Rios-Leyvraz Magali, Bloetzer Clemens, Chatelan Angeline, Bochud Murielle, Burnier Michel, Santschi Valérie, Paradis Gilles, Tabin René, Bovet Pascal, Chiolero Arnaud
Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
J Clin Hypertens (Greenwich). 2019 Jan;21(1):118-126. doi: 10.1111/jch.13436. Epub 2018 Nov 29.
Little is known on the effect of sodium intake on BP of children with clinical conditions. Our objective was therefore to review systematically studies that have assessed the association between sodium intake and BP in children with various clinical conditions. A systematic search of several databases was conducted and supplemented by a manual search of bibliographies and unpublished studies. Experimental and observational studies assessing the association between sodium intake and BP and involving children or adolescents between 0 and 18 years of age with any clinical condition were included. Out of the 6861 records identified, 51 full texts were reviewed, and 16 studies (10 experimental and 6 observational), involving overall 2902 children and adolescents, were included. Ten studies were conducted in children with elevated BP without identifiable cause, two in children with familial hypertension, one in children with at least one cardiovascular risk factor, one in children with chronic renal insufficiency, one in children with urolithiasis, and one in premature infants. A positive association between sodium intake and BP was found in all studies, except one. The meta-analysis of six studies among children with elevated BP without identifiable cause revealed a difference of 6.3 mm Hg (95% CI 2.9-9.6) and 3.5 mm Hg (95% CI 1.2-5.7) in systolic and diastolic BP, respectively, for every additional gram of sodium intake per day. In conclusion, our results indicate that the BP response to salt is greater in children with clinical conditions, mainly hypertension, than in those without associated clinical conditions.
关于钠摄入对患有临床疾病儿童血压的影响，目前所知甚少。因此，我们的目标是系统回顾评估钠摄入与患有各种临床疾病儿童血压之间关联的研究。我们对多个数据库进行了系统检索，并辅以手动检索参考文献和未发表的研究。纳入了评估钠摄入与血压之间关联且涉及0至18岁患有任何临床疾病的儿童或青少年的实验性和观察性研究。在识别出的6861条记录中，对51篇全文进行了审查，纳入了16项研究（10项实验性研究和6项观察性研究），共涉及2902名儿童和青少年。其中，10项研究针对原因不明的血压升高儿童，2项针对家族性高血压儿童，1项针对至少有一个心血管危险因素的儿童，1项针对慢性肾功能不全儿童，1项针对尿路结石儿童，1项针对早产儿。除一项研究外，所有研究均发现钠摄入与血压之间存在正相关。对6项针对原因不明的血压升高儿童的研究进行的荟萃分析显示，每天钠摄入量每增加1克，收缩压和舒张压分别相差6.3毫米汞柱（95%置信区间2.9 - 9.6）和3.5毫米汞柱（95%置信区间1.2 - 5.7）。总之，我们的结果表明，患有临床疾病（主要是高血压）的儿童对盐的血压反应比无相关临床疾病的儿童更大。
