Hypertension

HTN: Sodium (2015)

• Intervention
  What is the effect of reduced sodium intake on blood pressure in adults with hypertension?

  • Conclusion
    Results from 13 studies, including three meta-analyses, demonstrate a relationship between sodium intake and blood pressure (BP) in adults with hypertension. In four studies, BP increased with higher levels of sodium intake. In five studies, including two meta-analyses, a decrease in dietary sodium intake to 1,500mg to 2,000mg per day reduced systolic blood pressure and diastolic blood pressure up to 12mmHg and six mmHg, respectively. 
     
  • 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: What is the effect of reduced sodium intake on blood pressure in adults with hypertension?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Graudal N, Hubeck-Graudal T, Jürgens G, McCarron DA. The significance of duration and amount of sodium reduction intervention in normotensive and hypertensive individuals: a meta-analysis. Adv Nutr. 2015; 6(2):169-177.
      • Graudal NA, Hubeck-Gradual T, Jurgens G. Effects of a low-sodium diet vs. high-sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol and triglycerides. Am J Hypertension. 2012; 25(1): 1-15.
      • He FJ, Li J, MacGregor GA. Effect of longer-term modest salt reduction on blood pressure: Cochrane systematic review and meta-analysis of randomised trials. BMJ. 2013; 346: f1325.
      • He J, Gu D, Chen J, Jaquish CE, Rao DC, Hixson JE, Chen JC, Duan X, Huang JF, Chen CS, Kelly TN, Bazzano LA, Whelton PK; GenSalt Collaborative Research Group. Gender difference in blood pressure responses to dietary sodium intervention in the GenSalt study. J Hypertens. 2009 Jan; 27(1): 48-54.
         
      • Hu G, Tian H. A comparison of dietary and non-dietary factors of hypertension and normal blood pressure in a Chinese population. J Hum Hypertens. 2001; (15) 7: 487-493.
      • Jablonski K, Fedorova O, Racine M, Geolfos C, Gates P, Chonchol M, Fleenor B, Ladatta E, Bagrov A, Seals D. Dietary sodium restricition and association with urniary marinobufagenin, blood pressure and aortic stiffness. Clin J Am Soc Nephol. 2013 Nov; 8(11): 1952-1959.
      • Khaw KT, Bingham S, Welch A, Luben R, O'Brien E, Wareham N, Day N. Blood pressure and urinary sodium in men and women: the Norfolk Cohort of the European Prospective Investigation into Cancer (EPIC-Norfolk). Am J Clin Nutr. 2004; 80: 1,397-1,403. 
      • Kojuri J, Rahimi R. Effect of "no added salt diet" on blood pressure control and 24-hour urinary sodium excretion in mild to moderate hypertension. BMC Cardiovascular Disorders. 2007; 7: 34.
      • Lancaster KJ, Smiciklas-Wright H, Weltzel LB, Mitchell DC, Friedman JM, Jensen GL. Hypertension-related dietary patterns of rural older adults. Preventive Medicine, 2004; 38: 812-818.
      • Mente A, O'Donnell MJ, Rangarajan S, McQueen MJ, Poirier P, Wielgosz A, Morrison H, Li W, Wang X, Di C, Mony P, Devanath A, Rosengren A, Oguz A, Zatonska K, Yusufali AH, Lopez-Jaramillo P, Avezum A, Ismail N, Lanas F, Puoane T, Diaz R, Kelishadi R, Iqbal R, Yusuf R, Chifamba J, Khatib R, Teo K, Yusuf S; PURE Investigators. Association of urinary sodium and potassium excretion with blood pressure. N Engl J Med. 2014 Aug; 371(7): 601-611.
  • Search Plan and Results: HTN: Minerals (Sodium) 2015