By how much does dietary salt reduction lower blood pressure? III--Analysis of data from trials of salt reduction.
By how much does dietary salt reduction lower blood pressure? III--Analysis of data from trials of salt reduction.
复制标题
饮食中减少盐分可以降低多少血压？
作者：
M. Law;C. Frost;N. Wald
目的——确定饮食盐减少试验中所实现的血压降低是否与不同人群的血压和钠摄入量的估计值在数量上一致，如果是，则估计减少饮食盐对中风和缺血性心脏病死亡率的影响。设计——对 68 项交叉试验和 10 项饮食减盐随机对照试验的结果进行分析。主要结果指标——将每项试验观察到的收缩压降低与根据人群分析计算出的预测值进行比较。结果——在 45 项减盐持续 4 周或更短时间的试验中，观察到的血压下降幅度小于预测值，在持续时间最短的试验中，观察到的血压下降幅度与预测下降幅度之间的差异最大。在持续五周或更长时间的 33 项试验中，各个试验的预测减少量与观察到的大范围减少量密切匹配。这适用于所有年龄段以及高血压和正常血压的人。在50-59岁的人群中，通过适度减少膳食盐摄入量，每日钠摄入量减少50毫摩尔（约3克盐），几周后，收缩压将平均降低5毫米汞柱，对于高血压患者（170毫米汞柱）则可降低7毫米汞柱；舒张压会降低大约一半。据估计，整个西方人口盐摄入量的减少将使中风的发病率降低 22%，缺血性心脏病的发病率降低 16%[已修正]。结论——试验结果支持随附两篇论文中观察数据的估计。普遍适度减少饮食盐对中风和缺血性心脏病死亡率的影响将是巨大的——事实上，比全面实施推荐的药物治疗高血压政策所能达到的效果更大。然而，减少加工食品中添加的盐量也可以将血压降低至少两倍，并在英国每年避免约 75,000 人[已修正]死亡以及大量残疾。
OBJECTIVE--To determine whether the reduction in blood pressure achieved in trials of dietary salt reduction is quantitatively consistent with estimates derived from blood pressure and sodium intake in different populations, and, if so, to estimate the impact of reducing dietary salt on mortality from stroke and ischaemic heart disease. DESIGN--Analysis of the results of 68 crossover trials and 10 randomised controlled trials of dietary salt reduction. MAIN OUTCOME MEASURE--Comparison of observed reductions in systolic blood pressure for each trial with predicted values calculated from between population analysis. RESULTS--In the 45 trials in which salt reduction lasted four weeks or less the observed reductions in blood pressure were less than those predicted, with the difference between observed and predicted reductions being greatest in the trials of shortest duration. In the 33 trials lasting five weeks or longer the predicted reductions in individual trials closely matched a wide range of observed reductions. This applied for all age groups and for people with both high and normal levels of blood pressure. In people aged 50-59 years a reduction in daily sodium intake of 50 mmol (about 3 g of salt), attainable by moderate dietary salt reduction would, after a few weeks, lower systolic blood pressure by an average of 5 mm Hg, and by 7 mm Hg in those with high blood pressure (170 mm Hg); diastolic blood pressure would be lowered by about half as much. It is estimated that such a reduction in salt intake by a whole Western population would reduce the incidence of stroke by 22% and of ischaemic heart disease by 16% [corrected]. CONCLUSIONS--The results from the trials support the estimates from the observational data in the accompanying two papers. The effect of universal moderate dietary salt reduction on mortality from stroke and ischaemic heart disease would be substantial--larger, indeed, than could be achieved by fully implementing recommended policy for treating high blood pressure with drugs. However, reduction also in the amount of salt added to processed foods would lower blood pressure by at least twice as much and prevent some 75,000 [corrected] deaths a year in Britain as well as much disability.
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DOI：
10.1152/ajpendo.1988.254.2.e222
发表时间：
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期刊：
The American journal of physiology
影响因子：
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DOI：
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DOI：
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发表时间：
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影响因子：
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作者：
Cooper,R;VanHorn,L;Liu,K;Trevisan,M;Nanas,S;Ueshima,H;Larbi,E;Yu,CS;Sempos,C;LeGrady,D
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