Compared With Usual Sodium Intake, Low- and Excessive-Sodium Diets Are Associated With Increased Mortality: A Meta-Analysis

BACKGROUND The effect of sodium intake on population health remains controversial. The objective was to investigate the incidence of all-cause mortality (ACM) and cardiovascular disease events (CVDEs) in populations exposed to dietary intakes of low sodium (<115 mmol), usual sodium (low usual sod...

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Vydané v:American journal of hypertension Ročník 27; číslo 9; s. 1129 - 1137
Hlavní autori: Graudal, Niels, Jürgens, Gesche, Baslund, Bo, Alderman, Michael H.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States Oxford University Press 01.09.2014
Predmet:
Blood Pressure
Cardiovascular disease
Chi-Square Distribution
Diet
Diet, Sodium-Restricted - adverse effects
Diet, Sodium-Restricted - mortality
Disease-Free Survival
Evidence-based medicine
Health care
Health Status
Humans
Hypertension
Hypertension - diet therapy
Hypertension - etiology
Hypertension - mortality
Hypertension - physiopathology
Meta-analysis
Mortality
Odds Ratio
Recommended Dietary Allowances
Risk Assessment
Risk Factors
Salt
Sodium
Sodium Chloride, Dietary - adverse effects
Systematic review
Treatment Outcome
blood pressure
cardiovascular disease
salt
meta-analysis
mortality
diet
hypertension
stroke
sodium chloride
ISSN:0895-7061, 1941-7225, 1941-7225
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Shrnutí:BACKGROUND The effect of sodium intake on population health remains controversial. The objective was to investigate the incidence of all-cause mortality (ACM) and cardiovascular disease events (CVDEs) in populations exposed to dietary intakes of low sodium (<115 mmol), usual sodium (low usual sodium: 115-165 mmol; high usual sodium: 166-215 mmol), and high sodium (>215 mmol). METHODS The relationship between individual measures of dietary sodium intake vs. outcome in cohort studies and randomized controlled trials (RCTs) measured as hazard ratios (HRs) were integrated in meta-analyses. RESULTS No RCTs in healthy population samples were identified. Data from 23 cohort studies and 2 follow-up studies of RCTs (n = 274,683) showed that the risks of ACM and CVDEs were decreased in usual sodium vs. low sodium intake (ACM: HR = 0.91, 95% confidence interval (CI) = 0.82-0.99; CVDEs: HR = 0.90, 95% CI = 0.82-0.99) and increased in high sodium vs. usual sodium intake (ACM: HR = 1.16, 95% CI = 1.03-1.30; CVDEs: HR = 1.12, 95% CI = 1.02-1.24). In population representative samples adjusted for multiple confounders, the HR for ACM was consistently decreased in usual sodium vs. low sodium intake (HR = 0.86; 95% CI = 0.81-0.92), but not increased in high sodium vs. usual sodium intake (HR = 1.04; 95% CI = 0.91-1.18). Within the usual sodium intake range, the number of events was stable (high usual sodium vs. low usual sodium: HR = 0.98; 95% CI = 0.92-1.03). CONCLUSIONS Both low sodium intakes and high sodium intakes are associated with increased mortality, consistent with a U-shaped association between sodium intake and health outcomes.
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ObjectType-Evidence Based Healthcare-1
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ISSN:0895-7061
1941-7225
1941-7225
DOI:10.1093/ajh/hpu028