Lifetime risk for cardiovascular disease in a Chinese population: the Chinese Multi–Provincial Cohort Study

Liu

Journal of Hypertension

et al. 2016

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Section: Methodsmentioning

confidence: 99%

Lifetime risk of stroke in young-aged and middle-aged Chinese population

Liu

Journal of Hypertension

et al. 2016

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“…Blood pressure (BP) is one of the most important modifiable risk factors for cardiovascular diseases (CVD) in China [1]. Mean national consumption is more than 12 g/day of salt (sodium chloride), a level higher than in most other countries [2,3].…”

Section: Introductionmentioning

confidence: 99%

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

Moran

Liu

et al. 2015

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OBJECTIVE To estimate the effects of dietary salt reduction on blood pressure (BP) in Chinese adults and the effects of China-specific cooking salt reduction strategies (salt substitute and salt-restriction spoon). METHODS PubMed and China National Knowledge Infrastructure databases were searched for studies satisfying search criteria. Outcomes extracted from each included study were 24-hour urinary sodium (Na) excretion, salt (sodium chloride) intake, and BP level before and after dietary salt lowering. A random-effects meta-analysis was performed and results were evaluated for evidence of publication bias and heterogeneity. Because most studies aggregated results for hypertensive and normotensive participants, estimates were made for hypertensives only and for hypertensives and normotensives combined. RESULTS Six salt-restriction experiment studies (3,153 participants), four cooking salt-restriction spoon studies (3,715 participants), and four cooking salt substitute studies (1,730 participants) were analyzed. In salt-restriction experiment studies, the pooled estimate of mean change in 24-hour urinary Na excretion in hypertensive participants was −163.0 mmol/day (95% confident interval (CI): −233.5 to −92.5 mmol/day), which was associated with a mean reduction of −8.9 mmHg (95%CI: −14.1 to −3.7 mmHg) in systolic BP. Each 1.00g dietary salt reduction in hypertensives was associated with a reduction of 0.94 mmHg in systolic BP (95%CI: 0.69 to 1.03 mmHg). These systolic BP reductions in hypertensives were 1.71 times greater compared with the mixed hypertensive and normotensive group. Salt-restriction spoon studies demonstrated a 1.46 g decrease on daily salt intake level. The effect of salt substitute use on systolic BP control was substantial among the hypertensives (−4.2, 95%CI: −7.0 to −1.3 mmHg), but the change did not reach statistical significance in hypertensives and normotensives combined (−2.31, 95%CI: −5.57 to 0.94 mmHg) CONCLUSIONS Salt restriction lowers mean BP in Chinese adults, with the strongest effect among hypertensives. Future studies of salt restriction strategies should report results stratified by hypertension status and adjust for medication use.

The American Journal of Clinical Nutrition

“…Hypertension is one of the most common chronic noncommunicable diseases and is also a major risk factor for cardiovascular disease (CVD) 9 in China and worldwide (1,2). 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).…”

Section: Introductionmentioning

confidence: 99%

“…Several methods have been proposed for estimating 24-h urinary sodium 1 Supported by the China-Australia Health and HIV/AIDS program (CAHHF; grant HSS107). 2 Supplemental Figures 1-3 and Supplemental Tables 1-3 are available from the "Online Supporting Material" link in the online posting of the article and from the same link in the online table of contents at http://ajcn. nutrition.org.…”

Section: Introductionmentioning

confidence: 99%

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

Zhou

Tian

et al. 2017

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.