{"id":"bf70a82c97ac","type":"article","url":"https://hartvaat.nl/2024/11/01/bloeddrukverlagende-medicatie-en-natriumbeperking-gecombineerd-effect/","title":"Bloeddrukverlagende medicatie en natriumbeperking: gecombineerd effect","title_en":"Blood Pressure-Lowering Medications, Sodium Reduction, and Blood Pressure.","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","huisarts","internist"],"tags":["bloeddrukbehandeling"],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.124.23382","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.124.23382","authors":["Jing Song","Liangkai Chen","Hui Xiong","Yuan Ma","Sonia Pombo-Rodrigues","Graham A MacGregor","Feng J He"],"significance":6,"published":"2024-11-01","source_date":"2024-11-01","image":"","kennis":[],"congress":"","summary_en":"This study showed that combining blood pressure-lowering medications with sodium reduction produces greater blood pressure reduction than either alone, with additive effects supporting dual intervention strategies.","created":"2026-07-03T10:31:16Z","updated":"2026-07-03T13:30:17Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie onderzocht het gecombineerde effect van antihypertensiva en natriumbeperking op de bloeddruk. De combinatie gaf een groter effect dan elk apart, wat het belang van zoutbeperking naast medicatie benadrukt.","abstract_original":"BACKGROUND: Both blood pressure-lowering medication and sodium reduction are effective in hypertension control, but whether the effect of sodium reduction differ across blood pressure-lowering medications is unclear. This study aims to evaluate the dose-response effect of sodium intake reduction on blood pressure in treated hypertensive individuals and the impact of different classes of blood pressure-lowering drugs. METHODS: We searched multiple databases and reference lists up to July 9, 2024. Randomized controlled trials with a duration of ≥2 weeks comparing the effect of different levels of sodium intake (measured by 24-hour urinary sodium excretion) on blood pressure in hypertensive individuals treated with constant blood pressure-lowering medications were included. Instrumental variable meta-analyses based on random-effects models were conducted to evaluate the dose effect of sodium reduction on blood pressure. Subgroup analyses were performed based on the class of blood pressure-lowering drugs, age, baseline sodium and blood pressure levels, and study duration. RESULTS: We included 35 studies (median duration of 28 days) with a total of 2885 participants. For every 100 mmol reduction in 24-hour urinary sodium excretion, systolic blood pressure decreased by 6.81 mm Hg (95% CI, 4.96-8.66), diastolic blood pressure decreased by 3.85 mm Hg (95% CI, 2.26-5.43), and mean arterial pressure decreased by 4.83 mm Hg (95% CI, 3.22-6.44). The dose-response effects varied across classes of blood pressure-lowering medications, with greater effects observed in the β-blockers, renin-angiotensin-aldosterone system inhibitors, and dual therapy groups. No significant subgroup differences were observed across subgroups defined by age, baseline 24-hour urinary sodium excretion, blood pressure levels, or study duration. CONCLUSIONS: Pooled evidence suggests a dose-response relationship between sodium reduction and blood pressure in treated individuals with hypertension, influenced by the class of blood pressure-lowering medications."}