Blood Pressure Response to Changes in Sodium and Potassium Intake: A Metaregression Analysis of Randomised Trials

Journal of Human Hypertension. 2003;17(7):471-480

Hypertension is a major risk factor for cardiovascular disease and is highly prevalent in Western societies. A shift in the population blood pressure distribution to a 5 mm Hg lower level may prevent one-third of strokes and one-fifth of coronary events. Sodium and potassium have been implicated in the aetiology of hypertension.

The aim of the present analysis was to assess blood pressure response to sodium and potassium in relevant population subgroups. Metaregression analysis of randomised blood pressure trials was performed, taking into account age, gender, blood pressure, and habitual sodium and potassium intake in the trial populations. A total of 40 sodium trials and 27 potassium trials in adults with a duration of 2 weeks or more were identified. Data on change in blood pressure and urinary electrolyte excretions during intervention, trial design (parallel or crossover), number of participants, mean age, proportion of males, initial blood pressure, initial urinary electrolyte excretions, and body weight were abstracted.

The results of this study indicate an important role of sodium and potassium in blood pressure regulation, especially in hypertensive individuals. A favourable shift in the sodium/ potassium balance of the diet in the general population may have a substantial impact on hypertension related diseases, including stroke and myocardial infarction.

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