A Meta-Analysis of Effect of Dietary Salt Restriction on Blood Pressure
                        in Chinese Adults

Wang, Miao; Moran, Andrew E.; Liu, Jing; Qi, Yue; Xie, Weixin; Tzong, Keane Y.; Zhao, Dong

doi:10.1016/j.gheart.2014.10.009

Cited by 38 publications

(38 citation statements)

References 20 publications

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“…Of 1892 citations identified by the search, 13 studies from eight countries met inclusion criteria (Figure): 11 observational studies and two meta‐analyses . The primary outcomes of these 13 studies included mortality and cardiovascular events, blood pressure (BP) or diagnosis of hypertension, kidney disease, nonalcoholic fatty liver disease and obesity . Summary descriptions of the 13 included studies are listed in the Table and risk of bias assessments for all included studies are included in Appendix .…”

Section: Resultsmentioning

confidence: 99%

“…Krupp and colleagues, which assessed the effect of sodium intake in adolescence on BP in young adulthood, did not meet minimum methodologic criteria due to its observational study design, but was selected for review because of the paucity of studies in this population. The two meta‐analyses (Wang and colleagues, a meta‐analysis of RCTs and quasi‐experimental studies assessing the effect of dietary salt reduction strategies on BP in Chinese adults, and Liu and colleagues a meta‐analysis of observational studies assessing the association between salt intake and risk of chronic kidney disease [CKD]) did not meet the minimum methodologic criteria due to their inclusion of studies with cross‐sectional design or spot urine to estimate sodium intake, but were also selected for detailed review because of the importance of being able to interpret their contribution to the evidence base.…”

Section: Resultsmentioning

confidence: 99%

“…While they did not meet the minimum methodological criteria, the two meta‐analyses were also assessed in this review. One demonstrated beneficial effects of salt restriction on BP and the other showed that higher sodium intake was associated with greater risk of CKD . Although meta‐analyses are generally considered to provide stronger levels of evidence compared with primary studies, both of these meta‐analyses had major methodological weaknesses that increased their risk of bias.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The science of salt: A regularly updated systematic review of salt and health outcomes (December 2015–March 2016)

Wong

Arcand

Leung

et al. 2017

J of Clinical Hypertension

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The purpose of this review was to identify, summarize, and critically appraise studies on dietary salt relating to health outcomes that were published from December 2015 to March 2016. The search strategy was adapted from a previous systematic review on dietary salt and health. Overall, 13 studies were included in the review: one study assessed cardiovascular events, nine studies assessed prevalence or incidence of blood pressure or hypertension, one study assessed kidney disease, and two studies assessed other health outcomes (obesity and nonalcoholic fatty liver disease). Four studies were selected for detailed appraisal and commentary. One study met the minimum methodologic criteria and found an increased risk associated with lower sodium intake in patients with heart failure. All other studies identified in this review demonstrated positive associations between dietary salt and adverse health outcomes. | INTRODUCTIONExcess salt (sodium) consumption is associated with many adverse health effects, including hypertension and cardiovascular mortality.1,2 Based on the evidence from systematic reviews assessing dietary sodium reduction, the World Health Organization (WHO) recommends a sodium intake of <2 g/d (equivalent to 5 g/d of salt) in adults, with lower amounts for children based on their energy requirements relative to those of adults. 3,4 All WHO Member States have agreed on a target of reducing dietary sodium intake by 30%by 2025. 5Regularly updated reviews and critical appraisals of identified studies relating to health outcomes are published in the Journal of Clinical Hypertension, alternating with reviews of studies relating to salt reduction implementation programs. The last review of salt and health outcomes covered studies published between August and November 2015. | METHODOLOGYA detailed description of the methodological approach used to identify and evaluate the literature in this review has been previously published. 7 In summary, articles were identified on a weekly basis through a MEDLINE search strategy. 7 Studies examining the effects of salt on health outcomes, including studies of participants with any comorbidity (with the exception of acute illness), that were published from December 1, 2015 to March 31, 2016, were included in this review.All included studies were assessed for risk of bias by two independent reviewers. Randomized controlled trials (RCTs) were assessed using the Cochrane risk of bias tool. 8 Observational, nonrandomized studies were assessed using a modified Cochrane risk of bias tool. 9 For systematic reviews and meta-analyses, the c tool was applied. 10We identified the subset of included studies that met previously established minimum methodologic criteria for clinical and population studies on dietary salt 11 (Box). Detailed appraisals and written commentary were performed for these studies. Other studies were then selected for detailed review based on two independent reviewers identifying them either as potentially high impact, controversial, or important in terms ...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The science of salt: A regularly updated systematic review of salt and health outcomes (December 2015–March 2016)

Wong

Arcand

Leung

et al. 2017

J of Clinical Hypertension

View full text Add to dashboard Cite

show abstract

“…Numerous studies over the past couple of decades have shown that dietary sodium intake is positively associated with blood pressure (3)(4)(5)(6)(7). As a health intervention strategy, reducing sodium intake to #2.3 g/d has been recommended in many guidelines to achieve potential cardiovascular benefits (8,9).…”

Section: Introductionmentioning

confidence: 99%

Validation of spot urine in predicting 24-h sodium excretion at the individual level ,

Zhou

Tian

et al. 2017

The American Journal of Clinical Nutrition

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Background: Evidence for the effect of dietary sodium intake on the risk of cardiovascular disease has been controversial. One of the main explanations for the conflicting results lies in the great variability associated with measurement methods for sodium intake. Spot urine collection is a convenient method commonly used for sodium estimation, but its validity for predicting 24-h urinary sodium excretion at the individual level has not been well evaluated among the general population. Objective: The aim of this study was to evaluate the validity of the Kawasaki, the International Cooperative Study on Salt, Other Factors, and Blood Pressure (INTERSALT), and the Tanaka formulas in predicting 24-h urinary sodium excretion by using spot urine samples in Chinese adults. Design: We analyzed the relative and absolute differences and misclassification at the individual level from 3 commonly used methods for estimating sodium intake among 141 Chinese community residents. Results: The mean measured 24-h sodium excretion was 220.8 mmol/d. The median (95% CIs) differences between measured sodium and those estimated from the Kawasaki, INTERSALT, and Tanaka methods were 6.4 mmol/d (217.5, 36.8 mmol/d), 267.3 mmol/d (296.5, 246.9 mmol/d), and 242.9 mmol/d (259.1, 224.8 mmol/d), respectively. The proportions of relative differences .40% with the Kawasaki, INTERSALT, and Tanaka methods were 31.2%, 41.1%, and 22.0%, respectively; and the absolute difference for the 3 methods was .51.3 mmol/d (3 g salt) in approximately half of the participants. The misclassification rate was 63.1% for the Kawasaki method, 78.7% for the INTERSALT method, and 66.0% for the Tanaka method at the individual level. Conclusion:The results from our study do not support the use of spot urine to estimate 24-h urinary sodium excretion at the individual level because of its poor performance with respect to misclassification. This trial was registered at www.chictr.org.cn as ChiCTR-IOR-16010278.

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“…[21] Brook et al reported that reduction of hypertension can achieved through application of interventions that include lifestyle modifications. [22] In the present study, the main concern was to evaluate the effectiveness of the nursing intervention on cholesterol level and QOL among hypertensive patients with dyslipidemia.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of the nursing intervention on cholesterol level and quality of life among hypertensive patients with dyslipidemia

Ebrahem

Gahsh

Abd-Elalem

2017

CNS

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Objective: Hypertension and dyslipidemia are widely recognized a major risk factors for cardiovascular disease (CVD). The aim of this study was to evaluate the effectiveness of the nursing intervention on cholesterol level and quality of life (QOL) among hypertensive patients with dyslipidemia. Methods: Design: A quasi -experimental pre-post-test design was used to achieve the aim of the study. The study was conducted in the University Hospital at Shebin El-kom District, Menoufia Governorate, Egypt. Purposeful sample of 100 hypertensive patients with dyslipidemia on treatment from the previous mentioned setting. Instruments: (1) structured interview questionnaire to assess socio-demographic data, risk factors of hypertension and dyslipidemia and patient's knowledge about hypertension and dyslipidemia; (2) Physiological measurement to assess blood pressure, weight and cholesterol level; (3) QOL scale to assess healthful lifestyle. Results: The main findings of the study there was statistically significant improvement of total knowledge related to hypertension and dyslipidemia, and there was statistically significant reduction in blood pressure and cholesterol level post-intervention than pre-intervention. Conclusions: The nursing intervention has a positive effect on blood pressure, cholesterol level and QOL of hypertensive patients with dyslipidemia. Recommendations: The nursing intervention that includes of adherence to diet regimen, prescribed medication and performing physical exercise, stress management, assertiveness training should be integrated into medical outpatient clinic to assist patients diagnosed with hypertension to cope with their illness and improve the QOL of hypertensive patients.

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A Meta-Analysis of Effect of Dietary Salt Restriction on Blood Pressure in Chinese Adults

Cited by 38 publications

References 20 publications

The science of salt: A regularly updated systematic review of salt and health outcomes (December 2015–March 2016)

The science of salt: A regularly updated systematic review of salt and health outcomes (December 2015–March 2016)

Validation of spot urine in predicting 24-h sodium excretion at the individual level ,

The effectiveness of the nursing intervention on cholesterol level and quality of life among hypertensive patients with dyslipidemia

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