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Review
. 2016;25(2):402-13.
doi: 10.6133/apjcn.2016.25.2.25.

Association between salt and hypertension in rural and urban populations of low to middle income countries: a systematic review and meta-analysis of population based studies

Asvini K Subasinghe  1 , Simin Arabshahi  2 , Doreen Busingye  2 , Roger G Evans  3 , Karen Z Walker  4 , Michaela A Riddell  2 , Amanda G Thrift  2   5
Affiliations
Free article
Review

Association between salt and hypertension in rural and urban populations of low to middle income countries: a systematic review and meta-analysis of population based studies

Asvini K Subasinghe et al. Asia Pac J Clin Nutr. 2016.
Free article

Abstract
in English, Chinese

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.

背景与目的：在全球高血压患病率对死亡率贡献最大，在低中等收入国家高血 压的患病率呈增加的趋势。在低中收入国家的城市，过量的盐摄入与高血压患 病风险的增加有关，我们旨在研究农村地区是否亦如此。方法与研究设计：使 用多变量模型，我们进行了低中收入国家盐与高血压关系的meta 分析。结果： 共分析了来自18 个研究的134,916 名参与者。农村和城市居民高盐摄入的比例 在21.3%到89.5%之间。当盐摄入量作为连续型变量分析时，发现城市地区 （n=4）[合并效应尺度（ES）为1.42，95% CI 为1.19-1.69]比农村地区 （n=4）[合并效应尺度（ES）为1.07，95% CI 为1.04-1.10，p<0.001]。当盐摄 入量作为连续型变量分析时，体型偏瘦的农村人群（BMI <23 kg/m2）比体型不 偏瘦的农村人群（BMI >=23 kg/m2，p<0.001）盐摄入对高血压患病的影响更 大。结论：农村和城市地区高盐摄入的比例相近。与农村居民相比，城市居民 过多的盐摄入对高血压患病率的影响更大。在农村居民中，BMI 能调节盐摄入 和高血压的关系。.

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