Perry I J
Department of Epidemiology and Public Health, University College Cork, Ireland.
Nutr Metab Cardiovasc Dis. 2000 Aug;10(4):229-35.
Diet is a major contributor to variation in the occurrence of hypertension and cardiovascular disease, including stroke, worldwide. Dietary salt intake plays a critical role in blood pressure regulation. However the question of whether high dietary salt intake increases risk of stroke, either indirectly via effects on blood pressure or directly via alternative mechanisms has received limited attention.
Narrative review of evidence linking dietary salt intake with left ventricular hypertrophy and cardiovascular disease end-points.
There is accumulating evidence that high salt intake predicts left ventricular hypertrophy, independent of other variables including body mass index and blood pressure. Data are now available from nine different studies worldwide consistent with a significant independent effect of salt intake on left ventricular hypertrophy. There is also evidence from animal experiments and ecological studies of an independent association between salt intake and risk of stroke. However, data from prospective observational studies on the relation between sodium intake and cardiovascular endpoints (including stroke) are sparse and inconsistent. Data from Alderman et al suggesting that there may be a significant inverse association between urinary sodium excretion and risk of cardiovascular disease has attracted controversy. In a number of prospective studies no association between salt intake and cardiovascular disease end-points (including stroke) has been observed. In a recent analysis from the US NHANES follow-up study, there was evidence that high salt intake is strongly and significantly associated with risk of stroke, other cardiovascular disease and all cause mortality in overweight persons, but not in those of normal weight. These findings need to be replicated. However, current data on the association between salt intake, blood pressure and left ventricular hypertrophy support public policy recommendations on the need for a moderate reduction in dietary salt intake at the population level.
在全球范围内，饮食是高血压和心血管疾病（包括中风）发生差异的主要影响因素。饮食中的盐摄入量在血压调节中起着关键作用。然而，高盐饮食是否通过影响血压间接增加中风风险，或通过其他机制直接增加中风风险，这一问题受到的关注有限。
对饮食盐摄入量与左心室肥厚及心血管疾病终点之间关联证据的叙述性综述。
越来越多的证据表明，高盐摄入可预测左心室肥厚，独立于包括体重指数和血压在内的其他变量。目前全球有九项不同研究的数据表明盐摄入量对左心室肥厚有显著的独立影响。动物实验和生态学研究也有证据表明盐摄入量与中风风险之间存在独立关联。然而，关于钠摄入量与心血管终点（包括中风）之间关系的前瞻性观察性研究数据稀少且不一致。奥尔德曼等人的数据表明尿钠排泄与心血管疾病风险之间可能存在显著的负相关，但这一观点引发了争议。在一些前瞻性研究中，未观察到盐摄入量与心血管疾病终点（包括中风）之间的关联。在美国国家健康和营养检查调查（NHANES）随访研究的最近一项分析中，有证据表明高盐摄入与超重人群的中风风险、其他心血管疾病及全因死亡率密切相关，但与正常体重人群无关。这些发现需要重复验证。然而，目前关于盐摄入量、血压和左心室肥厚之间关联的数据支持在人群层面适度减少饮食盐摄入量的公共政策建议。
