Asvini K Subasinghe1, Simin Arabshahi2, Doreen Busingye2, Roger G Evans3, Karen Z Walker4, Michaela A Riddell2, Amanda G Thrift2,5. 1. Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia. Email: asvini.subasinghe@gmail.com. 2. Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia. 3. Department of Physiology, Monash University, Melbourne, Australia. 4. Department of Nutrition and Dietetics, Monash University, Melbourne, Australia. 5. Florey Neuroscience Institutes, Heidelberg, Victoria, Australia.
Abstract
BACKGROUND AND OBJECTIVES: The prevalence of hypertension, the greatest contributor to mortality globally, is increasing in low-and-middle income countries (LMICs). In urban regions of LMICs, excessive salt intake is associated with increased risk of hypertension. We aimed to determine whether this is the case in rural regions as well. METHODS AND STUDY DESIGN: We performed a meta-analysis of studies in rural and urban areas of LMICs in which the association of salt and hypertension were assessed using multivariable models. RESULTS: We identified 18 studies with a total of 134,916 participants. The prevalence of high salt intake ranged from 21.3% to 89.5% in rural and urban populations. When salt was analysed as a continuous variable, a greater impact of salt on hypertension was found in urban (n=4) (pooled effect size (ES) 1.42, 95% CI 1.19, 1.69) than in rural populations (n=4) (pooled ES 1.07, 95% CI 1.04, 1.10, p for difference <0.001). In studies where salt was analysed continuously, a greater impact of salt on hypertension was observed in lean rural populations (BMI <23 kg/m2) than in non-lean rural populations (BMI >=23 kg/m2, p for difference <0.001). CONCLUSIONS: The prevalence of high salt intake is similar in rural and urban regions. Excessive salt intake has a greater impact on the prevalence of hypertension in urban than rural regions. BMI appears to modify the relationship between salt and hypertension in rural populations.
BACKGROUND AND OBJECTIVES: The prevalence of hypertension, the greatest contributor to mortality globally, is increasing in low-and-middle income countries (LMICs). In urban regions of LMICs, excessive salt intake is associated with increased risk of hypertension. We aimed to determine whether this is the case in rural regions as well. METHODS AND STUDY DESIGN: We performed a meta-analysis of studies in rural and urban areas of LMICs in which the association of salt and hypertension were assessed using multivariable models. RESULTS: We identified 18 studies with a total of 134,916 participants. The prevalence of high salt intake ranged from 21.3% to 89.5% in rural and urban populations. When salt was analysed as a continuous variable, a greater impact of salt on hypertension was found in urban (n=4) (pooled effect size (ES) 1.42, 95% CI 1.19, 1.69) than in rural populations (n=4) (pooled ES 1.07, 95% CI 1.04, 1.10, p for difference <0.001). In studies where salt was analysed continuously, a greater impact of salt on hypertension was observed in lean rural populations (BMI <23 kg/m2) than in non-lean rural populations (BMI >=23 kg/m2, p for difference <0.001). CONCLUSIONS: The prevalence of high salt intake is similar in rural and urban regions. Excessive salt intake has a greater impact on the prevalence of hypertension in urban than rural regions. BMI appears to modify the relationship between salt and hypertension in rural populations.
Authors: Katherine J Overwyk; Zerleen S Quader; Joyce Maalouf; Marlana Bates; Jacqui Webster; Mary G George; Robert K Merritt; Mary E Cogswell Journal: Adv Nutr Date: 2020-09-01 Impact factor: 8.701
Authors: JoAnne Arcand; Michelle M Y Wong; Joseph Alvin Santos; Alexander A Leung; Kathy Trieu; Sudhir Raj Thout; Jacqui Webster; Norm R C Campbell Journal: J Clin Hypertens (Greenwich) Date: 2017-08 Impact factor: 3.738