Salt and hypertension in rural and urban populations of low to middle income countries: A systematic review and meta-analysis

Subasinghe, Asvini K; Arabshahi, Simin; Busingye, Doreen; Evans, Roger G.; Riddell, Michaela A; Thrift, Amanda G.

doi:10.1016/j.jnim.2014.10.077

Cited by 16 publications

(23 citation statements)

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“…These studies are summarized in Table . The outcomes examined were diverse: one study assessed mortality outcomes (category I), two studies assessed morbidity outcomes (category II), two studies assessed outcomes related to symptoms/quality of life/functional status (category III), six studies assessed BP outcomes (category IV), seven studies assessed other clinically relevant surrogate outcomes (category V), and 10 studies assessed physiologic outcomes (category VI) …”

Section: Resultsmentioning

confidence: 99%

More evidence that salt increases blood pressure and risk of kidney disease from the Science of Salt: A regularly updated systematic review of salt and health outcomes (April–July 2016)

Arcand

Wong

Santos

et al. 2017

J of Clinical Hypertension

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The purpose of this review is to identify, summarize, and critically appraise studies on dietary salt and health outcomes that were published from April to July 2016. The search strategy was adapted from a previous systematic review on dietary salt and health. We have revised our criteria for methodological quality and health outcomes, which are applied to select studies for detailed critical appraisals and written commentary. Overall, 28 studies were identified and are summarized in this review. Four of the 28 studies met criteria for methodological quality and health outcomes and five studies underwent detailed critical appraisals and commentary. Three of these studies found adverse effects of salt on health outcomes (chronic kidney disease and blood pressure) and two were neutral (fracture risk/bone mineral density and cognitive impairment). | INTRODUCTIONMeta-analyses and systematic reviews examining the relationship between dietary salt and health outcomes 1,2 have been the basis for consensus that excess salt (sodium) consumption is associated with multiple adverse health outcomes, including a positive causal relationship with blood pressure (BP). The high profile of dietary salt research has resulted in a rapidly growing literature on the health effects of dietary salt. To keep scientific, clinical, and policy stakeholders up to date with the growing body of literature, regularly updated reviews and critical appraisals of studies relating to health outcomes are published in the Journal, alternating with reviews of studies relating to salt reduction implementation programs. 6 The objective of this fourth health outcomes review is to summarize published articles on salt and health outcomes and to highlight and critically appraise the highest-quality articles that were published between April and July 2016. This article also reports on anupdated methodology developed and adopted to ensure an objective review of the most clinically relevant studies. | METHODOLOGYA detailed description of the methodological approach used to identify published articles for this review has been previously reported. 6Briefly, articles were identified on a weekly basis through a MEDLINE search strategy, which was adapted from a previous systematic review used to develop the WHO guideline on dietary sodium intake. 1,2 Figure). Among identified articles, studies were selected to undergo a detailed critical appraisal based on the outcomes examined and methodological quality, as described below. A secondary set of articles was considered for inclusion if judged by the authors to be impactful based on novelty of findings or potential for generating public discourse or scientific controversy or for informing public health policy.Articles were selected for detailed critical appraisal considering a hierarchy of health outcomes, which were those classified based on relevance to patients ( outcome and category I to V outcomes as secondary outcomes, the study was considered for inclusion as long as it met methodological quality criteria.Met...

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Section: Resultsmentioning

confidence: 99%

More evidence that salt increases blood pressure and risk of kidney disease from the Science of Salt: A regularly updated systematic review of salt and health outcomes (April–July 2016)

Arcand

Wong

Santos

et al. 2017

J of Clinical Hypertension

View full text Add to dashboard Cite

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“…The consumption of processed food, unlike other developed countries, has been reported as relatively low in Nepal (one in 10 people) . However, a repeat cross‐sectional study in 1981 and 2006 found that the proportion of those consuming a high amount of salt in Nepal increased from 56% to 90%; this increase was reported as one of the highest among LMICs …”

Section: Discussionmentioning

confidence: 99%

Knowledge, attitudes, and practices related to salt consumption in Nepal: Findings from the community‐based management of non‐communicable diseases project in Nepal (COBIN)

Ghimire

Adhikari

Rijal

et al. 2019

J of Clinical Hypertension

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High salt/sodium intake is associated with an increased risk of hypertension, which is a major risk factor for cardiovascular diseases. This paper aims to examine the association between salt consumption and salt‐related knowledge, attitudes, and practices (KAP) in Nepal. The cross‐sectional data used in this study were collected as part of the community‐based management of non‐communicable diseases project (COBIN) to understand the amount and KAP related to salt consumption in Nepal. Multivariate hierarchical logistic regression was performed to assess the association of salt‐related KAP and determinants of high salt consumption in Nepal. The mean per capita salt intake was 8.0 (±3.7) g/day, with 81.6% of the population reporting higher intake than the WHO recommendation of <5 g/day. People of upper castes [adjusted odds ratio (aOR) = 0.7; 95% confidence interval (CI): 0.5‐0.9], people in large families (aOR = 0.6; 95% CI: 0.5‐0.7), respondents who were advised to lower salt intake (aOR = 0.6; 95% CI: 0.4‐0.9) and who checked salt/sodium labels in food (aOR = 0.6; 95% CI: 0.4‐0.9) were less likely to consume higher amounts of salt. Similarly, people who added extra salt to their food at the table (aOR = 1.4; 95 CI: 1.1‐1.9) and who reported consuming high amounts of salt (aOR = 1.5; 95% CI: 1.1‐2.3) were more likely to have high salt intake. High salt intake was documented in this population. This study suggests the need for culturally tailored community‐based behavior modification through health education and dietary counseling to effectively reduce salt consumption and thereby support a reduction in hypertension and cardiovascular diseases in Nepal.

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“…Possible explanations for this phenomenon include the fact that epidemiologic and nutrition transition also affect people from rural regions. In rural areas, initiatives to change dietary behaviour should be implemented in order to reduce cardiovascular risk factors, especially reducing salt intake (34).…”

Section: Discussionmentioning

confidence: 99%

Prevalence, control and risk factors related to hypertension among Moroccan adults: a multicentre study

Achhab¹,

Nazek²,

Maalej³

et al. 2019

East Mediterr Health J

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Background: Hypertension is a leading risk factor for mortality and morbidity. Aims: The objective of this study was to determine the prevalence and clinical profile of hypertension in a large sample of individuals in Morocco. Methods: This was a multicentre and cross-sectional study conducted on patients consulting primary care physicians in Morocco between 2008 and 2009. Data were collected via a medical examination and a questionnaire covering patient demographics, medical history and cardiovascular risk factors. Results: In total, 10 714 individuals attending primary care physicians participated in this study. Mean age was 49.6 ± 16.3 years. The total prevalence of hypertension was 39.8%. When adjusted for age and sex, the overall prevalence of hypertension was 26.6% (26.3% in men and 28.0% in women). Among patients with history of hypertension, 85.9% of patients were prescribed antihypertensive medication and/or lifestyle and dietary advice. Nevertheless, only 17.1% had controlled hypertension. Conclusions: This study suggests that the prevalence of hypertension in Morocco is high. Hypertension may also be underdiagnosed and ineffectively treated. Efforts to heighten public awareness and control of hypertension should be enhanced in the public primary care services.

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Salt and hypertension in rural and urban populations of low to middle income countries: A systematic review and meta-analysis

Cited by 16 publications

References 0 publications

More evidence that salt increases blood pressure and risk of kidney disease from the Science of Salt: A regularly updated systematic review of salt and health outcomes (April–July 2016)

More evidence that salt increases blood pressure and risk of kidney disease from the Science of Salt: A regularly updated systematic review of salt and health outcomes (April–July 2016)

Knowledge, attitudes, and practices related to salt consumption in Nepal: Findings from the community‐based management of non‐communicable diseases project in Nepal (COBIN)

Prevalence, control and risk factors related to hypertension among Moroccan adults: a multicentre study

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