Tan Monique, He Feng J, MacGregor Graham A
Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK.
J Renin Angiotensin Aldosterone Syst. 2018 Oct-Dec;19(4):1470320318810015. doi: 10.1177/1470320318810015.
The latest Prospective Urban Rural Epidemiology (PURE) study claims that salt reduction should be confined to settings where its intake exceeds 12.7 g/day and that eating less than 11.1 g/day of salt could increase cardiovascular risk. More specifically, Mente et al. suggested that (a) salt intake was positively associated with stroke only when it exceeded 12.7 g/day, (b) salt intake was inversely associated with myocardial infarction and total mortality, and (c) these associations were largely independent of blood pressure. These provocative findings challenge the robust evidence on the role of salt reduction in the prevention of cardiovascular disease and call into question the World Health Organization's global recommendation to reduce salt intake to less than 5 g/day. However, Mente et al.'s re-analysis of the PURE data has several severe methodological problems, including erroneous estimations of salt intake from a single spot urine using the problematic Kawasaki formula. As such, these implausible results cannot be used to refute the strong evidence supporting the benefits of salt reduction for the general population worldwide.
最新的城乡前瞻性流行病学（PURE）研究称，减盐应局限于盐摄入量超过每日12.7克的人群，而每日盐摄入量低于11.1克可能会增加心血管疾病风险。具体而言，门特等人指出：（a）只有当盐摄入量超过每日12.7克时，才与中风呈正相关；（b）盐摄入量与心肌梗死和总死亡率呈负相关；（c）这些关联在很大程度上独立于血压。这些颇具争议的研究结果对减盐在预防心血管疾病方面的有力证据提出了挑战，并质疑了世界卫生组织将盐摄入量降至每日5克以下的全球建议。然而，门特等人对PURE数据的重新分析存在几个严重的方法学问题，包括使用有问题的川崎公式从单次随机尿样中错误估算盐摄入量。因此，这些不合理的结果不能用来反驳支持全球普通人群减盐有益的有力证据。
