Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride.

Graudal, Niels Albert; Hubeck-Graudal, Thorbjorn; Jurgens, Gesche

doi:10.1002/14651858.cd004022.pub3

Cited by 170Sodium Intake and HealthBlood Pressure and Hypertension StudiesRenin-Angiotensin System Studies

Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride.

Graudal, Niels Albert, Hubeck-Graudal, Thorbjorn, Jurgens, Gesche·2011·Cochrane Database of Systematic Reviews

DOI 10.1002/14651858.cd004022.pub3

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Abstract

BACKGROUND: In spite of more than 100 years of investigations the question of reduced sodium intake as a health prophylaxis initiative is still unsolved. OBJECTIVES: To estimate the effects of low sodium versus high sodium intake on systolic and diastolic blood pressure (SBP and DBP), plasma or serum levels of renin, aldosterone, catecholamines, cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglycerides. SEARCH METHODS: PUBMED, EMBASE and Cochrane Central and reference lists of relevant articles were searched from 1950 to July 2011. SELECTION CRITERIA: Studies randomizing persons to low sodium and high sodium diets were included if they evaluated at least one of the above outcome parameters. DATA COLLECTION AND ANALYSIS: Two authors independently collected data, which were analysed with Review Manager 5.1. MAIN RESULTS: A total of 167 studies were included in this 2011 update.The effect of sodium reduction in normotensive Caucasians was SBP -1.27 mmHg (95% CI: -1.88, -0.66; p=0.0001), DBP -0.05 mmHg (95% CI: -0.51, 0.42; p=0.85). The effect of sodium reduction in normotensive Blacks was SBP -4.02 mmHg (95% CI:-7.37, -0.68; p=0.002), DBP -2.01 mmHg (95% CI:-4.37, 0.35; p=0.09). The effect of sodium reduction in normotensive Asians was SBP -1.27 mmHg (95% CI: -3.07, 0.54; p=0.17), DBP -1.68 mmHg (95% CI:-3.29, -0.06; p=0.04). The effect of sodium reduction in hypertensive Caucasians was SBP -5.48 mmHg (95% CI: -6.53, -4.43; p<0.00001), DBP -2.75 mmHg (95% CI: -3.34, -2.17; p<0.00001). The effect of sodium reduction in hypertensive Blacks was SBP -6.44 mmHg (95% CI:-8.85, -4.03; p=0.00001), DBP -2.40 mmHg (95% CI:-4.68, -0.12; p=0.04). The effect of sodium reduction in hypertensive Asians was SBP -10.21 mmHg (95% CI:-16.98, -3.44; p=0.003), DBP -2.60 mmHg (95% CI: -4.03, -1.16; p=0.0004).In plasma or serum there was a significant increase in renin (p<0.00001), aldosterone (p<0.00001), noradrenaline (p<0.00001), adrenaline (p<0.0002), cholesterol (p<0.001) and triglyceride (p<0.0008) with low sodium intake as compared with high sodium intake. In general the results were similar in studies with a duration of at least 2 weeks. AUTHORS' CONCLUSIONS: Sodium reduction resulted in a 1% decrease in blood pressure in normotensives, a 3.5% decrease in hypertensives, a significant increase in plasma renin, plasma aldosterone, plasma adrenaline and plasma noradrenaline, a 2.5% increase in cholesterol, and a 7% increase in triglyceride. In general, these effects were stable in studies lasting for 2 weeks or more.

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While plasma renin activity responses on average are stronger in normotensive than in hypertensive populations, it can be weaker in some individual cases.
“However, while plasma renin activity responses on average are stronger in normotensive than in hypertensive populations (Graudal et al., 2017), it can be weaker in some individual cases (Graudal et al., 2021).”
From Thoroughly Calibrated Modular Agent-Based Model of the Human Cardiovascular and Renal Systems for Blood Pressure Regulation in Health and Disease (2021) · cites this paper as Graudal et al., 2017

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Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review
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Blood Pressure Effects of Sodium Reduction
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Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride
Graudal, N. A., Hubeck‐Graudal, T., & Jűrgens, G. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004022.pub5 · Cited by 130 · see citing works
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Sodium Intake as a Cardiovascular Risk Factor: A Narrative Review
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Effects of sodium and potassium supplementation on blood pressure and arterial stiffness: a fully controlled dietary intervention study
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Cost-effectiveness of salt reduction to prevent hypertension and CVD: a systematic review
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Effect of low-sodium salt substitutes on blood pressure, detected hypertension, stroke and mortality: A systematic review and meta-analysis of randomised controlled trials
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Mean Dietary Salt Intake in Urban and Rural Areas in India: A Population Survey of 1395 Persons
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The Significance of Duration and Amount of Sodium Reduction Intervention in Normotensive and Hypertensive Individuals: A Meta-Analysis
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Dietary Patterns and Risk for Metabolic Syndrome in Korean Women
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Dietary sodium, potassium, and alcohol: key players in the pathophysiology, prevention, and treatment of human hypertension
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The role of dietary salt in metabolism and energy balance: Insights beyond cardiovascular disease
Wu, Q., Burley, G., Li, L., Lin, S., & Shi, Y. (2023) · Diabetes Obesity and Metabolism · doi:10.1111/dom.14980 · Cited by 57 · see citing works
Initiatives to Reduce the Content of Sodium in Food Products and Meals and Improve the Population’s Health
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Iodine Status in the Colombian Population and the Impact of Universal Salt Iodization: A Double-Edged Sword?
Vargas‐Uricoechea, H., Fernández, M. V. P., Bastidas-Sánchez, B. E., Jojoa-Tobar, E., Ramı́rez, L. E., & Murillo-Palacios, J. (2019) · Journal of Nutrition and Metabolism · doi:10.1155/2019/6239243 · Cited by 48 · see citing works
Applying the Triangle Taste Test to Assess Differences between Low Sodium Salts and Common Salt: Evidence from Peru
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Effect of salt penetration and water migration on cooked salted egg yolk gel during storage: Physicochemical properties, structural characteristics and flavor changes
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Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol and triglyceride
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Reduced dietary sodium intake increases heart rate. a meta-analysis of 63 randomized controlled trials including 72 study populations.
Graudal, N. A., Hubeck-Graudal, T., & Jürgens, G. (2016) · Frontiers in Physiology · doi:10.3389/fphys.2016.00111 · Cited by 37 · see citing works
Dietary Sodium Restriction: Take It with a Grain of Salt
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Interventions That Successfully Reduced Adults Salt Intake—A Systematic Review
Silva-Santos, T., Moreira, P. A. M., Rodrigues, M., Padrão, P., Pinho, O., Norton, P. M. P. N. S., Ndrio, A., & Gonçalves, C. (2021) · Nutrients · doi:10.3390/nu14010006 · Cited by 35 · see citing works
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Gastrointestinal–Renal Axis: Role in the Regulation of Blood Pressure
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Systematic review
Mccormick, M. (2012)
A review of long-term effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol and triglyceride
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Authors: Graudal, N. A., Hubeck-Graudal, T., & Jurgens, G.
Affiliations: Copenhagen University Hospital (DK)
ORCID: Graudal, Niels Albert
Venue: Cochrane Database of Systematic Reviews
Publisher: John Wiley & Sons, Ltd
Published: 2011-11-09
Issue: 11
Pages: CD004022-CD004022
ISSN: 1361-6137 (ISSN-L)
DOI: 10.1002/14651858.cd004022.pub3
OpenAlex: W4232450481
Cited by: 170
References: 208
Citations by year: 2026: 2 · 2025: 4 · 2024: 9 · 2023: 8 · 2022: 14 · 2021: 11 · 2020: 13 · 2019: 8 · 2018: 13 · 2017: 17 · 2016: 21 · 2015: 24 · 2014: 10 · 2013: 9 · 2012: 6
Type: reference entry
Language: en
Update notices: new_version (2017-04-09)
Open access: closed
Locations: Cochrane Database of Systematic Reviews (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
Keywords: sodium restriction, high-salt diet, sodium intake, blood pressure, renin, aldosterone, catecholamines, cholesterol, triglycerides, HDL cholesterol, low-density lipoprotein, hypertension, normotension, racial differences, cardiovascular risk reduction, renin-angiotensin system, renin-aldosterone system
MeSH terms: Aldosterone, Blood Pressure, Catecholamines, Cholesterol, Diet, Sodium-Restricted, Humans, Hypertension, Renin, Triglycerides, Randomized Controlled Trials as Topic, Sodium Chloride, Dietary, Black People, White People, Asian People

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Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride.

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