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Effect of low-sodium salt substitutes on blood pressure, detected hypertension, stroke and mortality.

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dc.contributor.author Hernandez, Adrian V.
dc.contributor.author Emonds, Erin E.
dc.contributor.author Chen, Brett A.
dc.contributor.author Zavala-Loayza, Alfredo J.
dc.contributor.author Thota, Priyaleela
dc.contributor.author Pasupuleti, Vinay
dc.contributor.author Roman, Yuani M.
dc.contributor.author Bernabé Ortiz, Antonio
dc.contributor.author Miranda, J. Jaime
dc.date.accessioned 2019-07-04T16:59:31Z
dc.date.available 2019-07-04T16:59:31Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/6779
dc.description.abstract OBJECTIVE: A systematic review and meta-analysis was conducted to assess the efficacy of low-sodium salt substitutes (LSSS) as a potential intervention to reduce cardiovascular (CV) diseases. METHODS: Five engines and ClinicalTrials.gov were searched from inception to May 2018. Randomised controlled trials (RCTs) enrolling adult hypertensive or general populations that compared detected hypertension, systolic blood pressure (SBP), diastolic blood pressure (DBP), overall mortality, stroke and other CV risk factors in those receiving LSSS versus regular salt were included. Effects were expressed as risk ratios or mean differences (MD) and their 95% CIs. Quality of evidence assessment followed GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. RESULTS: 21 RCTs (15 in hypertensive (n=2016), 2 in normotensive (n=163) and 4 in mixed populations (n=5224)) were evaluated. LSSS formulations were heterogeneous. Effects were similar across hypertensive, normotensive and mixed populations. LSSS decreased SBP (MD -7.81 mm Hg, 95% CI -9.47 to -6.15, p<0.00001) and DBP (MD -3.96 mm Hg, 95% CI -5.17 to -2.74, p<0.00001) compared with control. Significant increases in urinary potassium (MD 11.46 mmol/day, 95% CI 8.36 to 14.55, p<0.00001) and calcium excretion (MD 2.39 mmol/day, 95% CI 0.52 to 4.26, p=0.01) and decreases in urinary sodium excretion (MD -35.82 mmol/day, 95% CI -57.35 to -14.29, p=0.001) were observed. Differences in detected hypertension, overall mortality, total cholesterol, triglycerides, glucose or BMI were not significant. Quality of evidence was low to very low for most of outcomes. CONCLUSIONS: LSSS significantly decreased SBP and DBP. There was no effect for detected hypertension, overall mortality and intermediate outcomes. Large, long-term RCTs are necessary to clarify salt substitute effects on clinical outcomes. en_US
dc.language.iso eng
dc.publisher BMJ Publishing Group
dc.relation.ispartofseries Heart
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Article en_US
dc.subject blood pressure variability en_US
dc.subject body mass en_US
dc.subject calcium excretion en_US
dc.subject cardiac risk factors and prevention en_US
dc.subject cardiovascular risk en_US
dc.subject cerebrovascular accident en_US
dc.subject cholesterol en_US
dc.subject cholesterol blood level en_US
dc.subject diastolic blood pressure en_US
dc.subject glucose blood level en_US
dc.subject human en_US
dc.subject hypertension en_US
dc.subject meta analysis en_US
dc.subject meta-analysis en_US
dc.subject mortality rate en_US
dc.subject outcome assessment en_US
dc.subject population research en_US
dc.subject potassium en_US
dc.subject priority journal en_US
dc.subject risk assessment en_US
dc.subject risk factor en_US
dc.subject sex difference en_US
dc.subject sodium restriction en_US
dc.subject systematic review en_US
dc.subject systemic review en_US
dc.subject systolic blood pressure en_US
dc.subject triacylglycerol blood level en_US
dc.subject urine level en_US
dc.title Effect of low-sodium salt substitutes on blood pressure, detected hypertension, stroke and mortality. en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1136/heartjnl-2018-314036
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.04
dc.relation.issn 1468-201X


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