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EFFECT OF DIETARY INTAKE OF SALT ON CARDIOVASCULAR DISEASES IN UK: A SYSTEMATIC REVIEW

INTRODUCTION

Nowadays, the level of dietary intake of salt has kept increasing persistently, from 0.25g of salt per day, in the olden days, to about 10g currently, in most countries (Thout et al., 2019; Jaques et al., 2021). Another UK study stated that the current consumption of salt is between 9g to 12g (He and McGregor, 2009). What a tremendous increase of more than 40 folds?  Although, dietary salt is composed of sodium ions that are responsible for maintaining the physiologic condition of the human body. Excess salt in our foods can have a great effect on our overall body function, especially the cardiovascular system.  The cardiovascular is composed of our heart (cardio) and blood circulation (Vascular). Increase intake of salt has been one of the major causes of high blood pressure, and other cardiovascular diseases.  As of 2017, it was reported that over three million deaths resulted from increased intake of dietary salt (Afshin et al., 2019). Public health measures regarding those that are at high risk of hypertension, or those that are classified as having mild hypertension include reduction in dietary salt intake and lifestyle programs (Lewington et al., 2002).

There still exist controversies over the reduction of salt intake and the risk of cardiovascular diseases. For example, a randomized control study showed that exist non-significant decrease in the effective reduction of salt intake had on cardiovascular morbidity and mortality (Taylor et al., 2011). At present, there is enough evidence regarding the causal-effect relationship between sodium intake and cardiovascular diseases (Jaques et al., 2021). According to a recent review of Jaques et al., he determined that there exists a cause-effect relationship between sodium intake on hypertension and cardiovascular damages in humans (Jaques et al., 2021). Several cohort studies have shown that very low sodium intake has resulted in hypotension and higher intake has resulted in hypertension when compared to moderate intake (Graudual, et al., 2014; Mente et al., 2016; Jaques et al., 2021).  This present study wishes to discover the effect of dietary intake on all cardiovascular diseases, which include: hypertension, hypotension, coronary heart disease, aortic disease, cardiovascular mortality and morbidity, heart failures, and peripheral arterial disease.

AIM

  • To determine the effect of dietary salt intake on cardiovascular diseases in the UK

SPECIFIC OBJECTIVES

  • To determine the effect of dietary salt intake on hypertension
  • To determine the effect of dietary salt intake on hypotension
  • To understand the role dietary salt intake, play in stroke condition
  • To measure the cardiovascular morbidity rate associated with dietary salt intake
  • To estimate the cardiovascular mortality rate associated with dietary salt intake
  • To determine the effect of dietary salt intake on coronary heart disease.
  • To understand the role of dietary salt intake in heart failure
  • To determine the association between dietary salt intake on peripheral arterial disease

RESEARCH PROBLEM

Every year, millions of people die as a result of cardiovascular-related issues (Afshin et al., 2019). Much research that has contributed to knowledge, has shown that there exists a causal relationship between dietary salt intake and cardiovascular diseases (Graudual, et al., 2014; Mente et al., 2016; Jaques et al., 2021). Our forefathers never suffered from several diseases we are experiencing today. This could be attributed to their eating lifestyle; they eat more vegetables and fruits and research has shown that they only take 0.25g of salt per and they live longer (Jaques et al., 2021). Nowadays, things have changed as we are now consuming about fifty times of salt in our diet per day (Thout et al., 2019). Therefore, this study aims to identify the effects of dietary salt on different cardiovascular outcomes.

RESEARCH QUESTIONS

  • What effect does dietary salt intake have on hypertension?
  • What effect does dietary salt intake have on hypotension?
  • What role do dietary salt intake, play in stroke condition?
  • How does dietary salt intake affect cardiovascular morbidity rate?
  • How does dietary salt intake affect cardiovascular mortality rate?
  • What effect does dietary salt intake have on coronary heart disease?
  • What role does dietary salt intake play in heart failure?
  • Is there an association between dietary salt intake and peripheral arterial disease?

SIGNIFICANCE OF THE STUDY

Several studies have shown that dietary intake of salt plays a major role in the risk of hypertension, and also influences the risk of cardiovascular mortality and morbidity (He and McGregor, 2009; Boschud et al., 2012). So, they suggested that the best option is, a salt reduction in foods (Boschud et al., 2012). However, several cohort studies have shown that low salt intake also affects cardiovascular outcomes, and they suggested a moderate intake of salt (Graudual, et al., 2014; Mente et al., 2016). Another school of thought that experimented using randomized clinical trial found out that reduction of salt in diets do not significantly reduce cardiovascular mortality and morbidity (Taylor et al., 2011). Hence, the present study wants to bridge the gap in knowledge by conducting a systematic review on the effect of dietary intake on different cardiovascular diseases.

METHODOLOGY

  • Study Design: This is a systematic review that will concentrate on reviewing current literature to determine the effect of dietary salt on cardiovascular diseases. In the search for this literature, keywords such as “Diet”, “Salt”, “Sodium”, “Cardiovascular diseases”, “Cardiovascular outcome”, “Hypertension”, “Coronary Heart Disease”, “Cardiovascular morbidity”, “Cardiovascular morality”, “UK”, and other related terms will be utilized. Databases such as Pubmed/ Medline, Google Scholar, Cochrane library will also be used to source data. Also, Inclusion and exclusion criteria will be used in selecting relevant literature for this study.
  • ANALYSIS
  • The following will be used for analysis in this review, they are; cluster analysis (CA) and/or factor analysis (FA), and/or principal component analysis (PCA). The results will be presented as odds ratios (OR).
  • RISK ASSESSMENT

The risk assessment conducted for this project is provided in the table below:

Table 1:  Risk assessment

Risk

Impact

Mitigation Plan

Inability to meet the deadline

Low

Get an extension from the supervisor in due time

Inability to get required process inputs, skill, and manpower

Moderate

Refer to municipalities and research institute for help

Inability to properly develop the process set up

High

Refer to your supervisor for help

Insufficient data

Low

Refer to journals and textbooks for help

  • SCHEDULE

Table 2: Project Plan

Task Name

Start Date

End Date

Duration (Days)

Initial Research

15/01/2022

29/01/2022

14

Proposal

29/01/2022

06/02/2022

21

Introduction Chapter

18/03/2022

23/03/2022

5

Literature Review Chapter

23/03/2022

20/04/2022

24

Methodology Chapter

20/04/2022

02/05/2022

12

Presentation 1

02/07/2022

10/07/2022

8

Analysis

10/07/2022

24/07/2022

14

Evaluation of Gotten Results

24/07/2022

01/08/2022

7

Discussion Chapter

01/08/2022

11/08/2022

10

Evaluation Chapter

11/08/2022

16/08/2022

5

Conclusion Chapter

16/08/2022

18/08/2022

2

Project Management Chapter

18/08/2022

20/08/2022

2

Abstract and Report compilation

20/08/2022

22/08/2022

2

Report Proofreading

22/08/2022

01/09/2022

10

Presentation 2

01/09/2022

11/09/2022

10

 

REFERENCES

Afshin, A., Sur, P.J., Fay, K.A., Cornaby, L., Ferrara, G., Salama, J.S., Mullany, E.C., Abate, K.H., Abbafati, C. and Abebe, Z. (2019) Health effects of dietary risks in 195 countries, 1990–  2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet, 393:      1958–1972.

Bochud, M., Marques-Vidal, P., Burnier, M., Paccaud, F. (2012) Dietary salt intake and   cardiovascular disease: summarizing the evidence. Public Health Reviews. 33:530-52.

Graudal, N., Jürgens, G., Baslund, B. and Alderman, M.H. (2014) Compared with usual sodium   intake, low- and excessive-sodium diets are associated with increased mortality: A meta-analysis. Am. J. Hypertens. 27:1129–1137

He, F.J. and McGregor, G.A (2009) A comprehensive review on salt and health and current experience of worldwide salt reduction programmes. Journal of Human Hypertension 23, 363-384

Jaques, D.A., Wuerzner, G. and Ponte, B. (2021) Sodium Intake as a Cardiovascular Risk Factor: A Narrative Review. Nutrients, 13: 3177.

Lewington, S., Clarke, R., Qizilbash, N., Peto, R. and Collins, R. (2002) Age-specific relevance   of usual blood pressure to vascular mortality: A meta-analysis of individual data for one million adults in 61 prospective studies. Lancet, 360: 1903–1913.

Mente, A., O’Donnell, M., Rangarajan, S., Dagenais, G., Lear, S., McQueen, M., Diaz, R., Avezum, A., Lopez-Jaramillo, P., Lanas, F. (2016). Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: A pooled analysis of data from four studies. Lancet, 388, 465–475

Taylor, R.S., Ashton, K.E, Moxham, T., Hooper, L., Ebrahim, S. (2011) Reduced dietary salt for the prevention of cardiovascular disease. Cochrane Database Syst Rev. 2(7):CD009217

Thout, S.R., Santos, J.A., McKenzie, B., Trieu, K., Johnson, C., McLean, R., Arcand, J.A., Campbell, N.R.C. and Webster, J.  (2019) The Science of Salt: Updating the evidence on global estimates of salt intake. J. Clin. Hypertens. 21: 710–721.

Last updated: Jan 14, 2022 03:30 PM

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