Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes
Authors: Jesper M. Kivelä
Journal: Annals of Internal Medicine (2020)

Letters7 January 2020Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular OutcomesJesper M. Kivelä, DMedScJesper M. Kivelä, DMedScUniversity of Helsinki, Helsinki, Finland (J.M.K.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0714 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Khan and colleagues (1) report that reduced salt intake in normotensive persons decreased the risk for all-cause mortality with a risk ratio (RR) of 0.90 (95% CI, 0.85 to 0.95) according to 3 studies with few events (n = 79). This finding was based on a reanalysis of a Cochrane review in which the RR for all-cause mortality at the longest follow-up was 0.90 (CI, 0.58 to 1.40) (2). However, the CI is narrower with the random-effects model used by Khan and colleagues than with the fixed-effects model used in the Cochrane review (2). The random-effects model recommended ...References1. Khan SU, Khan MU, Riaz H, et al. Effects of nutritional supplements and dietary interventions on cardiovascular outcomes: an umbrella review and evidence map. Ann Intern Med. 2019;171:190-8. [PMID: 31284304]. doi:10.7326/M19-0341 LinkGoogle Scholar2. Adler AJ, Taylor F, Martin N, et al. Reduced dietary salt for the prevention of cardiovascular disease. Cochrane Database Syst Rev. 2014:CD009217. [PMID: 25519688] doi:10.1002/14651858.CD009217.pub3 CrossrefMedlineGoogle Scholar3. Wiksten A, Rücker G, Schwarzer G. Hartung–Knapp method is not always conservative compared with fixed-effect meta-analysis. Stat Med. 2016;35:2503-15. [PMID: 26842654] doi:10.1002/sim.6879 CrossrefMedlineGoogle Scholar4. Röver C, Knapp G, Friede T. Hartung–Knapp–Sidik–Jonkman approach and its modification for random-effects meta-analysis with few studies. BMC Med Res Methodol. 2015;15:99. [PMID: 26573817] doi:10.1186/s12874-015-0091-1 CrossrefMedlineGoogle Scholar5. Turner RM, Jackson D, Wei Y, et al. Predictive distributions for between-study heterogeneity and simple methods for their application in Bayesian meta-analysis. Stat Med. 2015;34:984-98. [PMID: 25475839] doi:10.1002/sim.6381 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Helsinki, Helsinki, Finland (J.M.K.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0714. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes Safi U. Khan , Muhammad U. Khan , Haris Riaz , Shahul Valavoor , Di Zhao , Lauren Vaughan , Victor Okunrintemi , Irbaz Bin Riaz , Muhammad Shahzeb Khan , Edo Kaluski , M. Hassan Murad , Michael J. Blaha , Eliseo Guallar , and Erin D. Michos Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes Martin Mayer Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes John E. Cornell and Cynthia D. Mulrow Metrics Cited byDo methods in meta-analyses matter?The impact of excessive salt intake on human healthBiologically Active Dietary Supplements: Current Situation and Prospects for Tomorrow 7 January 2020Volume 172, Issue 1Page: 73-74KeywordsDisclosureMortalityNutritionRisk managementRisk ratioSaltsStatistical distributionsStatistical methods ePublished: 7 January 2020 Issue Published: 7 January 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...