High Salt Intake and Stroke: Meta‐analysis of the Epidemiologic Evidence

Li, Xiuyang; Cai, Xianlei; Bian, Pingda; Hu, Liu-Ru

doi:10.1111/j.1755-5949.2012.00355.x

Cited by 69 publications

(54 citation statements)

References 29 publications

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“…304 In meta-analyses of longitudinal studies, high sodium intakes associate with incident total stroke, stroke mortality, and CHD mortality (Figure 7). 305-307 This is supported by the strength of BP as a surrogate outcome, 308 and ecologic and experimental studies of sodium and CVD. 304 Indeed, the latter suggest that chronically high sodium induces additional, BP-independent damage to renal, myocardial, and vascular tissues.…”

Section: Nutrients and Cardiometabolic Healthmentioning

confidence: 95%

Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity

2016

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Suboptimal nutrition is a leading cause of poor health. Nutrition and policy science have advanced rapidly, creating confusion yet also providing powerful opportunities to reduce the adverse health and economic impacts of poor diets. This review considers the history, new evidence, controversies, and corresponding lessons for modern dietary and policy priorities for cardiovascular diseases, obesity, and diabetes. Major identified themes include the importance of evaluating the full diversity of diet-related risk pathways, not just obesity and blood lipids; focusing on foods and overall diet patterns, rather than single isolated nutrients; recognizing the complex influences of different foods on long-term weight regulation, rather than simply counting calories; and characterizing and implementing evidence-based strategies, including policy approaches, for lifestyle change. Evidence-informed dietary priorities include increased fruits, nonstarchy vegetables, nuts, legumes, fish, vegetable oils, yogurt, and minimally processed whole grains; and fewer red meats, processed (e.g., sodium-preserved) meats, and foods rich in refined grains, starch, added sugars, salt, and trans fat. More investigation is needed on cardiometabolic effects of phenolics, dairy fat, probiotics, fermentation, coffee, tea, cocoa, eggs, specific vegetable and tropical oils, vitamin D, individual fatty acids, and diet-microbiome interactions. Little evidence to-date supports cardiometabolic relevance of other popular priorities: e.g., local, organic, grass-fed, farmed/wild, non-GMO. Evidence-based personalized nutrition appears to depend more on non-genetic characteristics (e.g., physical activity, abdominal adiposity, gender, socioeconomic status, culture) than genetic factors. Food choices must be strongly supported by clinical behavior change efforts, health systems reforms, novel technologies, and robust policy strategies, including those targeting economic incentives, schools and workplaces, neighborhood environments, and the food system. Scientific advances provide crucial new insights on optimal targets and best practices to reduce burdens of diet-related cardiometabolic diseases.

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Section: Nutrients and Cardiometabolic Healthmentioning

confidence: 95%

Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity

2016

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“…Second, we did not use validated dietary and physical activity questionnaires. Given that salt intake was consistently found to be associated with risk of stroke in previous epidemiological studies 25,26 and salted food intake is a serious situation in China, 27 we used salt intake as a surrogate of diet quality. However, we are aware that salt intake could only reflect 1 aspect of overall dietary pattern, and other aspects, such as consumption of fat, and fruit/ vegetables are also important for stroke pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

Ideal Cardiovascular Health Metrics and the Risks of Ischemic and Intracerebral Hemorrhagic Stroke

Zhang

Zhou

Gao

et al. 2013

Stroke

195

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Background and Purpose-Previous studies showed an inverse association between ideal cardiovascular health (CVH) metrics and the total risk of cardiovascular diseases and stroke. This study aimed to investigate the relationship between ideal CVH metrics and the risks of ischemic and hemorrhagic stroke, respectively. Methods-We collected information on the 7 ideal CVH metrics (including smoking status, body mass index, dietary intake, physical activity, blood pressure, total cholesterol, and fasting blood glucose) among 91 698 participants from the Kailuan study, China (72 826 men and 18 872 women between the ages of 18 and 98 years), free of myocardial infarction and stroke at baseline (2006)(2007). Cox proportional hazards models were used to estimate stroke risk. Results-During the 4-year follow-up, we identified 1486 incident stroke events (1057 ischemic, 386 intracerebral hemorrhagic, and 43 subarachnoid hemorrhagic). The hazard ratios (95% confidence interval) for total stroke with adherence to 0 (reference), 1, 2, 3, 4, 5, and 6/7 ideal CVH metrics were: 1, 0.92 (0.69-1.23), 0.69 (0.52-0.92), 0.52 (0.39-0.68), 0.38 (0.28-0.51), 0.27 (0.18-0.40), and 0.24 (0.11-0.54), respectively (P trend <0.01), after adjusting for age, sex, education, income, and hospital. Similar inverse associations were observed for both ischemic and intracerebral hemorrhagic stroke (both P trend <0.01). Conclusions-We

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“…17 In our study, leisure time physical activity level was categorized as ideally active (>80 minutes/week), moderately active (<80 minutes/week), or inactive (none). Considering that salt intake plays an important role in the prevention of CVD, which includes stroke, in previous reports, [25][26][27] salt intake was used as a surrogate of ideal diet. Ideal dietary score was categorized as ideal (<6 g/day), intermediate (6-10 g/day) or poor (>10 g/day).…”

Section: Health Behaviorsmentioning

confidence: 99%