Background
In spite of more than 100 years of investigations the question of reduced sodium intake as a health prophylaxis initiative is still unsolved.
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View Current Version (9 Apr 2017) View all versionsNiels Albert Graudal, Dep. of Rheumatology TA4242/Internal Medicine, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, Copenhagen, DK-2100, Denmark. graudal@dadlnet.dk.
In spite of more than 100 years of investigations the question of reduced sodium intake as a health prophylaxis initiative is still unsolved.
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.
PUBMED, EMBASE and Cochrane Central and reference lists of relevant articles were searched from 1950 to July 2011.
Studies randomizing persons to low sodium and high sodium diets were included if they evaluated at least one of the above outcome parameters.
Two authors independently collected data, which were analysed with Review Manager 5.1.
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.
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.
Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride
Malgré plus de 100 ans d’études, la question de la diminution de l’apport en sodium à titre prophylactique sur la santé n’a pas encore été résolue.
Estimer les effets d’un apport faible en sodium comparé à un apport riche en sodium sur la pression artérielle systolique et diastolique (PPAS et PPAD) ainsi que sur les niveaux de rénine, d’aldostérone, de catécholamines, de cholestérol, de lipoprotéine de haute densité (HDL), de lipoprotéine de faible densité (LDL) et de triglycérides dans le sérum ou le plasma
Une recherche a été effectuée dans PUBMED, EMBASE et le registre Cochrane des essais contrôlés (CENTRAL) ainsi que les références bibliographiques des articles pertinents de 1950 à juillet 2011.
Les études randomisant les personnes selon les régimes faibles en sodium et riches en sodium ont été incluses si elles évaluaient au moins l’un des critères de jugement ci-dessus.
Deux auteurs ont extrait de manière indépendante les données, qui ont été analysées avec Review Manager 5.1.
Au total, 167 études ont été incluses dans cette mise à jour de 2011.
La diminution du sodium chez les Caucasiens normotendus a produit une PAS de -1,27 mmHg (IC à 95 % -1,88, -0,66 ; p = 0,0001) et une PPAD de -0,05 mmHg (IC à 95 % : -0,51, 0,42 ; p = 0,85). La diminution du sodium chez les Noirs normotendus a entraîné une PPAS de -4,02 mmHg (IC à 95 % -7,37, -0,68 ; p = 0,002) et une PPAD de -2,01 mmHg (IC à 95 % -4,37, 0,35 ; p = 0,09). La diminution du sodium chez les Asiatiques normotendus a donné une PPAS de -1,27 mmHg (IC à 95 % -3,07, 0,54 ; p = 0,17) et une PPAD de -1,68 mmHg (IC à 95 % -3,29, -0,06 ; p = 0,04). La diminution du sodium chez les Caucasiens hypertendus a produit une PPAS de -5,48 mmHg (IC à 95 % -6,53, -4,43 ; p<0.00001), et une PAD de -2,75 mmHg (IC à 95 % -3,34, -2,17 ; p<0.00001). La diminution du sodium chez les Noirs hypertendus a entraîné une PAS de -6,44 mmHg (IC à 95 % -8,85, -4,03 ; p = 0,00001) et une PAD de -2,40 mmHg (IC à 95 % -4,68, -0,12 ; p = 0,04). La diminution du sodium chez les Asiatiques hypertendus a donné une PAS de -10,21 mmHg (IC à 95 % -16,98, -3,44 ; p = 0,003) et une PAD de -2,60 mmHg (IC à 95 % -4,03, -1,16 ; p = 0,0004).
Une augmentation significative de la rénine (p<0.00001), l'dosterone (p<0.00001), de la noradrénaline (p<0.00001), de l’adrénaline (p<0.0002), du cholestérol (p<0.001) et des triglycérides (p<0.0008) a été notée dans le plasma ou le sérum en cas d’apport faible en sodium à un apport riche en sodium. En général, les résultats étaient similaires dans les études durant au moins 2 semaines
La diminution du sodium a entraîné une baisse de 1 % de la pression artérielle chez les personnes normotendues, une baisse de 3,5 % chez les personnes hypertendues, une augmentation significative de la rénine, de l'aldostérone, de l'adrénaline et de la noradrénaline dans le plasma, une augmentation de 2,5 % du cholestérol et une augmentation de 7 % des triglycérides. En général, ces effets étaient stables dans les études durant 2 semaines ou plus.
低ナトリウム食と高ナトリウム食が血圧、レニン、アルドステロン、カテコールアミン、コレステロール及びトリグリセリドに与える影響の比較
100年を超える研究が行われてきたにもかかわらず、予防的健康法としてのナトリウム摂取量の抑制に関する疑問は依然として解決されていない。
低ナトリウム摂取と高ナトリウム摂取が、収縮期血圧と拡張期血圧（SBPとDBP）、並びにレニン、アルドステロン、カテコールアミン、コレステロール、高比重リポ蛋白（HDL）、低比重リポ蛋白（LDL）及びトリグリセリドの血漿濃度や血清濃度に与える影響を比較、推定する。
1950年から2011年7月まで、PUBMED、EMBASE、Cochrane Central及び関連性のある論文の参考文献リストを検索した。
低ナトリウム食と高ナトリウム食にランダムに割り付けている研究を、少なくとも1つの上記アウトカムパラメーターを評価している場合に組み入れた。
2名のレビューアが別々にデータを抽出し、このデータをReview Manager 5.1で解析した。
この2011年の更新では、計167件の研究を対象とした。 正常血圧の白人における低ナトリウム摂取は、SBPを-1.27 mmHg（95％CI：-1.88～-0.66）低下させ（p = 0.0001）、DBPを-0.05 mmHg（95％CI：-0.51～0.42）低下させた（p = 0.85）。正常血圧の黒人における低ナトリウム摂取は、SBPを-4.02 mmHg（95％CI：-7.37～-0.68）低下させ（p = 0.002）、DBPを-2.01 mmHg（95％CI：-4.37～0.35）低下させた（p = 0.09）。正常血圧のアジア人における低ナトリウム摂取は、SBPを-1.27 mmHg（95%CI：-3.07～0.54）低下させ（p = 0.17）、DBPを-1.68 mmHg（95%CI：-3.29～-0.06）低下させた（p = 0.04）。高血圧の白人における低ナトリウム摂取は、SBPを-5.48 mmHg（95%CI：-6.53～-4.43）低下させ（p＜0.00001）、DBPを-2.75 mmHg（95%CI：-3.34～-2.17）低下させた（p＜0.00001）。高血圧の黒人における低ナトリウム摂取は、SBPを-6.44 mmHg（95%CI：-8.85～-4.03）低下させ（p = 0.00001）、DBPを-2.40 mmHg（95%CI：-4.68～-0.12）低下させた（p = 0.04）。高血圧のアジア人における低ナトリウム摂取は、SBPを-10.21 mmHg (95%CI：-16.98～-3.44)低下させ（p = 0.003）、DBPを-2.60 mmHg (95%CI: -4.03,～-1.16）低下させた（p = 0.0004)。 高ナトリウム摂取と比較して低ナトリウム摂取により、血漿あるいは血清中のレニン（p＜0.00001）、アルドステロン（p＜0.00001）、ノルアドレナリン（p＜0.00001）、アドレナリン（p＜0.0002）、コレステロール（p＜0.001）及びトリグリセリド（p＜0.0008）に有意な増加がみられた。概して、この結果は、少なくとも2週間継続した研究の結果と同等であった。
低ナトリウム摂取は、正常血圧者における血圧の1%低下、高血圧者における血圧の3.5%低下、血漿中レニン、血漿中アルドステロン、血漿中アドレナリン、血漿中ノルアドレナリンの有意な増加、コレステロールの2.5%増加、トリグリセリドの7%増加をもたらした。概して、これらの効果は、2週間以上継続した研究で一定していた。
監 訳: 吉田 雅博,2012.3.13
実施組織: 厚生労働省委託事業によりMindsが実施した。
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Efeitos da dieta com baixo versus alto teor de sódio na pressão arterial, renina, aldosterona, catecolaminas, colesterol e triglicerídeo
Apesar de mais de 100 anos de investigações, a questão de consumir menos sódio na dieta como forma de preservar a saúde (profilaxia) ainda não está resolvida.
Estimar os efeitos da baixa ingestão em comparação com a alta ingestão de sódio sobre a pressão arterial sistólica e diastólica (PAS e PAD), e sobre os níveis séricos ou plasmáticos de renina, aldosterona, catecolaminas, colesterol, lipoproteína de alta densidade (HDL), lipoproteína de baixa densidade (LDL) e triglicérides.
As buscas foram feitas no PUBMED, Embase e Cochrane Central e nas listas de referências de artigos relevantes, publicados entre 1950 a julho de 2011.
Ensaios clínicos randomizados que compararam o uso de dietas de baixo e de alto teor de sódio e que incluíssem pelo menos um dos desfechos de interesse da revisão.
Dois autores coletaram os dados independentemente e estes foram analisados usando o Review Manager 5.1.
Foram incluídos, nesta atualização de 2011, 167 estudos.
O efeito da redução do sódio alimentar em caucasianos normotensos sobre a PAS foi de -1,27 mmHg (95% CI: -1,88 a -0,66, p = 0,0001), e na PAD, de -0,05 mmHg (95% CI: -0,51 a 0,42, p = 0,85). O efeito da redução do sódio em negros normotensos foi de -4,02 mmHg na PAS (95% CI: -7,37 a -0,68, p = 0,002), e de -2,01 mmHg na PAD (95% CI: -4,37 a 0,35, p = 0,09). O efeito da redução do sódio em asiáticos normotensos foi de -1,27 mmHg na PAS (95% CI: -3,07 a 0,54, p = 0,17), e de -1,68 mmHg na PAD (95% CI: -3,29 a -0,06, p = 0,04). O efeito da redução do sódio em caucasianos hipertensos foi de -5,48 mmHg na PAS (95% CI: -6,53 a -4,43, p < 0,00001), e de -2,75 mmHg na PAD (95% CI: -3,34 a -2,17, p <0,00001). O efeito da redução do sódio em negros hipertensos foi de -6,44 mmHg na PAS (95% CI: -8,85 a -4,03, p = 0,00001), e de -2,40 mmHg na PAD (95% CI: -4,68 a -0,12, p = 0,04). O efeito da redução do sódio em asiáticos hipertensos foi de -10,21 mmHg na PAS (95% CI: -16,98 a -3,44, p = 0,003), e de -2,60 mmHg na PAD (95% CI: -4,03 a -1,16, p = 0,0004).
Os participantes com dieta pobre em sódio tiveram aumento significativo nos níveis plasmáticos ou séricos da renina (p < 0,00001), aldosterona (p < 0,00001), noradrenalina (p < 0,00001), adrenalina (p < 0,0002), colesterol (p < 0,001) e triglicerídeos (p < 0,0008), em comparação com o grupo de dieta rica em sódio. Em geral, os resultados foram semelhantes em estudos com duração de pelo menos duas semanas.
A redução do sódio alimentar resultou na diminuição de 1% na pressão arterial em normotensos, de 3,5% em hipertensos, e num aumento significativo nos níveis plasmáticos de renina, aldosterona, adrenalina e noradrenalina. Também levou a aumento nos níveis séricos de colesterol (de 2,5%) e dos triglicerídeos (de 7%). No geral, esses efeitos se mantiveram estáveis nos estudos com duração de duas semanas ou mais.
Tradução do Centro Cochrane do Brasil feita em 20/05/2013 (Maíra T. Parra)
低鈉飲食對比高鈉飲食在血壓、腎素、醛固酮、兒茶酚胺、膽固醇和三酸甘油酯上的影響
僅管有超過100年以上的調查，降低鈉攝取做為健康預防方法倡議的問題仍未解決。
想要估計低鈉對比高鈉攝取在收縮與舒張壓(SBP與DBP)、血漿或血清腎素、醛固酮、兒茶酚胺、膽固醇、高密度脂蛋白(HDL)、低密度脂蛋白 (LDL)與三酸甘油酯水準上的效果。
搜尋1950年到2011年7月的PUBMED、EMBASE及考科藍Central與相關文章的文獻參考清單。
若研究至少有評估上述成果參數之一，則包含有隨機排列民眾到低鈉與高鈉飲食的研究。
兩位作者獨立蒐集數據，數據使用Review Manager 5.1分析。
總計有167個研究被包含在此2011年的更新中。
減鈉在血壓正常的白種人身上的效果為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)。減鈉在血壓正常的黑人身上的效果為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)。減鈉在血壓正常的亞洲人身上的效果為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)。減鈉在高血壓白種人身上的效果為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)。減鈉在高血壓黑人身上的效果為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)。減鈉在高血壓亞洲人身上的效果為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)。
以低鈉攝取與高鈉攝取相比，在血漿或血清中，腎素 (p<0.00001)、醛固酮 (p<0.00001)、去甲腎上腺素 (p<0.00001)、腎上腺素(p<0.0002)、膽固醇 (p<0.001)與三酸甘油酯(p<0.0008) 中有顯著增加。一般而言，維持在至少為期2周，所有研究中結果類似。
減鈉導致血壓正常人身上1%的血壓降低、高血壓者降低3.5%，顯著的於血漿腎素、血漿醛固酮、血漿腎上腺素與血漿去甲腎上腺素中增加，2.5%的膽固醇增加以及三酸甘油酯增加7%。一般而言，這些效果於研究中穩定持續2周或以上。
Effects of low salt diet on blood pressure, hormones and lipids in people with normal blood pressure and in people with elevated blood pressure
We are commonly advised to cut down on salt. The previous version of this review looked at mostly short-term strategies to reduce salt intake. In the present updated version separate analyses of studies with a duration of 2 to 4 weeks or longer were performed. Low salt diets reduced systolic blood pressure by 1% in white people with normal blood pressure and by 3.5% in white people with elevated blood pressure. The effect was similar in trials of 4 weeks or longer. There were increases in some hormones and lipids which could be harmful if persistent over time. However, the studies were not designed to measure long-term health effects. Therefore we do not know if low salt diets improve or worsen health outcomes.
Most of the people who took part in the studies were whites, but in the small number of non-whites the blood pressure reduction was, if anything, greater. More research on reduced salt intake is required, particularly in non-white populations.
Effets d'un régime pauvre en sel sur la pression artérielle, les hormones et les lipides chez les personnes ayant une pression artérielle normale et chez les personnes présentant une pression artérielle élevée
Il est couramment conseillé de réduire la consommation de sel. La précédente version de cette revue a examiné les stratégies principalement à court terme visant à réduire l’apport en sel. Dans la version mise à jour actuelle, des analyses séparées des études durant entre 2 et 4 semaines ou plus ont été effectuées. Les régimes pauvres en sel ont réduit la pression artérielle systolique de 1 % chez les caucasiens ayant une pression artérielle normale et de 3,5 % chez les caucasiens ayant une pression artérielle élevée. L’effet était similaire dans les essais durant 4 semaines ou plus. Des augmentations de certaines hormones et de certains lipides susceptibles d’être nuisibles si elles persistent au fil du temps ont été notées. Les études n’étaient toutefois pas conçues pour mesurer les effets à long terme sur la santé. Nous ne savons donc pas si les régimes pauvres en sel améliorent ou aggravent les résultats sur la santé.
La plupart des personnes qui ont participé aux études étaient des caucasiens, mais la baisse de la pression artérielle était, le cas échéant, supérieure chez le petit nombre de personnes non caucasiennes. Des recherches supplémentaires doivent être menées sur l’apport réduit en sel, tout particulièrement auprès des populations non blanches..
Notes de traduction
Traduit par: French Cochrane Centre 1st December, 2011
Traduction financée par: Ministère du Travail, de l'Emploi et de la Santé Français
Efeitos da dieta com pouco sal na pressão arterial, hormônios e lipídeos em pessoas com pressão arterial normal e com pressão alta
É comum os médicos recomendarem a diminuição do consumo de sal na dieta. A versão anterior desta revisão buscou principalmente estudos que visavam reduzir a ingestão de sal no curto prazo. Na presente versão atualizada, foram realizadas análises separadas de estudos com duração de duas a quatro semanas ou mais. As dietas com pouco sal reduziram a pressão arterial sistólica em 1% em pessoas brancas com pressão arterial normal e em 3,5% em pessoas brancas com pressão arterial alta. Os efeitos foram parecidos em estudos com quatro semanas ou mais de duração. A dieta pobre em sal também provocou o aumento de alguns hormônios e lipídios, o que pode ser prejudicial se essa elevação persistir ao longo do tempo. Entretanto, estes estudos não foram realizados para medir os efeitos na saúde por um tempo prolongado. Sendo assim, nós não sabemos se dietas com pouco sal melhoram ou pioram os desfechos em saúde.
A maioria das pessoas que participaram dos estudos era branca, mas no pequeno grupo de não brancos, a redução da pressão arterial foi ainda maior. Mais pesquisas sobre dietas com pouco sal são necessárias, especialmente em populações não brancas.
Notas de tradução
Tradução do Centro Cochrane do Brasil feita em 20/05/2013 (Maíra T. Parra)
低鈉飲食對血壓正常者和高血壓者的血壓、荷爾蒙和脂質影響
我們通常會建議人們降低鈉的攝取量。本次文獻回顧的前一版本，主要檢視降低鈉攝取量的短期策略。目前這份更新版本，則分別分析持續2至4週以上的試驗。低鈉飲食可使血壓正常的白人收縮壓降低1%；血壓偏高的白人收縮壓降低3.5%。持續4週以上的試驗，所得結果相似。有些荷爾蒙和脂質若長時間持續增高，可能使身體受損，不過這些試驗並非專為測量長期健康影響而設計，因此我們無法得知低鈉飲食會使健康結果改善或惡化。
這些試驗的受試者大部分為白人，但所納入的非白人受試者，血壓的降低幅度較大。仍需進行更多關於低鈉飲食的研究，尤其是針對非白人族群的研究。
譯註
翻譯: East Asian Cochrane Alliance
翻譯補助: 台灣衛生福利部/台北醫學大學實證醫學研究中心
In the later years, population studies associating sodium intake with morbidity and mortality have contributed to the evidence of sodium reduction as a prophylaxis initiative, although not unambiguously, as the interpretation of the population studies have been conflicting (Aldermann 2010, Strazzulo 2009). In addition, recent studies have showed a direct harmful effect of sodium reduction on patients with established heart failure (Paterna 2008, Paterna 2009) and diabetes (Thomas 2011, Ekinci 2011), questioning the advisability of a general recommendation of reduced sodium intake.
Hitherto, the recommendation to reduce sodium intake is based on the effect on a surrogate marker, i.e. blood pressure (BP), and on the hypothetical benefits in terms of reduction in cardiovascular morbidity and mortality (Collins 1990, Law 1991, Bibbins-Domingo 2010). There is evidence from several published reviews of randomised studies (Grobbee 1986, Midgley 1996, Cutler 1997, Ebrahim 1998, Graudal 1998, He 2002, Hooper 2002) and other Cochrane reviews ( He 2004, Taylor 2011) of the effects of reduced sodium intake on BP. In addition sodium intake has been shown to affect other surrogate markers, such as the renin-angiotensin-aldosterone system, catecholamines and serum lipids. Since some of these effects are expected to be mutually dependent, the investigation of more than one effect makes it possible to detect the consistency of the results between the studies. The present review represents a second update of the first cumulative meta-analysis that includes an analysis of hormones and lipids in addition to blood pressure (Graudal 1998), first updated in 2003 (Jürgens 2004).
The purpose of the present review was to estimate the influence of low versus high dietary sodium intake on systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP) and blood concentrations of renin, aldosterone, catecholamines, cholesterol, HDL, LDL and triglyceride to contribute to the evaluation of the possible suitability of sodium reduction as a prophylaxis initiative and treatment of hypertension.
Randomised controlled trials (RCTs) allocating patients to either a low or a high sodium diet and in which the sodium intake was estimated by the 24-h urinary sodium excretion (either measured on the basis of a 24-h urine collection, or estimated from a sample of at least 8 hours).
Persons with normal or elevated blood pressure irrespective of race and age were included. Studies systematically investigating unhealthy patients with other diseases than elevated blood pressure, for instance diabetes or heart failure, were excluded.
The intervention was changed sodium intake, randomly dividing the investigated population into a group eating a low sodium diet and a group eating high sodium diet. Confounding was not allowed, i.e. studies treating persons with a concomitant intervention such as an antihypertensive medication, potassium supplementation or weight reduction were only included if the concomitant intervention was identical during the low and the high sodium diet.
Outcome measures were effects on SBP, DBP, MBP, renin, aldosterone, adrenaline, noradrenaline, triglyceride, cholesterol, LDL and HDL MBP was analysed separately in Caucasians. In studies of Blacks and Asians reporting BP only as MBP, SBP was estimated from MBP + 1/3 of MBP and DBP was estimated from MBP - 1/3 of MBP. Separate meta-analyses were performed for each outcome measure. Concerning blood pressure, participants were stratified according to race (Caucasians, Blacks and Asians) and according to level of blood pressure (hypertension or normotension). In studies, which investigated different races and different blood pressure levels, the first priority was to separate these subgroups. If separate data were not given, the study data would be analysed according to the biggest subgroup. Concerning all other outcome variables, no stratifications were performed.
Trial search: Parijs et al. published the first RCT of the effect of sodium reduction on BP in 1973 (1000 P SE Parijs 1973). In our first meta-analysis (Graudal 1998), a literature search in “MEDLINE” (1966-through December 1997) was performed using the following combinations of search terms: 1) salt or sodium, 2) restriction or dietary, 3) blood pressure or hypertension, 4) randomized or random. We combined 1, 2, 3 and 4 and found 291 references. Of these, 76 randomized trials from 60 references met the inclusion criteria. From the reference lists of these articles and from 4 previous meta-analyses (Grobbee 1986, Law 1991, Cutler 1991, Midgley 1996) additional 23 references reporting on 39 trials were identified, resulting in a total of 83 references.
Similar searches were made for hormones and lipids changing the third search term (blood pressure or hypertension) with the hormone or lipid term resulting in additional 5 sub-studies dealing with hormones and lipids (1086 P Jula 1992, 1087 P Jula 1992(2), 1025 Koolen 1984, 1104 Overlack 1993, Ruppert 1994). Of these 88 references, three dealing exclusively with diabetes patients were excluded in the 2003 update (Dodson 1989, Mühlhauser I 1996, Miller JA 1997).
In January 2002 a repeated search was performed through December 2001, revealing additional 12 references, of which one was excluded because it only included patients with diabetes (Imanishi M 2001). Accordingly, the 2003 updated review included a total of 96 references.
In December 2009 a literature search for the present update was performed from 1950 through December 2009. This search revealed a total of 511 references in PUBMED, 282 in EMBASE and 1428 in CENTRAL. Headlines and abstracts were read and 44 articles from PUBMED (26 included), 8 from EMBASE (1 included) and 129 from CENTRAL (45 included) were retrieved as full-papers for further review. A total of 72 new references investigating at least one of the effect variables met the inclusion criteria for this review. The search was not limited to English language studies. Two studies in Italian were identified and included. During the present revision we discovered that in a few of the previously included studies some subgroup data were published in two papers. To avoid duplication due to including subgroup data from several papers, we included them from the main paper only. As a result, 3 previously included references were excluded (Steegers 1991, Ruppert 1991, Ruppert 1994). A last search was performed on July 21, 2011, revealing 293 additional references. After screening of titles and abstracts, 4 full papers were retrieved of which 2 contained data to be included.
Consequently a total of 167 studies are included in this updated version of this systematic review.
Two authors independently recorded the following data from each trial:
the sample size (N);
the mean age of participants;
the fraction of females, males; Caucasians, Blacks and Asians;
the duration of the intervention;
the sodium reduction measured as the difference between 24-h urinary sodium excretion during low -sodium and high - sodium diets and standard deviation (SD);
SBP (SD) and DBP (SD) before and after intervention;
difference between changes in SBP and DBP obtained during low-sodium and high sodium diets and the SD of these differences;
for cross-over studies, when possible, the overall effect estimate and SE;
levels of hormones and lipids in the blood and their standard deviations during low-sodium and high-sodium diets. Concerning lipids, cholesterol units of mmol/l were transformed to mg/dl by means of the factor 38.6 and triglyceride units of mmol/l were transformed to mg/dl by means of the factor 88.4.
If there were discrepancies between reviewers they looked at the data together and came to an agreement.
This was performed using the Cochrane Risk of bias tool, including recording of allocation, blinding, incomplete outcome data and selective reporting.
This was defined as the mean difference (MD) between the changes from baseline to end of treatment during a low and a high sodium diet. When units within an analysis were different the standardized mean difference (SMD) was used.
Combined analyses were performed including both parallel and cross-over studies. The generic inverse variance data type was used to analyse the effect in order to ensure that the weight of the cross-over studies was not underestimated compared with the parallel studies. For parallel studies SE was calculated in the usual way as follows: SE (diff) = sqrt SE_{1} ^{2} + SE_{2} ^{2}. For cross-over studies the given SE (difference) was used. A linear regression equation linking the given SE to the calculated SE (sqrt SE_{1} ^{2} + SE_{2} ^{2}) was calculated by means of the studies which reported both SE (difference) and SE on blood pressure during both intervention periods. This equation was used to transform all calculated SEs to estimated “true” SEs (difference) in cross-over studies that did not report SE (difference). In this way it was ensured that cross-over studies were attributed proper weight compared with the parallel studies. There were not enough studies to calculate separate equations for Blacks and Asians and therefore the equations calculated in the white populations were used to transform these SEs when necessary.
The very few parallel studies were excluded and the large fraction of cross-over studies were analysed separately. As the large majority of cross-over studies reported separate data for each intervention period instead of overall estimates of effect, the continuous data type was used in the separate analyses of the cross-over studies.
If SD was not reported it was calculated from a given SE, 95% confidence interval, p-value or t-value, estimated from a figure or imputed from the formula SD (change) = sq root (SD1sq + SD2sq), SD1 is SD on blood pressure before intervention and SD2 is SD on blood pressure after intervention.
A chi-squared test included in the forest plot was used to assess whether observed differences in results are compatible with chance alone. A low P value (or a large chi-squared statistic relative to its degree of freedom) provides evidence of heterogeneity of intervention effects (variation in effect estimates beyond chance).
Funnel plots were assessed for asymmetry.
The weighted mean difference (WMD) was calculated for outcome measures with identical units in the included studies (BP, adrenaline, and lipids, after transformation). The standardized mean difference (SMD) was calculated for outcome measures with different units (renin, aldosterone, and noradrenaline). With this method, the difference in effect between two treatments is divided by the standard deviation of the measurements. By that transformation the effect measures become dimensionless and the outcomes from trials, which have used different units, can consequently be combined. If p was less than 0.05 in the test for heterogeneity, a random effect analysis was carried out. In the homogeneous meta-analyses the fixed effect model was used.
Level of significance: In case of multiple independent comparisons it is important to avoid coincidental significance. Twenty meta-analyses were performed. However, the blood pressure comparisons are not independent of each other and the blood pressure depends on renin and aldosterone as well as catecholamines. Concerning lipids these are mutually dependent, whereas the dependency on blood pressure and hormones is not obvious. Consequently the 20 meta-analyses could be sub-classified into a group of meta-analyses of mutually dependent blood pressures and hormones and an independent group of meta-analyses of mutually dependent lipid fractions. Consequently, the level of significance was reduced by means of the formula 1-0.951/N = 1-0.951/2 = 0.025, (N = number of independent investigations = 2).
All analyses: subgroup analyses were performed for studies with a duration of 2 weeks or more (hormones and lipids) and 4 weeks or more (all).
Lipids: subgroup analyses were performed for studies reducing sodium chloride intake to moderate levels (45 mmol or more).
Sources of bias: subgroup analyses were performed for contrasting sources of bias appearing from the risk of bias analysis.
Sensitivity analyses were performed excluding studies giving rise to asymmetry in the funnel plots.
See Characteristics of included studies.
167 references were included in the review. When results were reported by subgroup, the subgroup results were used. In the studies of persons with elevated BP the median of the mean ages was 51 years (range 23-73); the median duration was 28 days (4-365). The mean of the mean 24-hour sodium excretions in the high salt intake groups was 196 mmol and in the low salt intake groups was 71 mmol, corresponding to a mean sodium reduction of 125 mmol, and the median of mean sodium reductions was 94 mmol/24 hours (10-90 percentiles: 46-236). In the studies of persons with normal BP, the median of mean ages was 27 years (range 13-67); the median duration was 7 days (4-1100). The mean of the mean 24-hour sodium excretions in the high salt intake groups was 201 mmol and in the low salt intake groups was 50 mmol, corresponding to a mean sodium reduction of 150 mmol, and the median of mean sodium reductions was 146 mmol/24 hours (10-90 percentiles: 56-246). In 100 studies including 7005 participants there was information of the baseline 24 hour sodium excretion, not influenced by diets. This was 157 mmol (10-90 percentiles: 125-192).
See Characteristics of included studies and additional Table 1.
| |||||||
SG | AC | B (P+D) | IOD | SR | B (P) | B (D) | |
HR | 2 | 2 | 105 | 14 | 3 | 107 | 63 |
LR | 3 | 9 | 60 | 119 | 156 | 60 | 103 |
UR | 162 | 156 | 2 | 34 | 8 | 0 | 1 |
Total | 167 | 167 | 167 | 167 | 167 | 167 | 167 |
The obligatory trial quality criterion was randomization. Double blind, single blind or open studies with a parallel or a cross-over design were accepted. A study was defined as single blind if an investigator measured BP without knowledge of the diet or by a computerized manometer and as open if precautions to decrease observer bias were not mentioned. Only 10 studies (1034 SE Watt 1985, 1078 MBP SE Egan 1991, 1081 P TOHP I 1992, 1135 P TOHP II 1997, 1197 Dickinson 2009, 1198 SE He 2009, 1195 SE Jessani 2008, 1142 P Knuist 1998, 1107 SE MacFadyen 1994, 1136 P van Buul 1997) sufficiently explained the allocation concealment and only two studies use the intention to treat principle (1081 P TOHP I 1992; 1135 P TOHP II 1997).
We found two important contrasts: General blinding and blinding of outcome detection (additional Table 1). We performed sub-analyses of blood pressures in Whites, both normotensive and hypertensive populations, but not in Blacks and Asians due to the small numbers of trials. We did not perform sub-analyses on the biochemical outcomes (hormones and lipids) as they are supposed to be performed blindly in 100% of cases. The results of the sub-analyses are shown in the following section.
See Data and analyses.
In the meta-analyses of 62 trials (71 comparisons) of Caucasians with normal BP, the mean weighted difference (WMD) was a change in SBP of -1.27 [95% CI: -1.88, -0.66] mmHg (p = 0.0001) and in DBP of -0.05 [95% CI: -0.51, 0.42] mmHg (p = 0.85) (Figure 1 Figure 2). In sub meta-analyses of 16 trials (19 comparisons) with duration of at least 4 weeks, the WMD was a decrease in SBP of -1.29 [-1.96, -0.62] mmHg (p = 0.0002) and in DBP of -0.45 [95% CI: -0.90, 0.00] mmHg (p = 0.05).
In a meta-analyses of 28 normotensive trials (31 comparisons) in which MBP was measured, the mean weighted difference (WMD) of MBP was 0.00 [95% CI: -0.34, 0.33] mmHg (p = 0.99). In 13 trials (14 comparisons) in which only MBP was measured, the change was +1.01 [95% CI: 0.39, 1.63] mmHg (p = 0.001).
In the 74 trials (76 comparisons) of Caucasians with elevated BP, WMD was a decrease in SBP of -5.48 [95% CI: -6.53, -4.43] mmHg (p < 0.00001) and in DBP of -2.75 [ 95% CI: -3.34, -2.17] mmHg (p < 0.00001) (Figure 3; Figure 4). In sub meta-analyses of 47 trials (49 comparisons) with duration of at least 4 weeks, WMD was a decrease in SBP of -5.18 [-6.43, -3.94] mmHg (p = 0.0001) and in DBP of -2.59 [95% CI: -3.32, -1.85] mmHg (p = 0.00001).
In a meta-analyses of 21 hypertensive trials (23 comparisons) in which MBP was measured, the mean weighted difference (WMD) of MBP was -3.56 [95% CI:-4.07, -3.06] mmHg (p = 0.00001). In 5 trials (7 comparisons) in which only MBP was measured, the change was -2.03 [95% CI:-3.00, -1.06] mmHg (p = 0.0001).
In the meta-analyses of 6 trials (7 comparisons) of blacks with normal BP, WMD was a decrease in SBP of -4.02 [95% CI:-7.37, -0.68] mmHg (p = 0.02) and in DBP of -2.01 [95% CI:-4.37, 0.35] mmHg (p = 0.09).
In the meta-analyses of 8 trials (9 comparisons) of blacks with elevated BP, WMD was a decrease in SBP of -6.44 [95% CI:-8.85, -4.03] mmHg (p = 0.00001) and in DBP of -2.40 [95% CI:-4.68, -0.12] mmHg (p = 0.04).
In the meta-analyses of 3 trials (3 comparisons) of Asians with normal BP, WMD was a decrease in SBP of -1.27 [95% CI: -3.07, 0.54] mmHg (p = 0.17) and in DBP of -1.68 [95% CI:-3.29, -0.06] mmHg (p = 0.04).
In the meta-analyses of 7 trials (7 comparisons) of Asians with elevated BP, WMD was a decrease in SBP of -10.21 [95% CI:-16.98, -3.44] mmHg (p = 0.003) and in DBP of-2.60 [95% CI: -4.03, -1.16] mmHg (p = 0.0004).
Two parallel trials were excluded (1087 P Jula 1992(2), 1155 P Heer 2000).
In the remaining 70 cross-over trials of measurement of renin (81 comparisons), the standardized mean difference (SMD) of sodium reduction was 1.15 [95% CI: 0.99, 1.30] (Z= 14.81, p<0.00001) (Figure 3). In comparisons with a duration of at least 2 weeks (n = 29) the SMD was 0.67 [95% CI 0.53, 0.82], p = 0.00001 and in comparisons with a duration of at least 4 weeks (n = 14) the SMD was 0.47 [95% CI: 0.35, 0.60], p = 0.00001.
Three parallel trials were excluded (1087 P Jula 1992(2), 1111 P Howe 1994, 1155 P Heer 2000).
In the remaining 51 cross-over trials of measurement of aldosterone (59 comparisons), SMD was 1.36 [95% CI: 1.15, 1.57] (Z = 12.79, p<0.00001) (Figure 4). In comparisons with a duration of at least 2 weeks (n = 20), SMD was 0.99 [95% CI: 0.70, 1.28], p = 0.00001 and in comparisons with a duration of at least 4 weeks (n = 9), SMD was 0.70 [95% CI: 0.37, 1.04], p = 0.0001.
One parallel trial was excluded (1086 P Jula 1992).
In the remaining 31 cross-over trials of measurement of noradrenaline (39 comparisons), SMD was 0.52 [95% CI: 0.37, 0.67], (z = 6.67, p = 0.00001) (Analysis 6.4). In comparisons with a duration of at least 2 weeks (n = 12) the SMD was 0.17 [95% CI: 0.00, 0.33], p = 0.04 and in comparisons with a duration of at least 4 weeks (n = 6) the SMD was 0.06 [95% CI: -0.19, 0.32], p = 0.62.
One parallel trial was excluded (1086 P Jula 1992).
In the remaining 14 cross-over trials of measurement of adrenaline (16 comparisons), SMD was 0.30 [95% CI: 0.13, 0.46], (z = 3.58, p = 0.0003) (Analysis 6.3). In comparisons with a duration of at least 2 weeks (n = 8) the SMD was 0.21 [95% CI: -0.00, 0.43], p = 0.05 and in comparisons with a duration of at least 4 weeks (n = 5) the SMD was 0.24 [95% CI: -0.04, 0.52], p = 0.10.
Three parallel trials were excluded (1015 P Bulpitt 1983, 1085 P Sciarrone 1992, 1199 P Meland 2009).
In the remaining 24 cross-over trials of measurement of cholesterol (25 comparisons), WMD was an increase of 5.76 mg/dl [95% CI: 2.29, 9.24], p = 0.001 (Figure 5). In comparisons with a duration of at least 2 weeks (n = 13) WMD was 2.48 mg/dl [95% CI: -2.18, 7.14], p = 0.30 and in comparisons with a duration of at least 4 weeks (n = 9), WMD was 3.21 mg/dl [95% CI: -2.51, 8.93], p = 0.27.
One parallel trial was excluded (1085 P Sciarrone 1992).
In the remaining 15 cross-over trials of measurement of LDL (16 comparisons), WMD was a non-significant increase of 2.88 mg/dl [95% CI: -1.03, 6.79], p = 0.15 (Analysis 8.4). In comparisons with a duration of at least 2 weeks (n = 8), WMD was 2.45 mg/dl [95% CI: -3.15, 8.06], p = 0.39 and in comparisons with a duration of at least 4 weeks (n = 6), WMD was 3.72 mg/dl [95% CI: -2.67, 10.11], p = 0.25.
Two parallel trials were excluded (1085 P Sciarrone 1992, 1199 P Meland 2009).
In the remaining 17 cross-over trials of measurement of HDL (18 comparisons), there was no effect of sodium reduction on serum HDL: WMD: 0.09 mg/dl [95% CI: -1.44, 1.62] p = 0.91 (Analysis 8.3). This result did not change in comparisons with duration of at least 2 weeks (-0.61 mg/dl [-2.70, 1.47] (n=10)) or at least 4 weeks (-0.14 mg/dl [-2.58, 2.30] (n = 8)).
Two parallel trials were excluded (1085 P Sciarrone 1992, 1199 P Meland 2009) .
In the remaining 18 cross-over trials of measurement of triglyceride (19 comparisons), WMD was an increase of 6.78 mg/dl [95% CI: 2.81, 10.75], p = 0.0008 (Figure 6). In comparisons with a duration of at least 2 weeks (n = 11) the effect was 7.78 mg/dl [95% CI: 2.23, 13.34], p = 0.006 and in comparisons with a duration of at least 4 weeks (n = 7) the effect was 8.37 mg/dl [95% CI: -1.43, 18.18], p = 0.09.
Significance of general blinding and blinding of outcome detection for blood pressure outcomes in white normotensives and hypertensives, low bias risk versus high bias risk: details reported in "Data and analyses: 11 Bias analyses".
Inclusion of the few parallel studies did not change any of the results (data not shown).
The mean increase in se-cholesterol during sodium reduction to a moderate level (median 81mmol/24 hours, range 47-132) in 15 studies was 3.86 [95% CI: -0.74, 8.46] (p=0.10).
The mean increase in se-triglyceride during sodium reduction to a moderate level (median 81mmol/24 hours, range 47-132) in 12 studies was 8.03 [95% CI: 2.06, 14.01] (p=0.0008).
No significant differences were detected during sodium reduction to moderate levels.
The funnel plots of all analyses were investigated. For each funnel plot all studies giving rise to asymmetry were eliminated. The resulting effect was compared with the original analysis. All these analyses showed only marginal effects without significance (not shown).
The intake of sodium in the low sodium group was above 150 mmol in six studies, between 120 and 150 mmol in 3 studies and below 120 mmol in all other studies. Consequently, this meta-analysis in general compares the effects of a dietary sodium intake which is lower than normal (120 mmol) with a sodium intake which is either normal or above normal (150 mmol). The mean and the range of the baseline 24 hour sodium excretion of the included populations before diet manipulation (157 mmol/24(10-90 percentile: 125-192)) hours was within the range, which recently has been hypothesized to be physiologically determined (McCarron 2009, McCarron 2010). This sodium reduction from a generally normal to a subnormal level resulted in a 1% decrease in systolic 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.
Short-term studies have been assumed to reduce the blood pressure effect size to a lesser degree than longer-term studies (He 2002, He 2004). From a statistical point of view this is marginally true for normotensives, as the effect increased from -1.27/-0.05 mmHg to -1.29/-0.45 mmHg, when only studies with duration of 4 weeks or more were included. However, from a clinical point of view this mean difference of about 0.4 mmHg is probably unimportant. In the analysis of hypertensive persons there was no difference between the analysis of all studies versus the analysis of studies with duration of at least 4 weeks (-5.41/-2.68 mmHg vs. -5.03/-2.47 mmHg).
A similar objection has been directed against the possible adverse effects on hormones and lipids. In the previous analysis these effects were not significant in the longer-term studies, of which, however, there were very few. In the present analysis more studies are included and due to the increased statistical power the adverse effects on hormones and lipids are now significant or borderline significant also in the longer-term studies of at least 4 weeks (renin, aldosterone, adrenalin, and triglyceride). The long-term effect of sodium reduction on renin and aldosterone is in accordance with the findings of Oliver et al. in Yanomamo Indians, who ingest extremely small amounts of sodium. They had a 3 times higher level of renin in the blood and a 10 times higher excretion of aldosterone in the urine, than did normal controls (Oliver 1975). Thus, the present meta-analysis provides a possible explanation for the relatively small effect of reduced sodium intake on blood pressure: Compensatory activation of the renin-aldosterone system is proportional to the degree of sodium reduction. Furthermore, the increases in noradrenaline and adrenaline may contribute to this counter-regulation (Warren 1980).
The DASH study (1160 SE DASH 1, 2001) found a significantly higher effect of sodium reduction on blood pressure than the present meta-analysis. However, the majority of persons in this study were non-whites or they suffered from hypertension. In a later publication (1164 SE DASH 2, 2001) sufficient data was given to estimate the effect on DBP in Whites to be 1.4 mm Hg (Jürgens 2002). Considering that the DASH study only includes persons from the upper 50 percentile of normotension, this effect would probably have been smaller, if the whole spectrum of normotension had been investigated like in the meta-analysis. The DASH finding of a higher effect in Blacks prompted us to make a separate analysis on Blacks and Asians. The analysis of Blacks showed that the effect of sodium reduction in normotensive Blacks corresponded to the one found in hypertensive Blacks. This was in contradiction to the analyses of Whites and Asians in whom the effect was smaller in normotensives than in hypertensives. However, compared with previous analyses (Graudal 1998; Jürgens 2004), the diverging results within the black populations and between the black and white populations are smaller. Our cumulative meta-analysis (Graudal 1998) showed that up to 11 studies should be included before the result of the meta-analysis was stable, and in the beginning the effect was higher than the final effect. Consequently, it is probably too early to draw final conclusions about the effect of a low versus high sodium diet in Blacks and Asians. In Whites the results are still similar to the results from 1983 (Graudal 1998).
The blood pressure analyses were in general heterogeneous due to very big differences in the effect sizes. The heterogeneity of the hormone meta-analyses could in part be ascribed to the use of different units. No heterogeneity was detected in the lipid meta-analyses in which identical units were used in the included studies. Concerning sources of bias there was a general trend towards smaller effects in the low risk blinded groups than in the high risk open groups. These differences were, however, small and insignificant. Elimination of studies giving rise to asymmetry in the funnel plots did not change the results.
Previous meta-analyses of RCTs with other selection criteria have shown similar results of sodium reduction on blood pressure. In 1986, Grobbee and Hofman combined 13 studies of persons with normal and elevated BP in a meta-analysis and found a significant hypotensive effect of reduced sodium intake on SBP of -3.6 mmHg and a non-significant effect on DBP of -2.0 mmHg (Grobbee 1986). In 1991, a second meta-analysis of 24 RCTs showed an effect of -4.0/-2.5 mmHg for persons with elevated BP and -1.0/-0.2 for persons with normal BP (Cutler 1991). This was verified in an update from 1997 (Cutler 1997). In 1996, a meta-analysis of 53 RCTs showed an effect of -3.7/-0.9 mmHg in persons with elevated BP and -1.0/-0.1 in persons with normal BP (Midgley 1996). In a meta-analysis including 26 RCTs with a sodium reduction of at least 40 mmol lasting for more than 4 weeks, the effect was -4.2/-2.4 mmHg in persons with elevated BP and -1.6/-0.6 mmHg in persons with normal BP (He 2002). In an analysis of 8 RCTs lasting for at least 6 months the effect was -2.9/-2.1 mmHg for persons with elevated BP and -1.3/- 0.8 mmHg for persons with normal BP (Ebrahim 1998). These results were confirmed in an update (Hooper 2002) and a Cochrane Review (Taylor 2011,). All these results are very similar to the results of the present meta-analysis. Consequently, they confirm that selection of RCTs based on magnitude of sodium difference or duration of the intervention does not significantly change the overall effect size estimate.
As these almost identical meta-analyses have been performed by sceptics as well as by sodium reduction supporters, major disagreements about this effect size no longer seem to exist. However, there is still significant disagreement regarding the relevance of the effect size, and the political salt conflict (Taubes 1998) is still going strong. Two recent papers exemplify this (Strazzulo 2009, Aldermann 2010). In the meta-analysis of population studies by Strazzulo et al., a statistically significant 20% increased risk of cerebrovascular death was found in persons with a high salt intake compared with a low salt intake. However, in a response letter to a critical comment (Cohen 2010) Strazzulo et al. accepted that the statistical significance depended on the inclusion of incomplete data from one of the population studies. Another review of the same studies comes to the conclusion that low salt intake in population studies is not associated with an improved morbidity or mortality (Aldermann 2010). This has recently been verified in a population study, which showed an inverse relationship between sodium intake and cardiovascular mortality (Stolarz-Skrzypek 2011). Furthermore, the meta-analysis by Strazzulo et al. included two Asian population studies, in which the sodium intake in the high intake group was much higher than usually seen in Caucasians. If only American and European population studies had been included, there would be no difference between the high salt intake and low salt intake groups concerning strokes and other cardiovascular disease.
In a recent paper based on computer simulations of assumptions on associations between salt intake and blood pressure, and between blood pressure and mortality, it was concluded that a daily teaspoonful of salt (3g) was a bigger health risk than cigarette smoking (Bibbins-Domingo 2010). The sense of this conclusion can be judged by estimating the lack of accordance of these simulated projected effects with the above-mentioned observed effects in populations. The reason for this lack of accordance is probably that the authors overestimated the assumed linear relationship between salt intake and blood pressure and ignored the possibility that salt reduction may induce adverse effects. The present meta-analysis indicates that the adverse effect on lipids, especially triglyceride, is not just an acute effect as previously assumed (He 2002), but may be persistent also in longer-term studies. Furthermore, reduced sodium intake seems to harm patients with heart insufficiency and diabetes type 1 and 2. In all three patient groups reduced sodium intake is associated with increased mortality (Paterna 2008, Paterna 2009,Thomas 2011, Ekinci 2011).
The blood pressure effect of reduced sodium intake has been related to age. Freedman and Petitti analysed data from Intersalt (Intersalt 1988) and found the paradox that along with the significant association between increase in blood pressure with age and the salt excretion in urine, there was an inverse relationship between estimated blood pressure and salt excretion in urine at age 20. Freedman stated that unless you preferred to conclude that salt should be eaten in high doses by youngsters and in reduced amounts by the elderly, the findings were probably due to uncontrolled confounding, not to variation in salt intake (Freedman 2001). Furthermore, it is not clear whether the blood pressure of different age cohorts in a cross-sectional study like Intersalt is representative of each other, and therefore the age/blood pressure relationship may not be verified in a longitudinal study (Graudal 2000). This position is confirmed by a study showing that recent birth cohorts attained lower blood pressure than did earlier birth cohorts in the period 1887-1994 (Goff 2001). According to this study based on data from more than 50,000 persons, it can be estimated that the median blood pressure is about 15 mmHg lower in a 50 year old person from a recent birth cohort compared with a birth cohort from the late 19th century. Consequently there has been a dramatic fall in blood pressure during the 20th century. In this context the possible effect of sodium reduction of less than 1 mmHg in normotensive persons calls for reflection (Folkow 2011). Finally, it has been very difficult to maintain a significant sodium reduction in longer-term studies which should be taken into consideration when recommending sodium reduction. One reason for this could be that the sodium intake may be regulated by physiological mechanisms (McCarron 2009).
The present meta-analysis shows that low versus high sodium diet in Caucasians with normal BP decreases BP less than 1%. A significant concomitant and persistent increase in plasma renin, plasma aldosterone and to a lesser degree of plasma adrenaline and plasma noradrenaline may contribute to the small effect of sodium reduction on blood pressure. Furthermore, sodium reduction resulted in a significant increase in plasma cholesterol and plasma triglyceride, which expressed in percentage, was numerically larger than the decrease in blood pressure. The increase in triglyceride was numerically unchanged in studies with a duration of at least 2 weeks and in studies with sodium reduction to moderate levels of sodium intake. Due to the relatively small effects and due to the antagonistic nature of the effects (decrease in blood pressure, increase in hormones and lipids), these results do not support that sodium reduction may have net beneficial effects in a population of Caucasians.
In Caucasians with elevated BP, short-term sodium reduction decreases BP by about 2-2.5%, indicating that sodium reduction may be used as a supplementary treatment for hypertension. In Asians and Blacks the effect of sodium reduction was greater, but at present too few studies have been carried out to conclude different from that above.
Trials are needed to determine the effects on BP and other parameters of long-term reductions in sodium intake. The data suggesting that Blacks and Asians are more sensitive to sodium reduction than Caucasians requires further studies. In future studies of mixed populations, it is important that the effects on Caucasians, Blacks, and Asians are reported separately. Long-term RCTs with mortality and morbidity outcomes would be desirable to determine whether the benefits of sodium reduction outweigh the harms. However, such studies may not be practicable and instead well-designed prospective population studies could be an alternative. After more than 150 RCTs and 13 population studies without an obvious signal in favour of sodium reduction, another position could be to accept that such a signal may not exist.
Jacob Riis, Rasmus Moustgaard and Dr Peter C Gøtzsche, The Nordic Cochrane Center, are kindly thanked for assistance during the elaboration of the original review. Doug Salzwedel, The Cochrane Hypertension Review Group, is kindly thanked for his assistance in designing and running a complete literature search during the update of this review. Doris Christiansen and Johanne Worm are kindly thanked for their assistance in the acquisition of literature.
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
1 Whites, normotensive, DBP | 71 | 7299 | Mean Difference (Random, 95% CI) | -0.05 [-0.51, 0.42] |
2 Whites, normotensive, SBP | 70 | 7035 | Mean Difference (Random, 95% CI) | -1.27 [-1.88, -0.66] |
3 Whites, hypertensive, DBP | 76 | 4903 | Mean Difference (Random, 95% CI) | -2.75 [-3.34, -2.17] |
4 Whites, hypertensive, SBP | 74 | 4879 | Mean Difference (Random, 95% CI) | -5.48 [-6.53, -4.43] |
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
1 Whites, normotensive, MBP | 31 | 1790 | Mean Difference (Fixed, 95% CI) | -0.00 [-0.34, 0.33] |
2 Whites, hypertensive, MBP | 23 | 1511 | Mean Difference (Fixed, 95% CI) | -3.56 [-4.07, -3.06] |
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
1 Whites, normotensive, DBP | 20 | 4047 | Mean Difference (Random, 95% CI) | -0.45 [-0.90, 0.00] |
2 Whites, normotensive, SBP | 19 | 3753 | Mean Difference (Random, 95% CI) | -1.29 [-1.96, -0.62] |
3 Whites, hypertensive, DBP | 49 | 3748 | Mean Difference (Random, 95% CI) | -2.59 [-3.32, -1.85] |
4 Whites, hypertensive, SBP | 46 | 3543 | Mean Difference (Random, 95% CI) | -5.18 [-6.43, -3.94] |
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
1 Asians, normotensive, DBP | 3 | 393 | Mean Difference (Fixed, 95% CI) | -1.68 [-3.29, -0.06] |
2 Asians, normotensive, SBP | 3 | 393 | Mean Difference (Fixed, 95% CI) | -1.27 [-3.07, 0.54] |
3 Asians, hypertensive, DBP | 7 | 477 | Mean Difference (Random, 95% CI) | -2.60 [-4.03, -1.16] |
4 Asians, hypertensive, SBP | 8 | 477 | Mean Difference (Random, 95% CI) | -10.21 [-16.98, -3.44] |
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
1 Blacks, normotensive, DBP | 7 | 506 | Mean Difference (Random, 95% CI) | -2.01 [-4.37, 0.35] |
2 Blacks, normotensive, SBP | 7 | 506 | Mean Difference (Random, 95% CI) | -4.02 [-7.37, -0.68] |
3 Blacks, hypertensive, DBP | 9 | 674 | Mean Difference (Random, 95% CI) | -2.40 [-4.68, -0.12] |
4 Blacks, hypertensive, SBP | 9 | 674 | Mean Difference (Random, 95% CI) | -6.44 [-8.85, -4.03] |
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
1 Renin | 81 | 4078 | Std. Mean Difference (IV, Random, 95% CI) | 1.15 [0.99, 1.30] |
2 Aldosterone | 59 | 3348 | Std. Mean Difference (IV, Random, 95% CI) | 1.36 [1.15, 1.57] |
3 Adrenaline | 16 | 608 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.30 [0.13, 0.46] |
4 Noradrenaline | 39 | 1570 | Std. Mean Difference (IV, Random, 95% CI) | 0.52 [0.37, 0.67] |
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
1 Renin | 29 | 1650 | Std. Mean Difference (IV, Random, 95% CI) | 0.67 [0.53, 0.82] |
2 Aldosterone | 20 | 1170 | Std. Mean Difference (IV, Random, 95% CI) | 0.99 [0.70, 1.28] |
3 Adrenaline | 8 | 338 | Std. Mean Difference (IV, Fixed, 95% CI) | 0.21 [-0.00, 0.43] |
4 Noradrenaline | 12 | 576 | Std. Mean Difference (IV, Random, 95% CI) | 0.17 [0.00, 0.33] |
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
1 Cholesterol | 25 | 1546 | Mean Difference (IV, Fixed, 95% CI) | 5.76 [2.29, 9.24] |
2 Trigyceride | 19 | 1334 | Mean Difference (IV, Fixed, 95% CI) | 6.78 [2.81, 10.75] |
3 High density lipoprotein, HDL | 17 | 1210 | Mean Difference (IV, Fixed, 95% CI) | 0.09 [-1.44, 1.62] |
4 Low density lipoprotein, LDL | 16 | 1172 | Mean Difference (IV, Fixed, 95% CI) | 2.88 [-1.03, 6.79] |
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
1 Cholesterol | 13 | 848 | Mean Difference (IV, Fixed, 95% CI) | 2.48 [-2.18, 7.14] |
2 Trigyceride | 11 | 732 | Mean Difference (IV, Fixed, 95% CI) | 7.78 [2.23, 13.34] |
3 High density lipoprotein, HDL | 11 | 684 | Mean Difference (IV, Fixed, 95% CI) | -0.61 [-2.70, 1.47] |
4 Low density lipoprotein, LDL | 8 | 546 | Mean Difference (IV, Fixed, 95% CI) | 2.45 [-3.15, 8.06] |
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
1 Cholesterol | 15 | 820 | Mean Difference (IV, Fixed, 95% CI) | 3.86 [-0.74, 8.46] |
2 Trigyceride | 12 | 688 | Mean Difference (IV, Fixed, 95% CI) | 8.03 [2.06, 14.01] |
3 High density lipoprotein, HDL | 11 | 660 | Mean Difference (IV, Fixed, 95% CI) | -0.40 [-2.22, 1.42] |
4 Low density lipoprotein, LDL | 9 | 568 | Mean Difference (IV, Fixed, 95% CI) | 0.04 [-4.96, 5.04] |
Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
---|---|---|---|---|
1 Whites, normotensive, DBP perf-detec-high | 49 | Mean Difference (Random, 95% CI) | -0.05 [-0.59, 0.49] | |
2 Whites, normotensive, DBP perf-detec-low | 21 | Mean Difference (Random, 95% CI) | -0.03 [-0.99, 0.92] | |
3 Whites, normotensive, DBP outc-asses-high | 29 | Mean Difference (Random, 95% CI) | 0.04 [-0.78, 0.86] | |
4 Whites, normotensive, DBP outc-asses-low | 41 | 4966 | Mean Difference (Random, 95% CI) | -0.11 [-0.68, 0.46] |
5 Whites, normotensive, SBP perf-detec-high | 49 | 6012 | Mean Difference (Fixed, 95% CI) | -1.01 [-1.28, -0.74] |
6 Whites, normotensive, SBP perf-detec-low | 20 | 1003 | Mean Difference (Fixed, 95% CI) | -1.35 [-1.97, -0.74] |
7 Whites, normotensive, SBP outc-asses-high | 27 | 1965 | Mean Difference (Fixed, 95% CI) | -1.32 [-1.79, -0.85] |
8 Whites, normotensive, SBP outc-asses-low | 42 | 5050 | Mean Difference (Fixed, 95% CI) | -0.97 [-1.26, -0.67] |
9 Whites, hypertensive, DBP perf-detec-high | 41 | 2827 | Mean Difference (Fixed, 95% CI) | -2.56 [-3.05, -2.07] |
10 Whites, hypertensive, DBP perf-detec-low | 33 | 1747 | Mean Difference (Fixed, 95% CI) | -2.61 [-3.03, -2.19] |
11 Whites, hypertensive, DBP outc-asses-high | 24 | 1805 | Mean Difference (Fixed, 95% CI) | -2.49 [-3.12, -1.87] |
12 Whites, hypertensive, DBP outc-asses-low | 50 | 2808 | Mean Difference (Fixed, 95% CI) | -2.62 [-2.99, -2.24] |
13 Whites, hypertensive, SBP perf-detec-high | 39 | 2803 | Mean Difference (Fixed, 95% CI) | -4.94 [-5.65, -4.23] |
14 Whites, hypertensive, SBP perf-detec-hlow | 32 | 1673 | Mean Difference (Fixed, 95% CI) | -5.80 [-6.43, -5.16] |
15 Whites, hypertensive, SBP outc-asses-high | 24 | 1805 | Mean Difference (Fixed, 95% CI) | -5.18 [-6.14, -4.22] |
16 Whites, hypertensive, SBP outc-asses-low | 48 | 2784 | Mean Difference (Fixed, 95% CI) | -5.60 [-6.14, -5.06] |
Date | Event | Description |
---|---|---|
5 October 2011 | New citation required and conclusions have changed | Added one new author, re-run searches and included 74 new studies, updated and refined the methodology. |
5 October 2011 | New search has been performed | 1) Seventy-four new references were included. Three previously included references with subgroup data were excluded. 2) The analysis on blood pressure in Blacks were stratified in subgroups of normotensives and hypertensives. 3) New analyses of blood pressure in Asians stratified in subgroups of normotensives and hypertensives were added to the previous analyses of Whites and Blacks. 4) Two separate analyses of mean blood pressure (MBP) in Whites with normal blood pressure and with hypertension were performed. 5) Sub analyses of studies with a duration of 4 weeks or more were added. 6) Subanalyses of lipid studies with sodium reduction to moderate levels were added. 7) Two studies of children with a mean age of 13 years were included. |
Date | Event | Description |
---|---|---|
17 November 2002 | New citation required and conclusions have changed | Substantive amendment |
Graudal NA: Study design and definition of selection criteria; Data collection and analysis; Formulation of manuscript.
Hubeck-Graudal T: Data collection and analysis; Revision of manuscript.
Jürgens G: Data collection and analysis; Revision of manuscript.
None known.
All authors are employed at public institutions. None of the authors has any connection with or receives funds from the food and salt industries or has commercial interests that might bear on this article.
No sources of support supplied
The A.P. Møller Foundation for the Advancement of Medical Science , Denmark.
The A.P.M. foundation is a non-profit funding source, which donated a grant for the pay of Niels Graudal
Methods | Op CO | |
Participants | N15 Hyp Age41 | |
Interventions | SR98 Dur28 | |
Outcomes | SBP DBP | |
Notes | LoFo: 5 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | High risk | |
Allocation concealment (selection bias) | High risk | |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N6 Hyp Age28 | |
Interventions | SR305 Dur10 | |
Outcomes | SBP DBP Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | S BP | |
Participants | N62, M/F:62/0 Hyp Age60 | |
Interventions | SR23 Dur90 | |
Outcomes | SBP DBP | |
Notes | LoFO: 3 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | S CO | |
Participants | N27 Norm Age29 | |
Interventions | SR146 Dur4 | |
Outcomes | SBP DBP Aldo Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | High risk | |
Allocation concealment (selection bias) | High risk | |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op CO | |
Participants | N19 Hyp Age27 | |
Interventions | SR153 Dur4 | |
Outcomes | SBP DBP Aldo Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | High risk | |
Allocation concealment (selection bias) | High risk | |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op CO | |
Participants | N 8 (M/F:8/0) Normotension Age 30 | |
Interventions | SR 776 (796-20) Dur 6 | |
Outcomes | MAP, NE | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Sequence generation not described |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | Open study |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Open study |
Blinding of outcome assessment (detection bias) All outcomes | High risk | Open study |
Methods | Op CO | |
Participants | N20 Norm Age23 | |
Interventions | SR150 Dur14 | |
Outcomes | SBP DBP Aldo Renin NA A | |
Notes | LoFo:0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | Open study |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Open study |
Blinding of outcome assessment (detection bias) All outcomes | High risk | Open study |
Methods | SB P | |
Participants | N12 Hyp Age38 | |
Interventions | SR67 Dur56 | |
Outcomes | DBP | |
Notes | LoFo:0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Sequence generation not described |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | High risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | not blinded |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB P | |
Participants | N12 Hyp Age40 | |
Interventions | SR92 Dur56 | |
Outcomes | DBP | |
Notes | LoFo:0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | High risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N25 Hyp Age23 | |
Interventions | SR60 Dur 42 | |
Outcomes | SBP DBP | |
Notes | LoFo:1 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Sequence generation not described |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op CO | |
Participants | N136 Norm Age39 | |
Interventions | SR130 Dur14 | |
Outcomes | SBP DBP | |
Notes | Included 182 LoFo: 46 IT: yes (results not shown, but reported to be "similar") | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N19 Hyp Age49 | |
Interventions | SR76 Dur28 | |
Outcomes | SBP DBP Aldo Renin | |
Notes | LoFo:0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op P | |
Participants | N90 Hyp Age48 | |
Interventions | SR124 Dur 84 | |
Outcomes | SBP DBP | |
Notes | Included 113 LoFo:23 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | SB P | |
Participants | N38 Norm Age40 | |
Interventions | SR90 Dur72 | |
Outcomes | SBP DBP | |
Notes | LoFo: 4 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB P | |
Participants | N34 Hyp Age40 | |
Interventions | SR90 Dur72 | |
Outcomes | SBP DBP | |
Notes | LoFo: 4 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op P | |
Participants | N 65 (M/F29/36)(B/W/A.0/65/0) Hypertension Age 54.6 | |
Interventions | SR 59 (161-102) Dur 90 | |
Outcomes | SBP, DBP, chol | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op P | |
Participants | N28 Hyp Age55 | |
Interventions | SR 63 Dur 90 | |
Outcomes | SBP DBP | |
Notes | LoFo: 5 IT: No Weighted average of BP effects obtained ar 1,2,3,6 and 12 months. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N 9 (M/F:9/0) Normotension Age 23 | |
Interventions | SR 154 (196-42) Dur 5 | |
Outcomes | renin, Aldo | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N18 Hyp Age52 | |
Interventions | SR 56 Dur 28 | |
Outcomes | SBP DBP Renin | |
Notes | Included 20 LoFo:2 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | SB CO | |
Participants | N59 Norm Age16 | |
Interventions | SR55 Dur 24 | |
Outcomes | SBP DBP | |
Notes | Included 124(1984+1984b) LoFo: 11 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | B - Unclear |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N54 Norm Age16 | |
Interventions | SR72 Dur 24 | |
Outcomes | SBP DBP | |
Notes | Included 124(1984+1984b) LoFo: 11 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op CO | |
Participants | N30 Norm Age23 | |
Interventions | SR137 Dur14 | |
Outcomes | SBP DBP Aldo Renin NA A | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N22 Norm Age23 | |
Interventions | SR167 Dur14 | |
Outcomes | SBP DBP Aldo Renin NA A | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N 24 (M/F:14/10)(B/W/A.0/24/0) Hypertension Age 56.7 | |
Interventions | SR 77 (169-92) Dur 42 | |
Outcomes | SBP, DBP | |
Notes | LoFo:4. 24 of 28 completed the study. IT:No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | S BP | |
Participants | N94 (22 blacks) Hyp Age46 | |
Interventions | SR58 Dur28 | |
Outcomes | SBP DBP | |
Notes | Included 107 LoFo: 13 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op CO | |
Participants | N20 Hyp Age41 | |
Interventions | SR213 Dur14 | |
Outcomes | SBP DBP Aldo Renin NA | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | S CO | |
Participants | N25 Caucasians Hyp Age41 | |
Interventions | SR 208 Dur 14 | |
Outcomes | NA | |
Notes | LoFo:0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op P | |
Participants | N30 Hyp Age51 | |
Interventions | SR99 Dur63 | |
Outcomes | SBP DBP | |
Notes | Included 34 LoFo: 4 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | B - Unclear |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op P | |
Participants | N30 Hyp Age 46 | |
Interventions | SR161 Dur 84 | |
Outcomes | SBP DBP | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | SB CO | |
Participants | N12 Hyp Age36 | |
Interventions | SR100 Dur28 | |
Outcomes | SBP DBP Aldo Renin NA | |
Notes | Included 16 LoFo: 4 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op CO | |
Participants | N12 Hyp Age | |
Interventions | SR190 Dur5 | |
Outcomes | SBP DBP Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB P | |
Participants | N 191 (M/F:0/191) Normotension Age 17 | |
Interventions | SR 14 (600 mg) Dur 56 | |
Outcomes | SBP, DBP | |
Notes | LoFo: 13. 191 of 204 completed the study. IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | SB CO | |
Participants | N34 Norm Age23 | |
Interventions | SR144 Dur14 | |
Outcomes | SBP DBP | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N28 Norm Age23 | |
Interventions | SR163 Dur14 | |
Outcomes | SBP DBP | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | DB CO | |
Participants | N31 Norm Age23 | |
Interventions | SR60 Dur28 | |
Outcomes | SBP DBP | |
Notes | Included 75 (1985+1985b) LoFo: 9 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Low risk | |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N35 Norm Age22 | |
Interventions | SR75 Dur28 | |
Outcomes | SBP DBP | |
Notes | Included 75 (1985+1985b) LoFo: 9 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Low risk | |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | SB CO | |
Participants | N 8 males Norm Age36 | |
Interventions | SR181 Dur4 | |
Outcomes | SBP DBP Aldo Renin | |
Notes | LoFo:0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op CO | |
Participants | N9 Norm Age25 | |
Interventions | SR 200 Dur 14 | |
Outcomes | SBP DBP | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op P | |
Participants | N86 Hyp Age47 | |
Interventions | SR43 Dur180 | |
Outcomes | SBP DBP | |
Notes | LoFo: ? | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | SB P | |
Participants | N100 Hyp Age53 | |
Interventions | SR70 Dur 84 | |
Outcomes | SBP DBP | |
Notes | Included 108 LoFo:8 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N13 Norm Age24 | |
Interventions | SR222 Dur14 | |
Outcomes | SBP DBP Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N13 Norm Age27 | |
Interventions | SR232 Dur 14 | |
Outcomes | SBP DBP Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op CO | |
Participants | N6 Norm Age20 | |
Interventions | SR99 Dur9 | |
Outcomes | SBP DBP | |
Notes | LoFo:0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N11 Norm Age20 | |
Interventions | SR93 Dur9 | |
Outcomes | SBP DBP | |
Notes | LoFo:0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | SB P | |
Participants | N20 Hyp Age58 | |
Interventions | SR57 Dur60 | |
Outcomes | SBP DBP | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | DB CO | |
Participants | N5 Hyp Age58 | |
Interventions | SR217 Dur7 | |
Outcomes | SBP DBP | |
Notes | Included 7 LoFo: 2 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N40 Hyp Age24 | |
Interventions | SR72 (129-57) Dur42 | |
Outcomes | SBP DBP Renin NA A Chol | |
Notes | Included 42 LoFo: 2 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N15 Hyp Age52 | |
Interventions | SR100 Dur30 | |
Outcomes | SBP DBP | |
Notes | LoFo:0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op CO | |
Participants | N13 Norm Age24 | |
Interventions | SR313 Dur6 | |
Outcomes | SBP DBP Renin NA | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N9 Hyp Age25 | |
Interventions | SR328 Dur6 | |
Outcomes | SBP DBP Renin NA | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | SB CO | |
Participants | N16 Hyp Age63 | |
Interventions | SR50 Dur14 | |
Outcomes | SBP DBP Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | DB CO | |
Participants | N 8 Hypertension Age 63 | |
Interventions | SR 67 (135-68) Dur 14 | |
Outcomes | SBP, DBP | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | SB CO | |
Participants | N6 Hyp Age | |
Interventions | SR 97 Dur5 | |
Outcomes | SBP DBP Aldo Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op CO | |
Participants | N 6 (M/F:6/0)(B/W/A.0/6/0) Normotension Age 35 | |
Interventions | SR 134 (163-29) Dur 12 | |
Outcomes | SBP, DBP, renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | DB CO | |
Participants | N8 Norm Age23 | |
Interventions | SR106 Dur14 | |
Outcomes | SBP DBP Aldo Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op P | |
Participants | N103 Hyp Age58 | |
Interventions | SR63 Dur 48 | |
Outcomes | SBP DBP | |
Notes | Included 111 LoFo:8 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N20 Hyp Age57 | |
Interventions | SR150 Dur30 | |
Outcomes | SBP DBP Aldo Renin NA | |
Notes | LoFO: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op CO | |
Participants | N19 (White) Norm Age34 | |
Interventions | SR183 Dur5 | |
Outcomes | SBP DBP Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N23 (Black) Norm Age34 | |
Interventions | SR178 Dur5 | |
Outcomes | SBP DBP Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N16 (Black) Hyp Age34 | |
Interventions | SR178 Dur5 | |
Outcomes | SBP DBP Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N17 (White) Hyp Age34 | |
Interventions | SR 198 Dur 5 | |
Outcomes | SBP DBP Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | SB CO | |
Participants | N9 Norm Age32 | |
Interventions | SR190 Dur7 | |
Outcomes | SBP DBP | |
Notes | Allocation: random numbers LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N9 Hyp Age36 | |
Interventions | SR Dur | |
Outcomes | SBP DBP | |
Notes | Allocation: random numbers LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | S P | |
Participants | N228 (45 blacks) Norm Age40 | |
Interventions | SR23 Dur 1100 | |
Outcomes | SBP DBP | |
Notes | Included 252 LoFo: 24 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op CO | |
Participants | N10 Norm Age46 | |
Interventions | SR341 Dur4 | |
Outcomes | SBP DBP Aldo Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N12 Hyp Age47 | |
Interventions | SR331 Dur4 | |
Outcomes | SBP DBP Aldo Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | SB CO | |
Participants | N15 Norm Age24 | |
Interventions | SR192 (210.7-18.7) Dur 7 | |
Outcomes | SBP DBP Chol HDL LDL TG | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N 40 (M/F:40/0)(B/W/A.0/40/0) Normotension Age 25 | |
Interventions | SR 214 (239-25) Dur 7 | |
Outcomes | SBP, DBP, renin, aldo | |
Notes | LoFo: 5. 40 of 45 completed the study. IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op CO | |
Participants | N10 Norm Age33 | |
Interventions | SR117 Dur 13 | |
Outcomes | SBP DBP Renin NA | |
Notes | LoFo:4 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N 15 (B/W/A 0/15/0) Hypertension, Age 49 | |
Interventions | SR 100 (190-90) Dur 14 | |
Outcomes | SBP, DBP, chol, trig | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB P | |
Participants | N31 Hyp Age50 | |
Interventions | SR73 Dur28 | |
Outcomes | SBP DBP | |
Notes | 1990 + 1990 b Included 63 LoFo: 4 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB P | |
Participants | N28 Hyp Age54 | |
Interventions | SR49 Dur28 | |
Outcomes | SBP DBP | |
Notes | 1990 + 1990 b Included 63 LoFo: 4 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | B - Unclear |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op P | |
Participants | N30 (Black) Norm Age | |
Interventions | SR272 Dur7 | |
Outcomes | SBP (MBP +1/3MBP) DBP (MBP-1/3MBP) | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | SB CO | |
Participants | N13 Norm Age25 | |
Interventions | SR 246 Dur6 | |
Outcomes | SBP DBP Aldo | |
Notes | 1991 + 1991b included 25 LoFo. 2 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op CO | |
Participants | N 100 (M/F:52/48)(B/W/A.0/100/0) Normotension Age 13 | |
Interventions | SR 81 (179-98) Dur 28 | |
Outcomes | SBP, DBP | |
Notes | LoFo:10. 90 of 100 completed the study. IT:No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N 48 (M/F:38/10) Norm Age52 | |
Interventions | SR70 Dur28 | |
Outcomes | SBP DBP | |
Notes | included 50 LoFo. 2 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N11 Hyp Age54 | |
Interventions | SR102 Dur 42 | |
Outcomes | SBP DBP Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N21(6 blacks) Hyp Age54 | |
Interventions | SR91 Dur30 | |
Outcomes | SBP DBP Aldo Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N27 Hyp Age39 | |
Interventions | SR194 (214-21) Dur7 | |
Outcomes | SBP (MBP+1/3MBP) DBP (MBP-1/3MBP) Renin NA l Chol LDL | |
Notes | Eandomisation schedule LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Low risk | A - Adequate |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op CO | |
Participants | N 9 Norm Age not given | |
Interventions | SR 94 (111-17) Dur7 | |
Outcomes | SBP DBP | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N 9 (M/F:7/2)(B/W/A.0/9/0) Normotension Age 25 | |
Interventions | SR 97 (170-73) Dur 14 | |
Outcomes | SBP, DBP, renin, aldo | |
Notes | LoFo:0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | SB P | |
Participants | N744 (131 blacks) Norm Age43 | |
Interventions | SR 47 Dur 550 | |
Outcomes | SBP DBP | |
Notes | LoFo: 50 IT: yes | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Low risk | A - Adequate |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | DB P | |
Participants | N52 Norm Age66 | |
Interventions | SR75 Dur28 | |
Outcomes | SBP DBP | |
Notes | Included 114(1992+1992b) LoFo: 8 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB P | |
Participants | N54 Norm Age67 | |
Interventions | SR73 Dur28 | |
Outcomes | SBP DBP | |
Notes | Included 114(1992+1992b) LoFo: 8 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N20 Hyp Age42 | |
Interventions | SR78 Dur 28 | |
Outcomes | SBP DBP Aldo Renin NA A | |
Notes | Included 22 LoFO: 2 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB P | |
Participants | N91 Hyp Age54 | |
Interventions | SR82 Dur 56 | |
Outcomes | SBP DBP Chol HDL LDL TG | |
Notes | 95 included LoFO: 4 IT: No Lipid values were estimated on the basis of initial values(table 2) and changes (figure 4) | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | SB P | |
Participants | N35 Hyp Age43 | |
Interventions | SR146 Dur180 | |
Outcomes | NA A | |
Notes | Included 91 Hormones available in a subgroup | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB P | |
Participants | N36 Hyp Age45 | |
Interventions | SR82 Dur180 | |
Outcomes | Renin Aldosterone | |
Notes | Included 91 Hormones available in a subgroup | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N30 Norm Age46 saltsensitive | |
Interventions | SR270 Dur7 | |
Outcomes | SBP DBP Aldo Renin NA | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N108 Norm Age36 saltresistant | |
Interventions | SR275 Dur7 | |
Outcomes | SBP DBP Aldo Renin NA | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N25 Norm Age35 counteresulatory | |
Interventions | SR280 Dur7 | |
Outcomes | SBP DBP Aldo Renin NA | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op CO | |
Participants | N16 Norm Age29 | |
Interventions | SR186 Dur6 | |
Outcomes | SBP DBP Aldo Renin | |
Notes | LoFo:0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N7 Norm Age29 | |
Interventions | SR218 Dur 6 | |
Outcomes | SBP DBP Aldo Renin | |
Notes | LoFo:1 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | SB CO | |
Participants | N16 Norm Age24 | |
Interventions | SR 224 Dur7 | |
Outcomes | SBP DBP | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op CO | |
Participants | N 15 (M/F:15/0)(B/W/A.0/15/0) Normotension Age 25 | |
Interventions | SR 198 (219-21) Dur 6 | |
Outcomes | Renin, aldo, NE | |
Notes | LoFo: 5. 15 of 20 completed the study. IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation according to a Latin-Square design |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | SB CO | |
Participants | N8 Norm Age25 +Doxazosin | |
Interventions | SR190 (211-21) Dur8 | |
Outcomes | SBP (MBP+1/3MBP) DBP (MBP-1/3MBP) NA Chol HDL LDL TG | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N8 Norm Age26 -Doxazosin | |
Interventions | SR181(199-18) Dur8 | |
Outcomes | SBP (MBP+1/3) DBP (MBP-1/3) NA Chol HDL LDL TG | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | DB P | |
Participants | N36 Norm Age66 | |
Interventions | SR56 Dur42 | |
Outcomes | SBP DBP | |
Notes | Included 70 (1993+1993b) LoFo: 4 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB P | |
Participants | N30 Norm Age65 | |
Interventions | SR73 Dur42 | |
Outcomes | SBP DBP | |
Notes | Included 70 (1993+1993b) LoFo: 4 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | SB CO | |
Participants | N8 Norm Age36 | |
Interventions | SR152 Dur5 | |
Outcomes | SBP DBP Aldo Renin | |
Notes | LoFo. 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | DB CO | |
Participants | N17 Hyp Age73 | |
Interventions | SR79 Dur 35 | |
Outcomes | SBP DBP Aldo Renin | |
Notes | Included 18 LoFo. 1 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op P | |
Participants | N418 Hyp Age55 | |
Interventions | SR104 Dur28 | |
Outcomes | SBP DBP | |
Notes | 574 included LoFo: 156 IT: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB P | |
Participants | N19 Hyp Age | |
Interventions | SR69 Dur21 | |
Outcomes | SBP DBP | |
Notes | LoFo. 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N30 Hyp Age49 | |
Interventions | SR151 (198-47) Dur 14 | |
Outcomes | SBP DBP Renin Chol HDL TG | |
Notes | Included 47 LoFo. 17 IT: no | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | SB CO | |
Participants | N30 saltsensitive Norm Age46 | |
Interventions | SR270 Dur7 | |
Outcomes | Aldo Renin NA | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N108 saltresistant Norm Age36 | |
Interventions | SR275 Dur7 | |
Outcomes | Aldo Renin NA | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N25 counterregulatory Norm Age35 | |
Interventions | SR279 Dur7 | |
Outcomes | Aldo Renin NA | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk | outcome detection blinded |
Methods | DB CO | |
Participants | N 12 (M/F:12/0)(B/W/A.0/12/0) Normotension Age 24 | |
Interventions | SR 40 (165-115) Dur 4 | |
Outcomes | SBP, DBP, renin | |
Notes | LoFo:0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Low risk | Independently prepared schedule by Department of Pharmacy |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | SB CO | |
Participants | N12 (3 blacks) Hyp Age49 | |
Interventions | SR 296 Dur 5 | |
Outcomes | SBP DBP | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N 15 Hyp Age 45 | |
Interventions | SR 163 Dur 7 | |
Outcomes | SBP DBP Aldo Renin | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op P | |
Participants | N76 Hyp Age44 | |
Interventions | SR57 Dur365 | |
Outcomes | SBP DBP Aldo Renin NA A | |
Notes | Included 91 LoFo: 15 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB P | |
Participants | N 56 (M/F:31/25)(B/W/A.0/56/0) Hypertension Age 55 | |
Interventions | SR 80 (158-78) Dur 42 | |
Outcomes | SBP, DBP, aldo | |
Notes | LoFo:5. 56 of 61 completed the study. IT:No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op CO | |
Participants | N 31 (M/F:17/14)(B/W/A.0/0/31) Hypertension Age 48 | |
Interventions | SR 266 (298-32) Dur 7 | |
Outcomes | SBP, DBP | |
Notes | LoFo:0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N 36 (M/F:36/0)(B/W/A.0/36/0) Normotension Age 23 | |
Interventions | SR 58 (191-133) Dur 14 | |
Outcomes | SBP, DBP, NE | |
Notes | LoFo: 4. 36 of 40 completed the study. IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op CO | |
Participants | N 14 (M/F:14/0)(B/W/A.0/14/0) Normotension Age 26 | |
Interventions | SR 180 (203-23) Dur 7 | |
Outcomes | MAP, renin, NE | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N 81(M/F 81/0 (B/W/A 0/81/0) Normotension, Age 25 | |
Interventions | SR 112 (130-18) Dur 4 | |
Outcomes | SBP, DBP | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op CO | |
Participants | N 7 (M/F:7/0)(B/W/A.0/7/0) Normotension Age 33.7 | |
Interventions | SR 183 (201-18) Dur 5 | |
Outcomes | SBP, DBP, renin, NE | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op P | |
Participants | N 181 (M/F:95/86)(B/W/A.0/181/0) Hypertension Age 55 | |
Interventions | SR 16 (122-106) Dur 182 | |
Outcomes | SBP, DBP | |
Notes | LoFo: 27. 181 of 208 completed study. IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N 10 (M/F:10/0)(B/W/A.0/10/0) Hypertension Age 41 | |
Interventions | SR 131 (283-24) Dur 7 | |
Outcomes | SBP, DBP, renin, aldo | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N11 Hyp Age61 | |
Interventions | SR240 Dur7 | |
Outcomes | SBP (MBP+1/3MBP) DBP (MBP-1/3MBP) Aldo Renin NA | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N27 Hyp Age40 | |
Interventions | SR249 Dur7 | |
Outcomes | SBP (MBP+1/3MBP) DBP (MBP-1/3MBP) Aldo Renin NA | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N8 Hyp Age43 | |
Interventions | SR234 Dur7 | |
Outcomes | SBP (MBP+1/3MBP) DBP (MBP-1/3MBP) Aldo Renin NA | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | P SB | |
Participants | N 122 (B/W/A.67/55/0) Hypertension Age 62 | |
Interventions | SR 45 (187-142) Dur 90 | |
Outcomes | SBP, DBP | |
Notes | LoFo: 36. 122 of 158 completed the study. IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | random number table |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure stratified by race |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N11 (8 black) Hyp Age60 sodium sensitive | |
Interventions | SR146 Dur14 | |
Outcomes | SBP DBP | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N11 (6 black) Hyp Age60 sodium resistent | |
Interventions | SR127 Dur14 | |
Outcomes | SBP DBP | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | DB CO | |
Participants | N34 Norm Age23 | |
Interventions | SR133 (185-52) Dur7 | |
Outcomes | SBP DBP Chol HDL LDL TG | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N5 Norm Age27 | |
Interventions | SR176 Dur7 | |
Outcomes | SBP (MBP+1/3MBP) DBP (MBP-1/3MBP) NA A Chol | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N8 Hyp Age27 | |
Interventions | SR178 Dur7 | |
Outcomes | SBP (MBP+1/3MBP) DBP (MBP-1/3MBP) NA A Chol | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N16 Norm Age 64 | |
Interventions | SR 74 (175.2-104.8) Dur28 | |
Outcomes | SBP DBP Aldo Renin Chol HDL LDL TG | |
Notes | Included 21 LoFo: 5 IT: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N 43 (M/F:43/0)(B/W/A.0/43/0) Hypertension Age 46 | |
Interventions | SR 121 (233-112) Dur 14 | |
Outcomes | SBP, DBP, renin, aldo, NE | |
Notes | LoFo: 12. 43 of 55 completed study. IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N 14 (M/F:8/6)(B/W/A.4/7/3) Hypertension Age 46 | |
Interventions | SR 293 (329-36) Dur 7 | |
Outcomes | SBP, DBP | |
Notes | LoFo:0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N61 Hyp Age47 | |
Interventions | SR264 Dur14 | |
Outcomes | SBP DBP Aldo Renin | |
Notes | 79 were included. 65 were randomised. LoFo: 4 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op CO | |
Participants | N HT: 23 (M/F:11/12) NT 7 (M/F:3/4)(B/W/A.0/0/30) Hypertension and normotension Age 54 | |
Interventions | SR 194 (217-23) Dur 7 | |
Outcomes | SBP, DBP, renin, aldo | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N HT: 23 (M/F:11/12) NT 7 (M/F:3/4)(B/W/A.0/0/30) Hypertension and normotension Age 54 | |
Interventions | SR 194 (217-23) Dur 7 | |
Outcomes | SBP, DBP, renin, aldo | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N47 Hyp Age67 | |
Interventions | SR83 Dur 30 | |
Outcomes | SBP DBP | |
Notes | Included 52 randomised 48 LoFo: 1 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | SB P | |
Participants | N1190 (203 blacks) High norm Age 42 | |
Interventions | SR40 Dur 1100 | |
Outcomes | SBP DBP | |
Notes | LoFo: 99 IT: yes | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Low risk | |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op CO | |
Participants | N 232 (M/F:0/232)(B/W/A.0/232/0) Normotension Age 28 | |
Interventions | SR 65 (140-75(week 28)) Dur 196 | |
Outcomes | SBP, DBP | |
Notes | LoFo: 28.. 242 of 270 completed the study. IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Low risk | Randomisation by a closed envelope system |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | SB CO | |
Participants | N27 Norm Age25 sodium sensitive | |
Interventions | SR208 Dur7 | |
Outcomes | SBP (MBP+1/3MBP) DBP (MBP-1/3MBP) | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | DB CO | |
Participants | N99 (24 blacks) Hyp Age52 | |
Interventions | SR 55.4 (175.9-120.5) Dur28 | |
Outcomes | SBP DBP Chol HDL LDL TG | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N 16 (M/F:13/3)(B/W/A.0/16/0) Hypertension Age 50 | |
Interventions | SR 66 (191-125) Dur 56 | |
Outcomes | SBP, DBP, chol, HDL | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N 17 (M/F:4/13)(B/W/A.0/17/0) Hypertension Age 73 | |
Interventions | SR 79 (174-95) Dur 35 | |
Outcomes | Chol, HDL, LDL, Trig | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N, HT: 39; NT 8 (B/W/A.0/47/0) Hypertension and normotension Age 45 | |
Interventions | SR 170 (200-30) Dur 14 | |
Outcomes | Chol, HDL, LDL, trig | |
Notes | LoFo: 8 . 39 of 46 randomised hypertensives + 8 controls completed the study. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op P | |
Participants | N 361 (80% Caucasian) Pregnant women, Normotension Age 27.5 | |
Interventions | SR 40 (124-84) Dur 35 (mean duration) | |
Outcomes | DBP | |
Notes | LoFo: 67 (35 LowSalt, 32 NormalSalt) IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Low risk | Block randomisation. Treatment allocation in opaque sealed envelopes. |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | High risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N 12 (M/F:6/6)(B/W/A.0/12/0) Normotension Age 23.8 | |
Interventions | SR 235 (273-38) Dur 5 | |
Outcomes | MAP | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N 18, (8 males, 10 females) Normotensive Mean age 51 | |
Interventions | SR 149 (227-78) Dur 6 | |
Outcomes | SBP DBP Renin Aldosterone | |
Notes | LoFo: 0 SDs estimated on the basis of p-values | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not desribed |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N17 Hyp Age61 | |
Interventions | SR59 Dur42 | |
Outcomes | SBP DBP | |
Notes | 39 included 19 randomised LoFo: 2 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N 6 (M/F 6/0)(B/W/A 0/6/0) treated hypertension (from150/106 to 124/82) Age 46 | |
Interventions | SR 98 (325-227) Dur 6 | |
Outcomes | SBP DBP Renin | |
Notes | Included 8 LoFO: 2 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op CO | |
Participants | N 8 (M/F:8/0)(B/W/A.0/8/0) Normotension Age 33 | |
Interventions | SR 159 (207-48) Dur 7 | |
Outcomes | SBP, DBP, chol, NE | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N 39 (19HT and 20NT) (M/F:19/20)(B/W/A 39/0/0) Hypertension and normotension Age HT 43; NT 38 | |
Interventions | SR HT: 81 (114-33); NT: 180 (210-30) Dur 7 | |
Outcomes | SBP, DBP, renin, aldo | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | SB CO | |
Participants | N 8 Norm Age 25 | |
Interventions | SR 95 Dur 5 | |
Outcomes | SBP DBP Renin NA A | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N 187 (M/F:187/0)(B/W/A.0/187/0) Normotension Age 25 | |
Interventions | SR 206 (225-19) Dur 7 | |
Outcomes | SBP, DBP, renin, aldo | |
Notes | LoFo: 13. 187 of 200 completed study. IT: No. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB CO | |
Participants | N70 (Japanese) Hyp Age50 | |
Interventions | SR173 (204-31) Dur7 | |
Outcomes | SBP DBP | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op CO | |
Participants | N Hyp: 38 (M/F:21/17); Norm: 12 (M/F:6/6) (B/W/A.0/50/0) Hypertension and normotension Age 43 and 40 | |
Interventions | SR 183 (255-72) and 201 (265-64) Dur 7 | |
Outcomes | SBP, DBP, renin, aldo | |
Notes | LoFo: 5. 38 of 43 and 12 of 12 completed study. IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N 42 (M/F:34/8)(B/W/A.0/42/0) Normotension Age 26 | |
Interventions | SR 237 (273-36) Dur 4 | |
Outcomes | SBP, DBP, renin, aldo, NE, E, chol, HDL, LDL, Trig | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N 15 (M/F:15/0)(B/W/A.0/15/0) Hypertension and normotension Age 22.7 | |
Interventions | SR 131 (144-13) Dur 7 | |
Outcomes | SBP, DBP, renin, aldo, NE, E | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N 32 (M/F:32/0)(B/W/A.0/32/0) Normotension Age 25 | |
Interventions | SR139 (226-87) Dur 7 | |
Outcomes | SBP, DBP, renin, aldo | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N 7 (M/F:7/0)(B/W/A.0/7/0) Normotension Age 32 | |
Interventions | SR 154 (177-23) Dur 7 | |
Outcomes | MAP | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op CO | |
Participants | N 13 (M/F:10/3)(B/W/A.0/13/0) Hypertension Age 51 | |
Interventions | SR 209 (270-61) Dur 14 | |
Outcomes | SBP, DBP, Chol, HDL, LDL, Trig, | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N 20 (M/F:9/11)(B/W/A.0/0/20) Hypertension Age 59 | |
Interventions | SR 116 (167-51) Dur 7 | |
Outcomes | nocturnal MAP, NE and E | |
Notes | LoFo:0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | SB CO | |
Participants | 13 (M/F: 6/7) Hyp Age 60 | |
Interventions | SR 133 (265-132) Dur 28 | |
Outcomes | SBP DBP NA A TG: Chol: HDL: LDL: | |
Notes | 21 patients included 8 diabetes patients excluded LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | DB CO | |
Participants | N54 Norm Non-black Age 48 | |
Interventions | SR55 Dur30 | |
Outcomes | SBP DBP not mentioned, see DASH 2 | |
Notes | LoFo: 5% IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N37 Hyp Non-black Age 48 | |
Interventions | SR 55 Dur 30 | |
Outcomes | SBP DBP not mentioned, see DASH 2b | |
Notes | LoFo: 5% IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N68 Norm Black Age 48 | |
Interventions | SR55 Dur30 | |
Outcomes | SBP DBP not mentioned, see DASH 2c | |
Notes | LoFo: 5% IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N46 Hyp Black Age 48 | |
Interventions | SR 55 Dur 30 | |
Outcomes | SBP DBP not mentioned, see DASH 2d | |
Notes | LoFo: 5% IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk |
Methods | DB CO | |
Participants | N54 Norm Non-black Age 48 | |
Interventions | SR 55 Dur 30 | |
Outcomes | DBP: Table 4: referent+ 50% of female+50% of age = -1.3+0.3+(-0.4) = -1.4 | |
Notes | LoFo: 5% IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N37 Hyp Non-black Age 48 | |
Interventions | SR 55 Dur 30 | |
Outcomes | DBP: -1.2 + hypertensive = -1.4 + (-1.3) = -2.7 | |
Notes | LoFo: 5% IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N68 Norm Black Age 48 | |
Interventions | SR 55 Dur 30 | |
Outcomes | DBP: -1.4 + African American = -1.4 + (-2.5) = -3.9 | |
Notes | LoFo: 5% IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N46 Hyp Black Age 48 | |
Interventions | SR 55 Dur 30 | |
Outcomes | DBP: -1.4 + African American + hyperetnesive = -1.2 + (-2.5) + (-1.3) = -5.2 | |
Notes | LoFo: 5% IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N 19 Hyp Age 47 | |
Interventions | SR 161 Dur: 14 | |
Outcomes | SBP DBP Aldo Renin | |
Notes | Data available in patients in upper tertile of sodium excretion (19 of 55 patients) | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | High risk | |
Selective reporting (reporting bias) | High risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op P | |
Participants | N 35 (M/F:0/35)(B/W/A.0/34/1) Hypertension Age 64 | |
Interventions | SR 46 (132-86) Dur 90 | |
Outcomes | SBP, DBP, Chol, HDL, LDL, Trig | |
Notes | LoFo: 4. 35 of 39 completed the study. IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | SB P | |
Participants | N 471 (non-blacks) Hyp Age 66 | |
Interventions | SR 40 DUR: 105 | |
Outcomes | SBP DBP | |
Notes | 2001 + 2001b included 681 LoFo. 68 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | SB P | |
Participants | N 142 (blacks) Hyp Age 66 | |
Interventions | SR 40 DUR: 105 | |
Outcomes | SBP DBP | |
Notes | 2001 + 2001b included 681 LoFo. 68 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | DB CO | |
Participants | N 40 Hypertension Age 69 | |
Interventions | SR 73 (185-112) Dur 14 | |
Outcomes | SBP, DBP | |
Notes | LoFo:6; 40 of 46 completed the study. IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Sequenced treatments in Latin square design |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | SB CO | |
Participants | N20 (M/F: 16/4) Hyp Age 48 | |
Interventions | SR 110 Dur 14 | |
Outcomes | Renin Aldosteron | |
Notes | 138 included in acute study. 20 with SR> 100 mmol included in 14 day study. LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | outcome detection blinded |
Methods | Op CO | |
Participants | N 27 (M/F:20/7)(B/W/A.0/27/0) Norm Age 24.8 | |
Interventions | SR 186 (236-50) Dur 7 | |
Outcomes | MAP Ren, Aldo | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N 28 (M/F:21/7)(B/W/A.0/28/0) Norm Age 24 | |
Interventions | SR 202 (248-42) Dur 7 | |
Outcomes | MAP Ren, Aldo | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N 25 (2 blacks, 23 whites) Norm Mean age 34 (18-50) | |
Interventions | SR 300 (321-21) Dur 6 | |
Outcomes | SBP DBP Renin A | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N 108 (M/F:44/64/20 dropouts)(B/W/A.0/108/0) normotension Age 47 | |
Interventions | SR 90 (140-50) Dur 28 | |
Outcomes | SBP, DBP, renin | |
Notes | LoFo: 20. 108 completed study | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N 15 (M/F:15/0)(B/W/A.0/15/0) Normotension Age 26 | |
Interventions | SR 105 (175-70) Dur 5 | |
Outcomes | SBP, DBP, renin, aldo, NE, Chol, trig | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB P | |
Participants | N 65 (M/F:41/24)(B/W/A.0/0/65) Hypertension and normotension Age 46.6 | |
Interventions | SR 20 (1.4g) Dur 42 | |
Outcomes | SBP, DBP, | |
Notes | LoFo: 0. 71 tested, 46 included. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op CO | |
Participants | N 40 (M/F:0/23/17 dropouts) (B/W/A.15/8/0) Normotension Age 13 | |
Interventions | SR 86 (120-34) Dur 21 | |
Outcomes | SBP, DBP, renin, aldo | |
Notes | LoFo: 17. 23 completed study | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | OP CO | |
Participants | N 117 (M/F:67/50)(B/W/A.0/117/0) Hyp Age 54 | |
Interventions | SR 99 (171-72) Dur 7 | |
Outcomes | SBP DBP Aldo | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N 48 (M/F:38/10)(B/W/A.12/34/2) Hyp Age 51 | |
Interventions | SR 285 (309-24) Dur 28 | |
Outcomes | SBP DBP Cho Trig | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N 12 (M/F:6/6)(B/W/A.0/12/0) Hyper Age 64 | |
Interventions | SR 95 (155-60) Dur 28 | |
Outcomes | SBP DBP Chol, HDL, LDL, Trig, Renin, NE, E | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N 193 (M/F:89/104)(B/W/A.57/136/0) Mixed Hyper/Norm Age 49 | |
Interventions | SR 77 (141-64) Dur 30 | |
Outcomes | Chol, HDL, LDL, Trig, Renin, NE, E | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N 10 (M/F:10/0)(B/W/A.0/10/0) Normotension Age 25 | |
Interventions | SR 250 (270-20) Dur 7 | |
Outcomes | SBP, DBP, renin, aldo | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op CO | |
Participants | 56 Jamaicans (M/F: 34/22) Norm (125.9/76.3) Mean age 40.8 (25-55) | |
Interventions | SR 78.8 Dur 21 | |
Outcomes | SBP DBP | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Block randomisation |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | 58 Nigerians (M/F: 34/24) Norm (114.6/72.9) Mean age 46.6 (25-55) | |
Interventions | SR 72.2 Dur 21 | |
Outcomes | SBP DBP | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Block randomisation |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N 40 (M/F:17/23)(B/W/A 40/0/0) Hypertension Age 50 | |
Interventions | SR 78 (167-89) Dur 28 | |
Outcomes | SBP, DBP, renin, aldo | |
Notes | LoFo: 7. 40 of 47 completed study. IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op CO | |
Participants | N 14 (M/F:14/0)(B/W/A.0/14/0) Norm Age 57 | |
Interventions | SR 129 (188-59) Dur 7 | |
Outcomes | SBP DBP NE and E | |
Notes | LoFo: 2 excluded because of side effects | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N 448 (M/F:145/303)(B/W/A.0/0/448) Hypertension (107) and normotension (341) Age 56.4 | |
Interventions | SR 38 (237-199) Dur 365 | |
Outcomes | SBP, DBP | |
Notes | LoFo: 102. 448 of 550 completed study. IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation: computer generated random number |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N 39 (M/F: 20/19) Mixed hypertensive and normotensive (144/90.6) Age 53 | |
Interventions | SR 89 (140-51) Dur 28 | |
Outcomes | SBP DBP renin | |
Notes | LoFo: 7. 39 completed. IT: No Diet + salt capsules/placebo | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op CO | |
Participants | N 20 (M/F:12/8)(B/W/A.10/9/1) Norm Age 30 | |
Interventions | SR 171 (194-23) Dur 6 | |
Outcomes | SBP DBP Aldo Renin | |
Notes | LoFo: 2 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Prespecified randomised blocked table |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N 28, 10 males, 18 females, 5 blacks, 23 whites Hypertension Mean age 63 | |
Interventions | SR 155 (191-36) Dur 8 | |
Outcomes | SBP -10 DBP -4 Renin 1.64 ng/s Aldo 334.2 | |
Notes | LoFo: 0 Blood pressure effects estimated from figure 1. The effects of two genotype groups were added to one group and calculated as simple means. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | DB CO | |
Participants | N 16 (M/F:16/0)(B/W/A.0/16/0) Normotension Age 27 | |
Interventions | SR 149 (225-76) Dur 5 | |
Outcomes | SBP, DBP, renin, aldo, chol, HDL, LDL, Trig, | |
Notes | LoFo: 0 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op CO | |
Participants | N 184 (M/F:87/97)(B/W/A.0/184/0) Normotension Age 50 | |
Interventions | SR 81 (138-57) Dur 7 | |
Outcomes | SBP, DBP | |
Notes | LoFo:16; 184 of 200 completed the study. IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Low risk | Randomisation by computer generated numbers |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | N 22 (M/F:12/10)(B/W/A.0/22/0) Normotension Age 47 | |
Interventions | SR 47 (357-310) Dur 4 | |
Outcomes | SBP, DBP, renin, aldo | |
Notes | LoFo: 5. 22 of 27 completed study. IT: No. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op CO | |
Participants | N 29 (M/F: 7/22) Normotension (116/73) Mean age 63 | |
Interventions | SR 92 (156-64) Dur 14 | |
Outcomes | SBP DBP | |
Notes | LoFo: 3 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | computer generated |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | DB CO | |
Participants | Whites: 77; Blacks: 75; Asians: 35 Hypertension (Baseline BP 147/91) Mean Age 50 | |
Interventions | SR 55 (165-110) Dur 42 | |
Outcomes | SBP DBP Renin Aldosterone | |
Notes | LoFO: W/B/A: 6/6/6 IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | computer generated, ethnic stratfication |
Allocation concealment (selection bias) | Low risk | tablets supplied by independent company |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Methods | Op P | |
Participants | N 46 (M/F:34/12)(B/W/A.0/46/0) Hypertension Age 56 | |
Interventions | SR 43 (126-83) Dur 56 | |
Outcomes | SBP, DBP, Aldo, Chol, Trig | |
Notes | LoFo: 0. 71 tested, 46 included. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op CO | |
Participants | N 12 (M/F:4/8)(B/W/A.6/6) Hypertension Age 55.5 | |
Interventions | SR 206 (252-46) Dur 7 | |
Outcomes | SBP, DBP, renin, aldo | |
Notes | LoFo: 1. 12 of 13 completed study. IT: No | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not described |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Incomplete outcome data (attrition bias) All outcomes | Low risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | Op P | |
Participants | N 111 women 59 normotensives and 35 hypertensives completed Mean age 59 | |
Interventions | SR 42 (108-66) Dur 98 | |
Outcomes | SBP DBP | |
Notes | LoFo: 16 IT: No. Two different diets were compared and there was other differences between the diets than sodium intake. These differences were assumed not to influence blood pressure. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Allocation concealment (selection bias) | Unclear risk | Randomisation procedure not desribed in detail. randomisation stratified by BMI. |
Blinding (performance bias and detection bias) All outcomes | High risk | |
Selective reporting (reporting bias) | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | High risk |
Methods | CO, SB | |
Participants | N 132 (M/F: 73/59, W/B/A: 115/15/2) Hypertension Mean age: 51.5 | |
Interventions | SR 123 (208-85) 28 days | |
Outcomes | SBP DBP | |
Notes | ||
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding of participants and personnel (performance bias) All outcomes | High risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
| ||
Methods | CO DB | |
Participants | 10 males Normotension Mean age 32 | |
Interventions | SR 97 (191-94) 14 days | |
Outcomes | SBP DBP | |
Notes | ||
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Blinding (performance bias and detection bias) All outcomes | Low risk | |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | |
Blinding of outcome assessment (detection bias) All outcomes | Low risk |
Study | Reason for exclusion |
---|---|
Anderson 1990 | No data on urine sodium excretion |
Dodson 1989 | Includes only patients with diabetes mellitus |
Imanishi M 2001 | Includes only patients with diabetes mellitus |
Miller JA 1997 | Includes only patients with diabetes mellitus |
Mühlhauser I 1996 | Includes only patients with diabetes mellitus |
Palmer 1989 | No data on urine sodium excretion |
Parfrey 1981 | Withdrawal of paper by the authors due to erroneous form |
Ruppert 1991 | Sub study of Ruppert 1993 |
Ruppert 1994 | Sub study of Ruppert 1993 |
Steegers 1991 | Sub study of van Buul 1997 |