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The technical report on sodium intake and cardiovascular disease in low- and middle-income countries by the joint working group of the World Heart Federation, the European Society of Hypertension and the European Public Health Association

Item Type:Article
Title:The technical report on sodium intake and cardiovascular disease in low- and middle-income countries by the joint working group of the World Heart Federation, the European Society of Hypertension and the European Public Health Association
Creators Name:Mancia, G. and Oparil, S. and Whelton, P.K. and McKee, M. and Dominiczak, A. and Luft, F.C. and AlHabib, K. and Lanas, F. and Damasceno, A. and Prabhakaran, D. and La Torre, G. and Weber, M. and O'Donnell, M. and Smith, S.C. and Narula, J.
Abstract:Ingestion of sodium is essential to health, but excess sodium intake is a risk factor for hypertension and cardiovascular disease. Defining an optimal range of sodium intake in populations has been challenging and controversial. Clinical trials evaluating the effect of sodium reduction on blood pressure have shown blood pressure lowering effects down to sodium intake of less than 1.5 g/day. Findings from these blood pressure trials form the basis for current guideline recommendations to reduce sodium intake to less than 2.3 g/day. However, these clinical trials employed interventions that are not feasible for Population-wide implementation (i.e. feeding studies or intensive behavioural interventions), particularly in low and middle-income countries. Prospective cohort studies have identified the optimal range of sodium intake to reside in the moderate range (3-5 g/day), where the risk of cardiovascular disease and death is lowest. Therefore, there is consistent evidence from clinical trials and observational studies to support reducing sodium intake to less than 5 g/day in populations, but inconsistent evidence for further reductions below a moderate intake range (3-5 g/day). Unfortunately, there are no large randomized controlled trials comparing low sodium intake (< 3 g/day) to moderate sodium intake (3-5 g/day) in general populations to determine the net clinical effects of low sodium intake. Until such trials are completed, it is likely that controversy about optimal sodium intake range will continue. This working group calls for the completion of large definitive clinical trials to clarify the range of sodium intake for optimal cardiovascular health within the moderate to low intake range. We support interventions to reduce sodium intake in populations who consume high sodium intake (> 5 g/day), which should be embedded within an overall healthy dietary pattern.
Keywords:Sodium, Hypertension, LMIC
Source:European Heart Journal
ISSN:0195-668X
Publisher:Oxford University Press (U.K.)
Volume:38
Number:10
Page Range:712-719
Date:7 March 2017
Official Publication:https://doi.org/10.1093/eurheartj/ehw549
PubMed:View item in PubMed

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