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Assessment
Is there a relationship between sodium or sodium chloride intake and blood pressure in hypertensive adults?
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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
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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.
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Conclusion
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Intervention
What does the evidence indicate are the appropriate dietary components for decreasing hypertension?
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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).
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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.
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Conclusion