Sodium intake and blood pressure in children and adolescents: a systematic review and meta-analysis of experimental and observational studies.

TitreSodium intake and blood pressure in children and adolescents: a systematic review and meta-analysis of experimental and observational studies.
Publication TypeJournal Article
Year of Publication2018
AuthorsLeyvraz, M, Chatelan, A, da Costa, BR, Taffé, P, Paradis, G, Bovet, P, Bochud, M, Chiolero, A
JournalInternational journal of epidemiology
Volume47
Issue6
Pagination1796-1810
Date Published12/2018
DOI10.1093/ije/dyy121
ISSN1464-3685
Mots-clésAdolescent, Blood Pressure, Blood Pressure Determination, Child, Dietary/administration & dosage, Humans, Hypertension/prevention & control, Observational Studies as Topic, Overweight/etiology, Sodium Chloride
Abstract

Background: High sodium intake is a cause of elevated blood pressure in adults. In children and adolescents, less evidence is available and findings are equivocal. We systematically reviewed the evidence from experimental and observational studies on the association between sodium intake and blood pressure in children and adolescents.

Methods: A systematic search of the Medline, Embase, CINAHL and CENTRAL databases up to March 2017 was conducted and supplemented by a manual search of bibliographies and unpublished studies. Experimental and observational studies involving children or adolescents between 0 and 18 years of age were included. Random-effects meta-analyses were performed by pooling data across all studies, separately for experimental and observational studies, and restricting to studies with sodium intake and blood pressure measurement methods of high quality. Subgroup meta-analyses, sensitivity analyses and meta-regressions were conducted to investigate sources of heterogeneity and confounding. The dose-response relationship was also investigated.

Results: Of the 6572 publications identified, 85 studies (14 experimental; 71 observational, including 60 cross-sectional, 6 cohort and 5 case-control studies) with 58 531 participants were included. In experimental studies, sodium reduction interventions decreased systolic blood pressure by 0.6 mm Hg [95% confidence interval (CI): 0.5, 0.8] and diastolic blood pressure by 1.2 mm Hg (95% CI: 0.4, 1.9). The meta-analysis of 18 experimental and observational studies (including 3406 participants) with sodium intake and blood pressure measurement methods of high quality showed that, for every additional gram of sodium intake per day, systolic blood pressure increased by 0.8 mm Hg (95% CI: 0.4, 1.3) and diastolic blood pressure by 0.7 mm Hg (95% CI: 0.0, 1.4). The association was stronger among children with overweight and with low potassium intake. A quasi-linear relationship was found between sodium intake and blood pressure.

Conclusions: Sodium intake is positively associated with blood pressure in children and adolescents, with consistent findings in experimental and observational studies. Since blood pressure tracks across the life course, our findings support the reduction of sodium intake during childhood and adolescence to lower blood pressure and prevent the development of hypertension.

Alternate URL

http://www.ncbi.nlm.nih.gov/pubmed/29955869?dopt=Abstract

First publication date (online)

06/2018

WOS ID (UT)

000456664500015

Alternate JournalInt J Epidemiol
Citation Key / SERVAL ID9018
Peer reviewRefereed
PubMed ID29955869

                         

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