Abstract
BackgroundHypertension (HTN) is a ubiquitous risk factor for numerous non-communicable diseases, including cardiovascular disease and stroke. There are currently no wholly effective pharmacological therapies for subjects with HTN. However, salt substitutes have emerged as a potential therapy for the treatment of HTN. The aim of the present study was to assess the effect of salt substitutes on reducing systolic blood pressure (SBP) and diastolic BP (DBP), following a meta-analysis of randomized controlled trials.MethodsStudies were found via systematic searches of the Pubmed/Medline, Scopus, Ovid, Google Scholar and Cochrane library. Ten studies, comprised of 11 trials and 1119 participants, were included in the meta-analysis.ResultsPooled weighted mean differences showed significant reductions of SBP (WMD − 8.87 mmHg; 95% CI − 11.19, − 6.55, p < 0.001) and DBP (WMD − 4.04 mmHg; 95% CI − 5.70, − 2.39) with no statistically significant heterogeneity between the 11 included comparisons of SBPs and DBPs. The stratified analysis of trials based on the mean age of participants showed a significant reduction in the mean difference of SBP in both adults (< 65 years old) and elderly (≥65 years old). However, the DBP-lowering effect of salt substitutes was only observed in adult patients (WMD − 4.22 mmHg; 95% CI − 7.85, − 0.58), but not in the elderly subjects.ConclusionsThese findings suggest that salt-substitution strategies could be used for lowering SBP and DBP in patients with stage 2 HTN; providing a nutritional platform for the treatment, amelioration, and prevention of HTN.
Highlights
Hypertension (HTN) is a ubiquitous risk factor for numerous non-communicable diseases, including cardiovascular disease and stroke
Yang et al [14] investigated the effect of salt substitutes on different subsets separated by various characteristics of participants and according to the Cochrane Handbook for Systematic Reviews of Interventions [15], each arm was considered as an independent trial in the present meta-analysis
The stratified analysis of trials based on the mean age of participants showed a significant reduction in the mean difference of systolic blood pressure (SBP) in both adult (< 65 years old) (WMD − 10.38 mmHg; 95% confidence intervals (CI) − 16.16, − 4.60) and elderly participants (≥65 years old) (WMD − 9.98 mmHg;)
Summary
Hypertension (HTN) is a ubiquitous risk factor for numerous non-communicable diseases, including cardiovascular disease and stroke. New insights into the pathogenesis of HTN has suggested that a variety of risk factors contribute to the disease and may be modulated by various cellular and molecular mechanisms [4, 5]. Such mutations have been putatively linked to HTN pathogenesis; Cardiotonic steroids (CTSs) are a branch of hormones mechanistically related to natriuresis, the process of sodium excretion in the urine, and are believed to play an essential role in the pathogenesis of HTN, and exert impact via interaction with Na/K-ATPase, which regulates renal salt handling and help maintain the salt-sensitivity of blood pressure (BP) [6]. Among dietary supplements, salt substitutes have been purported to hold a potentially pivotal role in the manifestation and progression of HTN
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