Effectiveness and safety of the use of sodium nitrite in patients with hypertension and pulmonary hypertension: a scoping review

Abstract

Evidence suggests that sodium nitrite may be effective in the treatment of hypertension and pulmonary hypertension. However, its use remains debated due to safety concerns. In response, a scoping review was conducted to map current knowledge on the efficacy and safety of sodium nitrite in patients with hypertension or pulmonary hypertension, addressing the question: What evidence supports the effectiveness and safety of using sodium nitrite in these patients? The databases MEDLINE (PubMed), EMBASE, Scopus, Web of Science, and LILACS were searched for clinical studies on hypertensive patients at any disease stage without restrictions on age, sex, ethnicity, publication date, or status. The primary outcomes analyzed were the efficacy and safety of sodium nitrite. A total of nine articles were included, eight from databases and one from gray literature. Sample sizes ranged from 5 to 36 patients, with sodium nitrite doses between 240 µg/kg/h and 325 mg. Five studies showed positive results for treating essential hypertension. Regarding safety, only one study raised concerns about adverse effects, probably due to the high dose that was used. In pulmonary hypertension patients classified as groups 2, 3, and 5, four studies suggested sodium nitrite was effective and safe, but it was ineffective in group 1. The studies included several significant limitations that should be considered. As such, the current evidence is insufficient to definitively confirm the efficacy and safety of sodium nitrite in hypertensive patients. Further research with larger sample sizes is necessary to obtain more conclusive results.

Keywords: Adverse effects; Clinical outcomes; Qualitative synthesis; Treatment effectiveness; Vasodilators.