Whelton Paul K
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 440 Walnut Street, New Orleans, LA, 70118, USA,
Curr Hypertens Rep. 2014 Aug;16(8):465. doi: 10.1007/s11906-014-0465-5.
The scientific underpinning for recommended levels of dietary sodium and potassium intake is of great importance to healthcare providers and policy decision-makers. Recent clinical trials and meta-analyses confirm the capacity of dietary sodium reduction and potassium supplementation to reduce blood pressure with no harmful effects on blood lipid levels in customary clinical settings. Blood pressure is thought to be a good surrogate for cardiovascular disease events and the most important preventable risk factor for mortality and disability-adjusted life years. Cohort analyses and related pooling studies that have been used to explore the relationship between dietary Na and CVD were all based on secondary analyses of datasets that were not designed for this purpose. Most are of insufficient quality to provide dependable information. The limited information available from clinical trial experience and cohort studies of higher quality suggests a reduction in dietary Na decreases CVD morbidity and mortality. Modeling studies suggest that a small reduction in dietary sodium would result in a sizable general population health benefit. Some countries have experienced a progressive decline in average dietary sodium consumption. However, there is no evidence of a corresponding trend in the United States, and almost the entire population is failing to meet dietary sodium and potassium guideline recommendations.
推荐的膳食钠和钾摄入量水平的科学依据对医疗保健提供者和政策决策者极为重要。近期的临床试验和荟萃分析证实,在常规临床环境中,减少膳食钠摄入和补充钾能够降低血压,且对血脂水平无有害影响。血压被认为是心血管疾病事件的良好替代指标,也是死亡率和伤残调整生命年最重要的可预防风险因素。用于探索膳食钠与心血管疾病之间关系的队列分析和相关汇总研究均基于并非为此目的而设计的数据集的二次分析。大多数研究质量不足,无法提供可靠信息。来自高质量临床试验经验和队列研究的有限信息表明,减少膳食钠摄入可降低心血管疾病的发病率和死亡率。模型研究表明,膳食钠摄入量的小幅降低将给普通人群的健康带来可观益处。一些国家的平均膳食钠消费量已逐渐下降。然而,在美国没有证据表明存在相应趋势,而且几乎整个人口都未达到膳食钠和钾的指南建议。