Effect of salt reduction interventions in lowering blood pressure: A comprehensive systematic review and meta-analysis of controlled clinical trials

Aliasgharzadeh, Soghra; Tabrizi, Jafar Sadegh; Nikniaz, Leila; Ebrahimi-Mameghani, Mehrangiz; Yagin, Neda Lotfi

doi:10.1371/journal.pone.0277929

Cited by 17 publications

(11 citation statements)

References 119 publications

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“…It was estimated that a 0.4 gm/24 h sodium reduction would substantially reduce 9 million CVD events and save 4 million lives in the Chinese population by 2030 34 . The significant reductions of 2.67 mmHg in SBP and 1.39 mmHg in DBP identified in this meta-analysis are comparable to the findings of a recent meta-analysis, which found that health education interventions significantly reduced SBP and DBP by 2.8 and 2.1 mmHg, respectively 4 . Similarly, another meta-analysis found sodium reduction via dietary modifications reduced 2.9 mmHg in SBP and 1.2 mmHg in DBP 35 .…”

Section: Discussionsupporting

confidence: 86%

“…Excessive sodium intake (≥2 gm of sodium or equivalent to ≥5 gm of salt intake daily 1 ) is the leading dietary risk factor of hypertension (HTN) and cardiovascular disease (CVD) 1 , 2 , causing 1.65 million global deaths related to CVD annually 2 . The World Health Organization (WHO) recommends adults consume less than 2 gm of sodium daily 3 , as reducing sodium intake can lower blood pressure (BP) 4 , 5 , thereby reducing death and disability attributable to CVD 6 . However, most adults consume an average of 3.5–5.5 gm sodium daily 3 , which is significantly higher than the recommended amount.…”

Section: Introductionmentioning

confidence: 99%

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Technology-supported behavior change interventions for reducing sodium intake in adults: a systematic review and meta-analysis

Yan,

Chan,

Wang

et al. 2024

npj Digit. Med.

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The effects of technology-supported behavior change interventions for reducing sodium intake on health outcomes in adults are inconclusive. Effective intervention characteristics associated with sodium reduction have yet to be identified. A systematic review and meta-analysis were conducted, searching randomized controlled trials (RCTs) published between January 2000 and April 2023 across 5 databases (PROSPERO: CRD42022357905). Meta-analyses using random-effects models were performed on 24-h urinary sodium (24HUNa), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Subgroup analysis and meta-regression of 24HUNa were performed to identify effective intervention characteristics. Eighteen RCTs involving 3505 participants (51.5% female, mean age 51.6 years) were included. Technology-supported behavior change interventions for reducing sodium intake significantly reduced 24HUNa (mean difference [MD] −0.39 gm/24 h, 95% confidence interval [CI] −0.50 to −0.27; I2 = 24%), SBP (MD −2.67 mmHg, 95% CI −4.06 to −1.29; I2 = 40%), and DBP (MD −1.39 mmHg, 95% CI −2.31 to −0.48; I2 = 31%), compared to control conditions. Interventions delivered more frequently (≤weekly) were associated with a significantly larger effect size in 24HUNa reduction compared to less frequent interventions (>weekly). Other intervention characteristics, such as intervention delivery via instant messaging and participant-family dyad involvement, were associated with larger, albeit non-significant, effect sizes in 24HUNa reduction when compared to other subgroups. Technology-supported behavior change interventions aimed at reducing sodium intake were effective in reducing 24HUNa, SBP, and DBP at post-intervention. Effective intervention characteristics identified in this review should be considered to develop sodium intake reduction interventions and tested in future trials, particularly for its long-term effects.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Technology-supported behavior change interventions for reducing sodium intake in adults: a systematic review and meta-analysis

Yan,

Chan,

Wang

et al. 2024

npj Digit. Med.

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show abstract

“…Moreover, high DBP levels among non-elderly individuals tends to lead to increasing SBP in the course of time, although it has not been evaluated fully that high DBP level as well as SBP causes cardiovascular diseases 24) . Additionally, a meta-analysis evaluated that the salt reduction interventions on BP led to a significant reduction in SBP among subjects aged 25-60 years 25) . It has been supposed that SBP had a stronger association with age and BMI than lifestyle factors except for salt reduction.…”

Section: Discussionmentioning

confidence: 99%

Association of Blood Pressure with Lifestyle Factors Other Than Sodium Restriction among Japanese Men with Non-Hypertensive Blood Pressure Levels: A Cross Sectional Study

Masuda,

Kishimoto,

Moriyama

et al. 2024

JAMHTS

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Objectives: Objectives: The aim of this study is to evaluate the association of lifestyle factors, other than sodium restriction, with blood pressure (BP) levels among middle-aged and elderly men with non-hypertensive BP levels. Low-sodium diets are a common approach to prevent hypertension. It has also been well-known that some lifestyles are associated with hypertension. Additionally, it is effective to address prevention starting from the normal stage to prevent the development of hypertension. However, there are a few studies which have presented the association of BP with combined lifestyles among relatively healthy men. Therefore, an investigation of how a combination of various lifestyles such as sleep duration, habitual exercise, routine drinking, daily breakfast, and dinner timing may provide benefit to individuals with nonhypertensive BP levels.Subjects: Subjects: A total of 124 Japanese men who had a systolic blood pressure (SBP) less than 139 mmHg and a diastolic blood pressure (DBP) less than 89 mmHg during the 'anti-aging health checkups' were enrolled in the study. Methods: Methods:The analyses were conducted for all subjects using personal data regarding clinical characteristics and lifestyles. A multiple regression analysis was conducted to identify the association between BP and lifestyle factors. Further interaction effects of combined lifestyle factors after adjustment for confounders were calculated.Results: Results: It was obvious that SBP and DBP were associated with age and BMI. Drinking habit had a significant positive association with an increase only in DBP level. Moreover, routine drinking combined with sleep duration, habitual exercise, daily breakfast and dinner timing had an association with DBP. Whereas, SBP did not have any significant association with lifestyles. Conclusion: Conclusion:Our findings suggest that the combination of a no-routine drinking habit with even one healthy lifestyle is a significant suggestion for an appropriate DBP level in relatively healthy middle-aged and elderly men. These results might motivate the necessary lifestyle modification to maintain normal BP.

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“…The role of excessive salt intake in hypertension and the health benefits of salt reduction are very well documented [ 1 , 2 , 3 ]. Although sodium is essential for almost all physiological functions, from nutrient absorption to nervous impulse transmission and muscle contraction [ 4 , 5 , 6 ], in excess it adversely impacts the metabolism [ 7 ], immunity [ 8 ], fibrosis [ 9 ], and cardiopulmonary work [ 10 , 11 , 12 ] among many other effects.…”

Section: Introductionmentioning

confidence: 99%

Low-Salt Diet Regulates the Metabolic and Signal Transduction Genomic Fabrics, and Remodels the Cardiac Normal and Chronic Pathological Pathways

Iacobas,

Allen,

Iacobas

2024

CIMB

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Low-salt diet (LSD) is a constant recommendation to hypertensive patients, but the genomic mechanisms through which it improves cardiac pathophysiology are still not fully understood. Our publicly accessible transcriptomic dataset of the left ventricle myocardium of adult male mice subjected to prolonged LSD or normal diet was analyzed from the perspective of the Genomic Fabric Paradigm. We found that LSD shifted the metabolic priorities by increasing the transcription control for fatty acids biosynthesis while decreasing it for steroid hormone biosynthesis. Moreover, LSD remodeled pathways responsible for cardiac muscle contraction (CMC), chronic Chagas (CHA), diabetic (DIA), dilated (DIL), and hypertrophic (HCM) cardiomyopathies, and their interplays with the glycolysis/glucogenesis (GLY), oxidative phosphorylation (OXP), and adrenergic signaling in cardiomyocytes (ASC). For instance, the statistically (p < 0.05) significant coupling between GLY and ASC was reduced by LSD from 13.82% to 2.91% (i.e., −4.75×), and that of ASC with HCM from 10.50% to 2.83% (−3.71×). The substantial up-regulation of the CMC, ASC, and OXP genes, and the significant weakening of the synchronization of the expression of the HCM, CHA, DIA, and DIL genes within their respective fabrics justify the benefits of the LSD recommendation.

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Effect of salt reduction interventions in lowering blood pressure: A comprehensive systematic review and meta-analysis of controlled clinical trials

Cited by 17 publications

References 119 publications

Technology-supported behavior change interventions for reducing sodium intake in adults: a systematic review and meta-analysis

Technology-supported behavior change interventions for reducing sodium intake in adults: a systematic review and meta-analysis

Association of Blood Pressure with Lifestyle Factors Other Than Sodium Restriction among Japanese Men with Non-Hypertensive Blood Pressure Levels: A Cross Sectional Study

Low-Salt Diet Regulates the Metabolic and Signal Transduction Genomic Fabrics, and Remodels the Cardiac Normal and Chronic Pathological Pathways

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