What is the evidence for a trade-off between clinical benefits and harms when following a low sodium programme compared to a moderate sodium programme?
The evidence for a low sodium programme compared with a moderate sodium programme was based on a single small trial. The committee noted that patients median intake of sodium at both baseline and at the end of the study was similar between the 2 groups (at the end of the study, low sodium 1398 mg/day, moderate sodium 1461 mg/day). Notwithstanding the similar reduction in sodium consumption in each group, quality of life in the low sodium group was lower than in the moderate sodium group. This suggested that the restrictive nature of the programme itself, independent of the actual reduction in sodium consumption achieved, had a negative impact on quality of life. There was no clinically important difference in renal function (measured by creatinine) between the low and moderate sodium programmes, which was to be expected given the similarity in the actual sodium levels consumed.