title: Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride.
abstract: BACKGROUND
  In spite of more than 100 years of investigations the question of reduced sodium intake as a health prophylaxis initiative is still unsolved.
  
  
  OBJECTIVE
  To estimate the effects of low sodium versus high sodium intake on systolic and diastolic blood pressure (SBP and DBP), plasma or serum levels of renin, aldosterone, catecholamines, cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglycerides.
  
  
  METHODS
  PUBMED, EMBASE and Cochrane Central and reference lists of relevant articles were searched from 1950 to July 2011.
  
  
  METHODS
  Studies randomizing persons to low sodium and high sodium diets were included if they evaluated at least one of the above outcome parameters.
  
  
  METHODS
  Two authors independently collected data, which were analysed with Review Manager 5.1.
  
  
  RESULTS
  A total of 167 studies were included in this 2011 update.The effect of sodium reduction in normotensive Caucasians was SBP -1.27 mmHg (95% CI: -1.88, -0.66; p=0.0001), DBP -0.05 mmHg (95% CI: -0.51, 0.42; p=0.85). The effect of sodium reduction in normotensive Blacks was SBP -4.02 mmHg (95% CI:-7.37, -0.68; p=0.002), DBP -2.01 mmHg (95% CI:-4.37, 0.35; p=0.09). The effect of sodium reduction in normotensive Asians was SBP -1.27 mmHg (95% CI: -3.07, 0.54; p=0.17), DBP -1.68 mmHg (95% CI:-3.29, -0.06; p=0.04). The effect of sodium reduction in hypertensive Caucasians was SBP -5.48 mmHg (95% CI: -6.53, -4.43; p<0.00001), DBP -2.75 mmHg (95% CI: -3.34, -2.17; p<0.00001). The effect of sodium reduction in hypertensive Blacks was SBP -6.44 mmHg (95% CI:-8.85, -4.03; p=0.00001), DBP -2.40 mmHg (95% CI:-4.68, -0.12; p=0.04). The effect of sodium reduction in hypertensive Asians was SBP -10.21 mmHg (95% CI:-16.98, -3.44; p=0.003), DBP -2.60 mmHg (95% CI: -4.03, -1.16; p=0.0004).In plasma or serum there was a significant increase in renin (p<0.00001), aldosterone (p<0.00001), noradrenaline (p<0.00001), adrenaline (p<0.0002), cholesterol (p<0.001) and triglyceride (p<0.0008) with low sodium intake as compared with high sodium intake. In general the results were similar in studies with a duration of at least 2 weeks.
  
  
  CONCLUSIONS
  Sodium reduction resulted in a 1% decrease in blood pressure in normotensives, a 3.5% decrease in hypertensives, a significant increase in plasma renin, plasma aldosterone, plasma adrenaline and plasma noradrenaline, a 2.5% increase in cholesterol, and a 7% increase in triglyceride. In general, these effects were stable in studies lasting for 2 weeks or more.
authors.affiliation: Department of Rheumatology TA4242/Internal Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. graudal@dadlnet.dk.
authors.forename: Niels Albert
authors.initials: NA
authors.lastname: Graudal
authors.forename: Thorbjorn
authors.initials: T
authors.lastname: Hubeck-Graudal
authors.forename: Gesche
authors.initials: G
authors.lastname: Jurgens
mesh_terms: D000450:Aldosterone / Q000097:blood; D044466:Asian People; D044383:Black People; D001794:Blood Pressure / Q000187:drug effects* / Q000528:radiation effects; D002395:Catecholamines / Q000097:blood; D002784:Cholesterol / Q000097:blood; D004039:Diet, Sodium-Restricted; D006801:Humans; D006973:Hypertension / Q000178:diet therapy* / Q000208:ethnology; D016032:Randomized Controlled Trials as Topic; D012083:Renin / Q000097:blood; D017673:Sodium Chloride, Dietary / Q000494:pharmacology*; D014280:Triglycerides / Q000097:blood; D044465:White People
chemical_list: D002395:Catecholamines; D017673:Sodium Chloride, Dietary; D014280:Triglycerides; D000450:Aldosterone; D002784:Cholesterol; D012083:Renin