Abstract P386: Salt is an Important Risk Factor for Hypertension in Rural Disadvantaged Populations

Abstract

Introduction: Hypertension is the greatest contributor to mortality globally, and its prevalence is high in low to middle income countries (LMICs). High salt intake and poor dietary choices are associated with the risk of hypertension, but their role in rural areas of LMICs is unclear. Hypotheses: We aimed to establish the prevalence of high salt intake and to examine whether there is a clear relationship between high salt intake and hypertension in disadvantaged rural settings. We also aimed to assess the available information about the association of hypertension with other dietary factors. Methods: We searched electronic databases to identify studies in rural LMICs, in which the association of salt and other dietary factors with hypertension were assessed using multivariable models. A meta-analysis was conducted to assess these associations using a random effects model. Results: We identified 13 studies with a total of 134,404 participants for the systematic review. The pooled effect sizes (ESs) and 95% confidence intervals (CIs) for studies in which salt intake was assessed as a categorical variable (n=5) were 1.31 (95% CI: 1.19,1.44) in all participants, 1.70 (0.99,2.92) in males and 1.27 (95% CI: 1.04,1.54) in females. We also found a positive association between fat intake and the risk of hypertension (n=2) 1.47 (95% CI: 1.13, 1.90).There were few studies of other dietary factors and hypertension in rural regions of LMICs. Conclusions: To the best of our knowledge, no other systematic review and or meta-analyses have been conducted to investigate the relationship between diet and hypertension in rural populations of LMICs. Our findings show that high salt intake is a significant risk factor for hypertension in rural areas of LMICs. We also show a large gap in the literature regarding the relationship between dietary factors other than salt with the risk of hypertension. Salt reduction strategies should be implemented on a community level in these populations in order to drive a change in dietary behaviour.