Department of Clinical Medicine and Surgery, ESH Excellence Center of Hypertension, 'Federico II' University of Naples Medical School, Naples, Italy.
J Hypertens. 2018 Apr;36(4):734-743. doi: 10.1097/HJH.0000000000001604.
Arterial stiffness is an independent cardiovascular risk factor and sodium intake could be a determinant of arterial stiffness. Nevertheless, the studies that investigated the effect of reducing dietary sodium intake on arterial stiffness in humans provided inconsistent results. Therefore, we performed a systematic review and a meta-analysis of the available randomized controlled trials of salt restriction and arterial stiffness to try and achieve more definitive conclusions.
A systematic search of the online databases available (from 1996 through July 2017) was conducted including randomized controlled trials that reported arterial stiffness, expressed by carotid-femoral pulse wave velocity (PWV), as difference between the effects of two different sodium intake regimens. For each study, the mean difference and 95% confidence intervals were pooled using a random effect model. Sensitivity, heterogeneity, publication bias, subgroup and meta-regression analyses were performed.
Eleven studies met the predefined inclusion criteria and provided 14 cohorts with 431 participants and 1-6 weeks intervention time. In the pooled analysis, an average reduction in sodium intake of 89.3 mmol/day was associated with a 2.84% (95% CI: 0.51-5.08) reduction in PWV. There was no significant heterogeneity among studies and no evidence of publication bias was detected. No single feature of the studies analyzed seemed to impact on the effect of salt restriction on PWV.
The results of this meta-analysis indicate that restriction of dietary sodium intake reduces arterial stiffness. This effect seems be at least in part independent of the changes in blood pressure.
动脉僵硬度是心血管疾病的独立危险因素，而钠摄入量可能是动脉僵硬度的决定因素。然而，研究表明，减少饮食中的钠摄入量对人体动脉僵硬度的影响结果并不一致。因此，我们对现有的关于盐限制和动脉僵硬度的随机对照试验进行了系统回顾和荟萃分析，以试图得出更明确的结论。
我们对在线数据库（1996 年至 2017 年 7 月）进行了系统搜索，包括报告了动脉僵硬度的随机对照试验，其通过颈股脉搏波速度（PWV）来表示，即两种不同的钠摄入方案的效果差异。对于每一项研究，采用随机效应模型对平均值差异和 95%置信区间进行汇总。进行了敏感性分析、异质性分析、发表偏倚分析、亚组分析和荟萃回归分析。
11 项研究符合预先设定的纳入标准，提供了 14 个队列，共 431 名参与者，干预时间为 1-6 周。在汇总分析中，平均减少 89.3mmol/天的钠摄入量与 PWV 降低 2.84%（95%CI：0.51-5.08）相关。研究之间没有明显的异质性，也没有发现发表偏倚的证据。分析中没有一个研究特征似乎对盐限制对 PWV 的影响有影响。
荟萃分析的结果表明，限制饮食中的钠摄入量可以降低动脉僵硬度。这种影响似乎至少部分独立于血压的变化。
