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Randomized trials of sodium reduction: an overview
J A Cutler1, D Follmann, P S Allender
1Division of Epidemiology and Clinical Applications, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA. cutlerj@gwgate.nhlbi.nih.gov
The American Journal of Clinical Nutrition
|February 1, 1997
Summary
Reducing dietary sodium intake significantly lowers blood pressure in both hypertensive and normotensive individuals. This dietary change offers a safe strategy to decrease cardiovascular disease risk in the general population.
Area of Science:
- Cardiovascular Health
- Dietary Interventions
- Clinical Trials
Background:
- Dietary sodium intake is a major contributor to hypertension.
- Previous research indicates a link between sodium reduction and blood pressure.
- A comprehensive update of existing evidence is needed to confirm these effects.
Purpose of the Study:
- To systematically review and meta-analyze randomized clinical trials on sodium reduction and blood pressure.
- To quantify the blood pressure-lowering effects of sodium reduction in different populations.
- To assess the safety and potential population-level impact of dietary sodium reduction.
Main Methods:
- Updated systematic review and meta-analysis of randomized controlled trials.
- Included 32 trials with 2635 participants, excluding confounded or non-standard trials.
- Independent data abstraction by two reviewers, with reconciliation for discrepancies.
Main Results:
- Pooled analysis showed significant blood pressure reduction in all participants, hypertensive, and normotensive groups.
- Systolic/diastolic blood pressure reductions were -4.8/-2.5 mm Hg in hypertensive and -1.9/-1.1 mm Hg in normotensive subjects.
- Weighted regression analysis revealed dose-response relationships, particularly consistent in normotensive individuals.
Conclusions:
- Sodium reduction effectively lowers blood pressure in both hypertensive and normotensive individuals.
- The achieved sodium reduction levels in trials pose no safety concerns.
- Substantial dietary sodium reduction in the US population could significantly reduce cardiovascular morbidity and mortality.