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Meta-Analysis
. 2020 Feb 27;20(1):98.
doi: 10.1186/s12872-020-01347-x.

The hypotensive effect of salt substitutes in stage 2 hypertension: a systematic review and meta-analysis

Sadegh Jafarnejad  1 , Hamed Mirzaei  2 , Cain C T Clark  3 , Mohsen Taghizadeh  2 , Armin Ebrahimzadeh  2
Affiliations
Meta-Analysis

The hypotensive effect of salt substitutes in stage 2 hypertension: a systematic review and meta-analysis

Sadegh Jafarnejad et al. BMC Cardiovasc Disord. .

Abstract

Background: Hypertension (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.

Methods: Studies 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.

Results: Pooled 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.

Conclusions: These 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.

Keywords: Diastolic blood pressure; Hypertension; Meta-analysis; Salt substitutes; Systolic blood pressure.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of literature search of the present meta-analysis
Fig. 2
Fig. 2
Forest plot of comparison of blood pressure between salt substitutive and control groups. a systolic blood pressure and (b) diastolic blood pressure. Random effects model was used to estimate the weighted mean differences of indicators. CI, confidence interval; I-squared inconsistency
Fig. 3
Fig. 3
Sensitivity analysis for the effect of salt substitutes on (a) systolic blood pressure, b diastolic blood pressure
Fig. 4
Fig. 4
Funnel plot detailing publication bias of included studies according to (a) systolic blood pressure and (b) diastolic blood pressure. MD = Mean Difference, SE = standard error
See this image and copyright information in PMC

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