***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Sodium intake is high in people with type 2 diabetes ( T2DM ) . The aim of this study was to investigate whether urinary sodium excretion can be reduced by educating people with T2DM to read food labels and choose low sodium products . METHOD In a 3 month r and omised controlled trial , 78 men ( n=49 ) and women ( n=29 ) with T2DM were recruited from a Diabetes Centre at a University teaching hospital . The intervention group was educated in a single session to use the nutrition information panel on food labels to choose products which complied with the Food St and ards Australia New Zeal and ( FSANZ ) guideline of < 120 mg sodium/100 g food . The control group continued on their usual diet . The primary outcome measure was 24h urinary sodium excretion which was performed at baseline and 3 months . Data was analysed using repeated measures analysis of variance , independent sample s t-test and Pearson 's correlations . RESULTS At 3 months mean urinary sodium excretion was unchanged in the intervention ( 174±13 mmol/24 h and 175±13 mmol/24 h ) and control group ( 167±15mmol/24h and 161±13 mmol/24 h ) , and there was no between group difference ( p>0.05 ) . CONCLUSION Sodium excretion was not reduced following the label reading education provided to this group of people with T2DM Background : Dietary sodium influences intermediate physiological traits in healthy adults independent of changes in blood pressure . The purpose of this study was to test the hypothesis that dietary sodium affects cardiac autonomic modulation during mental stress . Method : In a prospect i ve , r and omized cross-over design separated by 1 month between diets , 70 normotensive healthy young adults ( F/M : 44/26 , aged 18–38 years ) consumed a 5-day low ( 10 mmol/day ) , normal ( 150 mmol ) , and high ( 400 mmol ) sodium diet followed by heart rate variability ( HRV ) recordings at rest and during 5-min computerized mental arithmetic . Women were studied in the low hormone phase of the menstrual cycle following each diet . Results : Diet did not affect resting blood pressure , but heart rate ( HR ) ( mean ± SE ) was 66 ± 1 , 64 ± 1 , and 63 ± 1 bpm in low , normal , and high sodium conditions , respectively ( analysis of variance P = 0.02 ) . For HRV , there was a main effect of sodium on resting SD of normalized RR intervals ( SDNN ) , square root of the mean squared difference of successive normalized RR intervals ( RMSSD ) , high frequency , low-frequency normalized units ( LFnu ) , and high-frequency normalized units ( HFnu ) ( P < 0.01 for all ) . The response to low sodium was most marked and consistent with sympathetic activation and reduced vagal activity , with increased LFnu and decreased SDNN , RMSSD , and HFnu compared to both normal and high sodium conditions ( P ⩽0.05 for all ) . Dietary sodium-by-mental stress interactions were significant for mean NN , RMSSD , high-frequency power , LFnu , and low frequency/high frequency ratio ( P < 0.05 for all ) . The interactions signify that sodium restriction evoked an increase in resting sympathetic activity and reduced vagal activity to the extent that mental stress caused modest additional disruptions in autonomic balance . Conversely , normal and high sodium evoked a reduction in resting sympathetic activity and incremental increase in resting vagal activity , which were disrupted to a greater extent during mental stress compared to low sodium . Conclusion : We conclude that autonomic control of HRV at rest and during mental stress is altered by dietary sodium in healthy normotensive young adult men and women There is a paucity of quality evidence regarding the effects of sodium restriction in patients with CKD , particularly in patients with pre-end stage CKD , where controlling modifiable risk factors may be especially important for delaying CKD progression and cardiovascular events . We conducted a double-blind placebo-controlled r and omized crossover trial assessing the effects of high versus low sodium intake on ambulatory BP , 24-hour protein and albumin excretion , fluid status ( body composition monitor ) , renin and aldosterone levels , and arterial stiffness ( pulse wave velocity and augmentation index ) in 20 adult patients with hypertensive stage 3 - 4 CKD as phase 1 of the LowSALT CKD study . Overall , salt restriction result ed in statistically significant and clinical ly important reductions in BP ( mean reduction of systolic/diastolic BP , 10/4 mm Hg ; 95 % confidence interval , 5 to 15 /1 to 6 mm Hg ) , extracellular fluid volume , albuminuria , and proteinuria in patients with moderate-to-severe CKD . The magnitude of change was more pronounced than the magnitude reported in patients without CKD , suggesting that patients with CKD are particularly salt sensitive . Although studies with longer intervention times and larger sample sizes are needed to confirm these benefits , this study indicates that sodium restriction should be emphasized in the management of patients with CKD as a means to reduce cardiovascular risk and risk for CKD progression Objectives : As evidence suggests visit-to-visit variability ( VVV ) of blood pressure ( BP ) is associated with cardiovascular events and mortality , there is increasing interest in identifying interventions that reduce VVV of BP . We investigated the effects of weight loss and sodium reduction , alone or in combination , on VVV of BP in participants enrolled in phase II of the Trials of Hypertension Prevention . Methods : BP readings were taken at 6-month intervals for 36 months in 1820 participants with high-normal DBP who were r and omized to weight loss , sodium reduction , combination ( weight loss and sodium reduction ) , or usual care groups .  VVV of BP was defined as the SD of BP across six follow-up visits . Results : VVV of SBP was not significantly different between participants r and omized to the weight loss ( 7.2 ± 3.1 mmHg ) , sodium reduction ( 7.1 ± 3.0 mmHg ) , or combined ( 6.9 ± 2.9 mmHg ) intervention groups vs. the usual care group ( 6.9 ± 2.9 mmHg ) . In a fully adjusted model , no difference ( 0.0 ± 0.2 mmHg ) in VVV of SBP was present between individuals who successfully maintained their weight loss vs. individuals who did not lose weight during follow-up ( P = 0.93 ) . Also , those who maintained a reduced sodium intake throughout follow-up did not have lower VVV of SBP compared to those who did not reduce their sodium intake ( 0.1 ± 0.3 mmHg ; P = 0.77 ) . Results were similar for VVV of DBP . Conclusions : These findings suggest that weight loss and sodium reduction may not be effective interventions for lowering VVV of BP in individuals with high-normal DBP Background — Recent studies have raised the possibility of adverse effects of low sodium , particularly < 2300 mg/d , on cardiovascular disease ; however , these paradoxical findings might have result ed from suboptimal measurement of sodium and potential biases related to indication or reverse causation . Methods and Results — Phases 1 and 2 of the Trials of Hypertension Prevention ( TOHP ) collected multiple 24-hour urine specimens among prehypertensive individuals . During extended posttrial surveillance , 193 cardiovascular events or cardiovascular disease deaths occurred among 2275 participants not in a sodium reduction intervention with 10 ( TOHP II ) or 15 ( TOHP I ) years of posttrial follow-up .  Median sodium excretion was 3630 mg/d , with 1.4 % of the participants having intake < 1500 mg/d and 10 % < 2300 mg/d , consistent with national levels . Compared with those with sodium excretion of 3600 to < 4800 mg/d , risk for those with sodium < 2300 mg/d was 32 % lower after multivariable adjustment ( hazard ratio , 0.68 ; 95 % confidence interval , 0.34–1.37 ; P for trend=0.13 ) . There was a linear 17 % increase in risk per 1000 mg/d increase in sodium ( P=0.05 ) . Spline curves supported a linear association of sodium with cardiovascular events , which continued to decrease from 3600 to 2300 and 1500 mg/d , although the data were sparse at the lowest levels . Controlling for creatinine levels had little effect on these results . Conclusions — Results from the TOHP studies , which overcome the major method ological challenges of prior studies , are consistent with overall health benefits of reducing sodium intake to the 1500 to 2300 mg/d range in the majority of the population , in agreement with current dietary guidelines Abstract Blood pressure ( BP ) control in hypertensives has improved in recent years ; however , it remains insufficient . We investigated the trend of BP control status in hypertensive patients with antihypertensive medication and salt intake . Two hundred and eight treated hypertensive patients were prospect ively followed between 2007 and 2012 . During this period , average clinic BP significantly decreased from 137 ± 12/80 ± 9 to 133 ± 11/76 ± 8 mmHg , and the achievement rate of BP control defined as < 140/90 mmHg increased from 58 % to 71 % ( p < 0.01 ) . Morning home BP also significantly decreased from 132 ± 8/80 ± 8 to 130 ± 8/76 ± 7 mmHg , and the percentage of patients with sustained hypertension ( CBP ≥140/90 mmHg and HBP ≥135/85 mmHg ) decreased from 27 % to 16 % ( p < 0.05 ) . The number of antihypertensive drugs  increased significantly from 2.1 ± 1.2 to 2.3 ± 1.1 ( p < 0.01 ) , while no differences were observed in urinary salt excretion ( 9.0 ± 2.4 g/day in 2007 , 9.0 ± 2.6 g/day in 2012 ) . Office and home BP decreased and the rate of BP control increased in treated hypertensive patients in the past 5 years . Intensive pharmacological therapy , but not a reduction in salt intake appears to have contributed to improved BP control Objectives To determine the relationship between the reduction in salt intake that occurred in Engl and , and blood pressure ( BP ) , as well as mortality from stroke and ischaemic heart disease ( IHD )  . Design Analysis of the data from the Health Survey for Engl and . Setting and participants Engl and , 2003 N=9183 , 2006 N=8762 , 2008 N=8974 and 2011 N=4753 , aged ≥16 years .  Outcomes BP , stroke and IHD mortality . Results From 2003 to 2011 , there was a decrease in mortality from stroke by 42 % ( p<0.001 ) and IHD by 40 % ( p<0.001 ) . In parallel , there was a fall in BP of 3.0±0.33/1.4±0.20 mm Hg ( p<0.001/p<0.001 ) , a decrease of 0.4±0.02 mmol/L ( p<0.001 ) in cholesterol , a reduction in smoking prevalence from 19 % to 14 % ( p<0.001 ) , an increase in fruit and vegetable consumption ( 0.2±0.05 portion/day , p<0.001 ) and an increase in body mass index ( BMI ; 0.5±0.09 kg/m2 , p<0.001 ) . Salt intake , as measured by 24 h urinary sodium , decreased by 1.4 g/day ( p<0.01 ) . It is likely that all of these factors ( with the exception of BMI ) , along with improvements in the treatments of BP , cholesterol and cardiovascular disease , contributed to the falls in stroke and IHD mortality . In individuals who were not on antihypertensive medication , there was a fall in BP of 2.7±0.34/1.1±0.23 mm Hg ( p<0.001/p<0.001 ) after adjusting for age , sex , ethnic group , education , household income , alcohol consumption , fruit and vegetable intake and BMI . Although salt intake was not measured in these participants , the fact that the average salt intake in a r and om sample of the population fell by 15 % during the same period suggests that the falls in BP would be largely attributable to the reduction in salt intake rather than antihypertensive medications . Conclusions The reduction in salt intake is likely to be an important contributor to the falls in BP from 2003 to 2011 in Engl and . As a result , it would have contributed substantially to the decreases in stroke and IHD mortality BACKGROUND AND OBJECTIVES Systolic BP and large elastic artery stiffness both increase with age and are reduced by dietary sodium restriction . Production of the natriuretic hormone marin 
    Output:
    
The findings of this systematic review are consistent with previous data relating increased dietary salt to increased blood pressure and adverse health outcomes