EFFERVESCENT TABLETS AND HIGH BLOOD PRESSURE: WHAT IS THE EVIDENCE?

Abstract

The relationship between sodium intake and hypertension is well established, the WHO recommends a limit of 5g of daily salt consumption in the general population, which is equivalent to 2g of sodium. It is known that the main source of salt consumption is associated with diet, however, other forms of consumption are often neglected, as is the case of sodium present in drugs. Sodium is widely used in the formulation of medicines and can be used as an active ingredient or as an excipient. Some pharmaceutical formulations contain large amounts of sodium as an excipient, such as effervescent drugs. Therefore, these drugs with high sodium content contribute to the overall sodium intake, and may contribute to the increase in blood pressure and, consequently, to the increased cardiovascular risk of our users.

The aim of this study was to review the literature on the influence of effervescent tablets on blood pressure and potential cardiovascular risk, using the SORT classification.
A search for Clinical Guidance Standards and guidelines, systematic reviews, meta-analyzes and randomized controlled clinical trials was conducted at Medline, Cochrane Library, Bandolier, DARE, TRIP Database, Evidence Based Medicine online, Clinical Evidence and Pubmed published between 2008 and 2018, using the keywords (MeSH terms) “effervescent drugs”, “hypertension”. The American Academy of Family Physicians’ SORT Scale (Strength of Recommendation Taxonomy) was used to assign the level of evidence and recommendation strength.

This systematic review suggests that exposure to drugs with a high level of sodium, namely effervescent, may be associated with an increase in blood pressure and a consequent increased risk of cardiovascular events.
Despite the results obtained, the present review highlights the scarcity of evidence in this field of investigation, and further studies are needed to characterize this iatrogenic risk.