Current Data on Dietary Sodium, Arterial Structure and Function in Humans: A Systematic Review.

Christiana Tsirimiagkou,Yannis Manios,Athanase D Protogerou,Maria Yannakoulia,Kalliopi Karatzi,Antonios Argyris,Eirini D Basdeki

doi:10.3390/nu12010005

Christiana Tsirimiagkou, Yannis Manios + Show 5 more

Open Access

https://doi.org/10.3390/nu12010005

Copy DOI

Abstract

Background: Subclinical arterial damage (SAD) (arteriosclerosis, arterial remodeling and atheromatosis) pre-exists decades before cardiovascular disease (CVD) onset. Worldwide, sodium (Na) intake is almost double international recommendations and has been linked with CVD and death, although in a J-shape manner. Studies regarding dietary Na and major types of SAD may provide pathophysiological insight into the association between Na and CVD. Objectives: Systematic review of data derived from observational and interventional studies in humans, investigating the association between dietary Na with (i) atheromatosis (arterial plaques); (ii) arteriosclerosis (various biomarkers of arterial stiffness); (iii) arterial remodeling (intima–media thickening and arterial lumen diameters). Data sources: Applying the PRISMA criteria, the PubMed and Scopus databases were used. Results: 36 studies were included: 27 examining arteriosclerosis, four arteriosclerosis and arterial remodeling, three arterial remodeling, and two arterial remodeling and atheromatosis. Conclusions: (i) Although several studies exist, the evidence does not clearly support a clinically meaningful and direct (independent from blood pressure) effect of Na on arterial wall stiffening; (ii) data regarding the association of dietary Na with arterial remodeling are limited, mostly suggesting a positive trend between dietary Na and arterial hypertrophy but still inconclusive; (iii) as regards to atheromatosis, data are scarce and the available studies present high heterogeneity. Further state-of-the-art interventional studies must address the remaining controversies.

Highlights

Cardiovascular disease (CVD) is responsible for 31 percent of all deaths worldwide (WHO 2018).The onset of cardiovascular disease (CVD) is preceded for decades by subclinical vascular functional and/or structural alterations, leading to transient or permanent subclinical arterial damage (SAD)
We performed a systematic review of the literature to investigate the relationship between dietary Na intake with arterial function and structure using gold-standard non-invasive vascular biomarkers to measure arteriosclerosis, arterial remodeling and atheromatosis
The results of this systematic review indicate that: (i) several studies have investigated the association of dietary Na with arterial stiffness, the evidence does not clearly support a clinically meaningful, direct and independent from blood pressure (BP) effect of Na on the arterial wall to increase arterial stiffness; (ii) data regarding the association between dietary Na and arterial remodeling are limited, mostly suggesting a positive trend between dietary Na and arterial hypertrophy, but still inconclusive; (iii) data regarding the association between dietary Na and atheromatosis are scarce and the available studies present high heterogeneity

Summary

Introduction

Cardiovascular disease (CVD) is responsible for 31 percent of all deaths worldwide (WHO 2018).The onset of CVD is preceded for decades by subclinical vascular functional and/or structural alterations, leading to transient or permanent subclinical arterial damage (SAD). Major types of SAD include atheromatosis (arterial atheromatic plaque formation), arteriosclerosis (arterial stiffening due to loss of the arterial wall’s elastic properties) and arterial remodeling (changes in arterial wall and lumen dimensions to maintain mechanical homeostasis). Carotid ultrasonography is widely used to detect structural changes in the arterial wall (such as arterial plaques, indices of arterial remodeling, e.g., carotid intima–media thickness (cIMT) and arterial. Subclinical arterial damage (SAD) (arteriosclerosis, arterial remodeling and atheromatosis) pre-exists decades before cardiovascular disease (CVD) onset. Studies regarding dietary Na and major types of SAD may provide pathophysiological insight into the association between Na and CVD. Objectives: Systematic review of data derived from observational and interventional studies in humans, investigating the association between dietary Na with (i) atheromatosis (arterial plaques); (ii) arteriosclerosis (various biomarkers of arterial stiffness); (iii) arterial remodeling (intima–media thickening and arterial lumen diameters). Results: 36 studies were included: 27 examining arteriosclerosis, four arteriosclerosis and arterial remodeling, three arterial remodeling, and two arterial remodeling and atheromatosis

Objectives

Methods

Results

Discussion

Conclusion