Department of Clinical Medicine and Surgery, ESH Excellence Center of Hypertension, Federico II, University of Naples Medical School, Naples, Italy.
AORN "A. Cardarelli", Naples, Italy.
J Clin Hypertens (Greenwich). 2020 May;22(5):814-825. doi: 10.1111/jch.13852. Epub 2020 Apr 9.
Central blood pressure (cBP) is highly associated with cardiovascular risk. Although reduction of salt intake leads to lower peripheral blood pressure (BP), the studies on cBP provided inconsistent results. Therefore, we performed a systematic review and a meta-analysis of the available intervention trials of salt reduction on cBP values to reach definitive conclusions. A systematic search of the online databases available (up to December 2018) was conducted including the intervention trials that reported non-invasively assessed cBP changes after two different salt 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. Fourteen studies met the pre-defined inclusion criteria and provided 17 cohorts with 457 participants with 1-13 weeks of intervention time. In the pooled analysis, salt restriction was associated with a significant reduction in augmentation index (9.3%) as well as central systolic BP and central pulse pressure. There was a significant heterogeneity among studies (I = 70%), but no evidence of publication bias. Peripheral BP changes seemed to partially interfere on the relationship between salt restriction and cBP. The results of this meta-analysis indicate that dietary salt restriction reduces cBP. This effect seems to be, at least in part, independent of the changes in peripheral BP.
中心血压（cBP）与心血管风险高度相关。尽管减少盐的摄入量会导致外周血压（BP）降低，但关于 cBP 的研究结果并不一致。因此，我们对现有的盐减少干预试验进行了系统评价和荟萃分析，以得出明确的结论。对在线数据库（截至 2018 年 12 月）进行了系统搜索，包括报告了两种不同盐摄入量方案后非侵入性评估 cBP 变化的干预试验。对于每项研究，使用随机效应模型汇总平均差异和 95%置信区间。进行了敏感性、异质性、发表偏倚、亚组和荟萃回归分析。14 项研究符合预先确定的纳入标准，并提供了 17 个队列，共有 457 名参与者，干预时间为 1-13 周。在荟萃分析中，盐限制与增强指数（9.3%）以及中心收缩压和中心脉压的显著降低相关。研究之间存在显著的异质性（I = 70%），但没有发表偏倚的证据。外周血压变化似乎部分干扰了盐限制与 cBP 之间的关系。荟萃分析的结果表明，饮食盐限制可降低 cBP。这种效果似乎至少部分独立于外周血压的变化。
