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Sodium intake reduction may help improve BP in hypertensive individuals

19 May 2019

A recent study shows evidence of an association between blood pressure (BP) and sodium reduction (SR), with hypertensive individuals demonstrating a clinically significant drop in BP with SR.

A linear dose-response relation was observed between SR and BP in study groups with mean BP above the 75th percentile (131/78 mm Hg). For systolic blood pressure (SBP), there was a dose-response relation of –7.7 mm Hg/100 mmol SR (95 percent CI, –10.4 to –5.0). For diastolic blood pressure (DBP), the dose-response relation was –3.0 mm Hg/100 mmol SR (–4.6 to –1.4).

On the other hand, there was a weak association between SR and BP in study groups with mean BP ≤131/78 mm Hg. The dose-response relation was –1.46 mm Hg/100 mmol SR (–2.7 to –0.20) for SBP and –0.07 mm Hg/100 mmol SR (–1.5 to 1.4) for DBP.

“Only study groups with a BP in the highest 25th percentile of the population showed a clinically significant drop in BP with SR,” the authors said. “The policy of lowering dietary sodium intake in the general population may need to be reframed to target patients with hypertension.”

In this meta-regression analysis, the dose-response relations between SR and BP were estimated in study groups with mean BP above or below the 75th percentile of the general population. The authors conducted a literature search from 1 January 1946 to 11 April 2018 and identified 133 randomized controlled trials allocating healthy or hypertensive individuals to SR or usual sodium intake.

The authors also performed multivariable regression analyses of the mean SR vs the mean BP effect adjusted for effect modifiers.

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