Marcella Malavolti, Tommaso Filippini, Teresa Urbano, Marco Vinceti
8th FESTEM Symposium, Madrid, September 28-October 1, 2022
Abstract
Introduction: Sodium intake has received considerable attention as risk factor of cardiovascular diseases (CVDs). Although high Na intake has been certainly associated with increased blood pressure, hypertension and CVDs, its relation at moderate-low level of exposure is more debated as well as the shape of the such relation. In this study, we aimed to investigate the dose-response relation between sodium intake with CVD risk by performing a systematic review of epidemiological observational studies and by implementing dose-response meta-analysis.
Material and Methods: We performed a comprehensive literature search in SCOPUS, MEDLINE and EMBASE databases from inception up to March 2022. According to the PECOS research questions “What is the shape of the relation between sodium intake and risk of cardiovascular diseases in observational cohort studies?”, inclusion criteria for study identification and selection were: Population: human adults aged ≥ 18 years; Exposure: assessment of Na intake using either urinary excretion and dietary intake Comparing different exposure levels; Outcome: evaluation of risk of any cardiovascular disease; Study design: prospective cohort studies. For the assessment of the shape of the relation between sodium exposure and CVD risk we conducted a dose-response meta-analysis by implementing cubic spline regression using a mixed-effects model and the one-stage approach.
Results: We identified 43 prospective cohort studies, published between 1991 and 2021. Of these studies, 16 were carried out in American, 17 in European and 10 in Asian populations. Main outcomes investigated were total CVDs, stroke (total, ischemic and hemorrhagic), coronary heart disease, myocardial infarction and health failure. Both incidence and mortality were evaluated.
Conclusion: Results of the review and dose-response meta-analysis will be presented. Findings for the present study will be helpful to assess the relation between sodium exposure and risk of CVDs and to update the evidence needed for the implementation of dietary recommendations.