title: Effects of salt substitutes on blood pressure: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Clinical trials assessing the effects of salt substitutes on blood pressure (BP) have reported mixed results.
  
  
  OBJECTIVE
  A meta-analysis of randomized controlled trials was conducted to evaluate the effect of salt substitutes on BP, including systolic BP (SBP) and diastolic BP (DBP).
  
  
  METHODS
  Studies were identified via systematic searches of the PubMed, Embase, Cochrane Library, Wanfang Data, and the China National Knowledge Infrastructure databases through December 2013. Random-effects models were used to estimate pooled mean differences in SBP and DBP.
  
  
  RESULTS
  Six cohorts from 5 articles (1 trial enrolled 2 cohorts for independent intervention) consisting of 1974 participants were included. Pooled results showed that salt substitutes had a significant effect on SBP (mean difference: -4.9 mm Hg; 95% CI: -7.3, -2.5 mm Hg; P < 0.001) and DBP (mean difference: -1.5 mm Hg; 95% CI: -2.7, -0.3 mm Hg; P = 0.013). Significant heterogeneity was found for both SBP (I(2) = 76.7%) and DBP (I(2) = 65.8%). The sensitivity analysis indicated that the pooled effects of salt substitutes on SBP and DBP were robust to systematically dropping each trial. Furthermore, no evidence of significant publication bias from funnel plots or Egger's tests (P = 0.17 and 0.22 for SBP and DBP, respectively) was found.
  
  
  CONCLUSIONS
  This meta-analysis showed that salt-substitution strategies are effective at lowering SBP and DBP, which supports a nutritional approach to preventing hypertension.
authors.affiliation: From the State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y-GP, WL, X-XW, YL, and L-CZ) and the Public Health School, Gansu University of Traditional Chinese Medicine, Gansu, China (J-HH).
authors.forename: Ya-Guang
authors.initials: YG
authors.lastname: Peng
authors.affiliation: From the State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y-GP, WL, X-XW, YL, and L-CZ) and the Public Health School, Gansu University of Traditional Chinese Medicine, Gansu, China (J-HH).
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: From the State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y-GP, WL, X-XW, YL, and L-CZ) and the Public Health School, Gansu University of Traditional Chinese Medicine, Gansu, China (J-HH).
authors.forename: Xiao-Xiao
authors.initials: XX
authors.lastname: Wen
authors.affiliation: From the State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y-GP, WL, X-XW, YL, and L-CZ) and the Public Health School, Gansu University of Traditional Chinese Medicine, Gansu, China (J-HH).
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: From the State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y-GP, WL, X-XW, YL, and L-CZ) and the Public Health School, Gansu University of Traditional Chinese Medicine, Gansu, China (J-HH).
authors.forename: Ji-Hong
authors.initials: JH
authors.lastname: Hu
authors.affiliation: From the State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y-GP, WL, X-XW, YL, and L-CZ) and the Public Health School, Gansu University of Traditional Chinese Medicine, Gansu, China (J-HH).
authors.forename: Lian-Cheng
authors.initials: LC
authors.lastname: Zhao
mesh_terms: D001794:Blood Pressure / Q000187:drug effects*; D002681:China; D016208:Databases, Factual; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic; D012492:Salts / Q000008:administration & dosage*
chemical_list: D012492:Salts
keywords: blood pressure; hypertension; meta-analysis; randomized controlled trial; salt substitutes