Key result
A low-sodium diet did not significantly reduce systolic blood pressure compared to a high-sodium diet in the overall normotensive population (mean decline 1 mm Hg; 95% CI 0-3; P=0.17).
Why the study?
The role of sodium restriction on blood pressure in normotensive individuals remains unclear, particularly in Indo-Asian populations.
Does a low-sodium diet reduce systolic blood pressure in normotensive Indo-Asian adults?
RCT (n=200)
randomized
No
Does a low-sodium diet reduce systolic blood pressure in normotensive Indo-Asian adults?
Short-term sodium restriction significantly lowers systolic blood pressure in Indo-Asian adults with high-normal blood pressure, supporting targeted primary prevention strategies.
BACKGROUND: Hypertension is a major modifiable risk factor, and while sodium restriction in hypertensive patients appears effective, its role in normotensive individuals remains unclear. We assessed the effect of a low vs. high-sodium diet on blood pressure in normotensive Indo-Asian adults. METHODS: A randomized, controlled, crossover trial was conducted on 200 normotensive subjects randomly selected from the general population in Karachi, Pakistan. Participants were randomized to either a low (20 mEq/day) or a high-sodium diet (220 mEq/day) for 1 week, followed by 1 week of washout, then the alternate diet for 1 week. The primary outcome was difference in systolic blood pressure (SBP) measured at the end of each phase in the overall population. RESULTS: Mean (95% confidence interval) decline in 24-h urinary sodium excretion was 81.0 (69.6-92.4) mEq/day (P < 0.001), and in SBP was 1 (0-3)mm Hg (P = 0.17) between high and low-sodium phase. A significant interaction was detected (P = 0.001) between dietary sodium and baseline SBP with a greater adjusted mean (95% confidence interval) decline in SBP (6 (2-9)mm Hg) among participants with high-normal SBP (130-139 mm Hg) and no significant change (-1(-2 to 1)) in those with normal baseline SBP (<130 mm Hg), respectively. CONCLUSIONS: Reducing sodium intake has a beneficial effect on blood pressure in Indo-Asians with high-normal SBP, at least in the short term. Given the ubiquity of high-normal blood pressure (BP), and frank hypertension in this population, we argue that primary prevention strategies, targeted at use of discretionary sodium, should now be designed and evaluated.
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Jessani et al. (2008) conducted an RCT in Normotension (n=200). Low-sodium diet vs. High-sodium diet (220 mEq/day) was evaluated on difference in systolic blood pressure (SBP) measured at the end of each phase in the overall population (MD 1 mm Hg, 95% CI 0-3, p=0.17). A low-sodium diet did not significantly reduce systolic blood pressure compared to a high-sodium diet in the overall normotensive population (mean decline 1 mm Hg; 95% CI 0-3; P=0.17).
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