementation Manual
    image description
    Evidence Analysis Library Proven Research When It Matters Most Sign In
    Essential Evidence For continued Success.
  • Index
  • About
    • About the EAL
    • Citing Content from the EAL
    • Permission to Reprint Content from the EAL
    • FAQs
    • Join the EAL Team - Volunteer
  • Risk ScreenMood Disorders
  • ResourcesMood Disorders
  • Login
  • Not A Member?
  • Contact us
  • Help
Home

  • Increase Font Size
  • Decrease Font Size
  • View as PDF

  • Assessment
    Is there a relationship between sodium or sodium chloride intake and blood pressure in hypertensive adults?
    • Conclusion

      In 15 studies of hypertensive adults,* a lower sodium or sodium chloride intake was associated with significantly lower blood pressure (BP) (-1.3mmHg to -16.8mmHg SBP; -1.9mmHg to -10.7mmHg DBP). Factors that affect this relationship included dietary pattern, race, ethnicity and age of subjects. In studies comparing blood pressure response to varying levels of sodium or sodium chloride intake, lowered blood pressures were noted with reduction in sodium intakes from (120mmol to 350mmol to 30mmol to 330mmol). A greater BP-lowering response was observed in the following groups: Those consuming a low-sodium diet with their usual dietary pattern vs. a DASH dietary pattern in black subjects and in older subjects.

      * Definition of hypertension varied by study, country or version of JNC report.

      See Table: Sodium and Blood Pressure Response

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    • Evidence Summary: Sodium Intake and Blood Pressure in Hypertensive Adults
      • Detail
      • Quality Rating Summary
        For a summary of the Quality Rating results, click here.
      • Worksheets
        • Appel LJ, Espeland MA, Easter L, Wilson AC, Folmar S, Lacy CR. Effects of reduced sodium intake on hypertension control in older individuals:  results from the Trial of Nonpharmacologic Interventions in the Elderly (TONE). Arch Intern Med. 2001 Mar 12; 161 (5): 685-693.
        • Bray GA, Vollmer WM, Sacks FM, Obarzanek E, Svetkey LP, Appel LJ. A further subgroup analysis of the effects of the DASH diet and three dietary sodium levels on blood pressure: Results of the DASH-sodium trial. AM J Cardiol. 204 Jul 15; 94(2): 222-227.
        • Coruzzi P, Brambilla L, Brambilla V, Gualerzi M, Rossi M, Parati G, Di Rienzo M, Tadonio J, Novarini A. Potassium depletion and salt sensitivity in essential hypertension. J Clin Endocrinol Metab. 2001 Jun; 86(6): 2,857-2,862.
        • He FJ, MacGregor GA. Effect of longer-term modest salt reduction on blood pressure. Cochrane Database Syst Rev. 2004; (1): CD004937. PMID: 15266549 
        • He FJ, Markandu ND, MacGregor GA. Importance of the renin system for determining blood pressure fall with acute salt restriction in hypertensive and normotensive whites. Hypertension. 2001 Sep; 38 (3): 321-325.
        • Jürgens G, Graudal NA. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride. Cochrane Database Syst Rev. 2003; (1): CD004022. Review. Update in: Cochrane Database Syst Rev. 2004; (1): CD004022
        • Radhika G, Sathya RM, Sudha V, et al. Dietary salt intake and hypertension in an urban south Indian population. J Assoc Physicians India. 2007; 55: 405-411.
    • Search Plan and Results: NA: Sodium and Blood Pressure Update 2009
       
  • Intervention
    What does the evidence indicate are the appropriate dietary components for decreasing hypertension?
    • Conclusion

      Consuming a diet rich in fruits and vegetables and low-fat dairy products and low in sodium and saturated fat will decrease blood pressure. Reductions have been 4 – 12 mm Hg in systolic and 1 – 3 mm Hg in diastolic. This dietary pattern enhanced by weight loss and increased physical activity will also have beneficial effects (4 - 10 mm Hg in systolic and 3 - 5 mm Hg in diastolic).

    • Grade: I
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
 
Close

Copyright 2023 Academy of Nutrition and Dietetics (Academy), All Rights Reserved | Privacy Policy. LX-131-228