El valor de p del test no es un ‘índice matemático’, es simplemente una frecuencia relativa / The p-value of the test is not a ‘mathematical index’, it is simply a relative frequency

Las revistas científicas más importantes en campos como medicina, biología y sociología publican reiteradamente artículos y editoriales denunciando que un gran porcentaje de médicos no entiende los conceptos básicos del análisis estadístico, lo que favorece el riesgo de cometer errores al interpretar los datos, los hace más vulnerables frente a informaciones falsas y reduce la eficacia de la investigación. Este problema se extiende a lo largo de toda su carrera profesional y se debe, en gran parte, a una enseñanza deficiente en estadística que es común en países desarrollados. En palabras de H. Halle y S. Krauss, ‘el 90% de los profesores universitarios alemanes que usan con asiduidad el valor de p de los test no entiende lo que mide ese valor’. Es importante destacar que los razonamientos básicos del análisis estadístico son similares a los que realizamos en nuestra vida cotidiana y que comprender los conceptos básicos del análisis estadístico no requiere conocimiento matemático alguno. En contra de lo que muchos investigadores creen, el valor de p del test no es un ‘índice matemático’ que nos permita concluir claramente si, por ejemplo, un fármaco es más efectivo que el placebo. El valor de p del test es simplemente un porcentaje.(AU)

Abstract. Leading scientific journals in fields such as medicine, biology and sociology repeatedly publish articles and editorials claiming that a large percentage of doctors do not understand the basics of statistical analysis, which increases the risk of errors in interpreting data, makes them more vulnerable to misinformation and reduces the effectiveness of research. This problem extends throughout their careers and is largely due to the poor training they receive in statistics – a problem that is common in developed countries. As stated by H. Halle and S. Krauss, ‘90% of German university lecturers who regularly use the p-value in tests do not understand what that value actually measures’. It is important to note that the basic reasoning of statistical analysis is similar to what we do in our daily lives and that understanding the basic concepts of statistical analysis does not require any knowledge of mathematics. Contrary to what many researchers believe, the p-value of the test is not a ‘mathematical index’ that allows us to clearly conclude whether, for example, a drug is more effective than a placebo. The p-value of the test is simply a percentage.(AU)

Is reduced ferredoxin the physiological electron donor for MetVF-type methylenetetrahydrofolate reductases in acetogenesis? A hypothesis / ¿Es la ferredoxina reducida el donante de electrones fisiológico para las metilentetrahidrofolato reductasas de tipo MetVF en la acetogénesis? Una hipótesis

The methylene-tetrahydrofolate reductase (MTHFR) is a key enzyme in acetogenic CO2 fixation. The MetVF-type enzyme has been purified from four different species and the physiological electron donor was hypothesized to be reduced ferredoxin. We have purified the MTHFR from Clostridium ljungdahlii to apparent homogeneity. It is a dimer consisting of two of MetVF heterodimers, has 14.9 ± 0.2 mol iron per mol enzyme, 16.2 ± 1.0 mol acid-labile sulfur per mol enzyme, and contains 1.87 mol FMN per mol dimeric heterodimer. NADH and NADPH were not used as electron donor, but reduced ferredoxin was. Based on the published electron carrier specificities for Clostridium formicoaceticum, Thermoanaerobacter kivui, Eubacterium callanderi, and Clostridium aceticum, we provide evidence using metabolic models that reduced ferredoxin cannot be the physiological electron donor in vivo, since growth by acetogenesis from H2 + CO2 has a negative ATP yield. We discuss the possible basis for the discrepancy between in vitro and in vivo functions and present a model how the MetVF-type MTHFR can be incorporated into the metabolism, leading to a positive ATP yield. This model is also applicable to acetogenesis from other substrates and proves to be feasible also to the Ech-containing acetogen T. kivui as well as to methanol metabolism in E. callanderi.(AU)

Frequentist and Bayesian Hypothesis Testing: An Intuitive Guide for Urologists and Clinicians / Pruebas de hipótesis frecuentista y bayesiana: Una Guía intuitiva para urólogos y clínicos

Given the limitations of frequentist method for null hypothesis significance testing, different authors recommend alternatives such as Bayesian inference. A poor understanding of both statistical frameworks is common among clinicians. The present is a gentle narrative review of the frequentist and Bayesian methods intended for physicians not familiar with mathematics. The frequentist p-value is the probability of finding a value equal to or higher than that observed in a study, assuming that the null hypothesis (H0) is true. The H0 is rejected or not based on a p threshold of 0.05, and this dichotomous approach does not express the probability that the alternative hypothesis (H1) is true. The Bayesian method calculates the probability of H1 and H0 considering prior odds and the Bayes factor (Bf). Prior odds are the researcher's belief about the probability of H1, and the Bf quantifies how consistent the data is concerning H1 and H0. The Bayesian prediction is not dichotomous but is expressed in continuous scales of the Bf and of the posterior odds. The JASP software enables the performance of both frequentist and Bayesian analyses in a friendly and intuitive way, and its application is displayed at the end of the paper. In conclusion, the frequentist method expresses how consistent the data is with H0 in terms of p-values, with no consideration of the probability of H1. The Bayesian model is a more comprehensive prediction because it quantifies in continuous scales the evidence for H1 versus H0 in terms of the Bf and the

Dadas las limitaciones del método de significancia frecuentista basado en la hipótesis nula, diferentes autores recomiendan alternativas como la inferencia bayesiana. Es común entre los médicos una comprensión deficiente de ambos marcos estadísticos. Esta es una revisión narrativa amigable de los métodos frecuentista y bayesiano dirigida quienes no están familiarizados con las matemáticas. El valor de p frecuentista es la probabilidad de encontrar un valor igual o superior al observado en un estudio, asumiendo que la hipótesis nula (H0) es cierta. La H0 se rechaza o no con base en un umbral p de 0.05, y este enfoque dicotómico no expresa la probabilidad de que la hipótesis alternativa (H1) sea verdadera. El método bayesiano calcula la probabilidad de H1 y H0 considerando las probabilidades a priori y el factor de Bayes (fB). Las probabilidades a priori son la creencia del investigador sobre la probabilidad de H1, y el fB cuantifica cuán consistentes son los datos con respecto a H1 y H0. La predicción bayesiana no es dicotómica, sino que se expresa en escalas continuas del fB y de las probabilidades a posteriori. El programa JASP permite realizar análisis frecuentista y bayesiano de una forma simple e intuitiva, y su aplicación se muestra al final del documento. En conclusión, el método frecuentista expresa cuán consistentes son los datos con H0 en términos de valores p, sin considerar la probabilidad de H1. El modelo bayesiano es una predicción más completa porque cuantifica en escalas continuas la evidencia de H1 versus H0 en términos del fB y de las probabilidades a posteriori.

How much do the Patients with Acute Myocardial Infarction Know about Chest Pain, Thrombolytic Therapy, and Other Factors Affecting the Treatment Time in the Emergency Room?

Abstract Background: Treatment time in the emergency room for acute myocardial infarction is very important and can be life-saving if one understands the importance of a patient's chest pain. Objetice: The aim of this study is to evaluate how much patients entering the emergency room due to acute myocardial infection (AMI) know about chest pain and thrombolytic therapy. Materials and Methods: One hundred fifty patients (126 males,14 females) from three different institutes with complaints of chest pain were randomly chosen to participate in this study. The mean age of the patients was 55.4 ± 11.2 years (71+33). Patients were asked to fill out a questionnaire consisting of 70 questions within the first seven days. All differences in categorical variables were computed using the χ2-test and Fisher Exact test. A two-tailed hypothesis was used in all statistical evaluations, and p<0.05 was considered significant. Results: It was observed that 17% of the patients came to the hospital within the first 30 minutes; 18.3% of them came to the hospital between 30 minutes and 1 hour; 27.5% of them came to the hospital between 1 hour and 3 hours; and 21.4% of them came to the hospital more than 6 hours after symptoms began. It was also observed that 68% of the patients were not aware of the AMI, and 96% of them had no prior knowledge of antithrombolytic therapy. Conclusion: Because the majority of the patients did not have enough information about AMI, a training program should be implemented to ensure that people to come to the hospital earlier. (Int J Cardiovasc Sci. 2021; [online].ahead print, PP.0-0)

Uso del factor Bayes durante el análisis estadístico: un ejemplo / Use of the Bayes factor during statistical analysis: an example

El factor de Bayes resulta una prueba recomendable para la comprobación de las hipótesis esta-dísticas atendiendo al estado de los p valores, empleando la escala de clasificación de Jeffreys preferiblemente

The Bayes factor is a recommended test for the verification of statistical hypotheses taking into account the state of the p values, preferably using the Jeffreys classification scale.

Elaboration and psychometric analysis of a questionnaire to evaluate the knowledge of community health workers about breastfeeding / Elaboração e análise psicométrica de um questionário para avaliar o conhecimento de agentes comunitários de saúde sobre amamentação

Abstract Objectives: to develop and analyze the psychometric properties of a questionnaire to assess community health workers' knowledge on breastfeeding. Methods: this is a methodological study for the development of an instrument and analysis of validity and reliability. For the elaboration of items and identification of dimensions, a literature review was conducted. The items were submitted to the evaluation of a committee of judges, for apparent and content analysis. Construct validation was conducted through hypothesis test, with the participation of 282 community health workers and 19 pediatricians and obstetric nurses. For analysis and comparison of scores, the Mann-Whitney U test was used, assuming a significance level of 5%. Reliability was assessed using Cronbach's alpha coefficient and temporal consistency of the instrument was assessed using test-retest and Kappa analysis. Results: the final instrument presented a favorable opinion from the committee of judges. The hypothesis test showed that the questionnaire has discriminatory power to assess professionals with a higher level of knowledge (p<0.001). The Kappa test revealed that 63% of the items showed substantive to almost perfect agreement. The 32-item questionnaire showed a Cronbach's alpha of 0.794. Conclusion: the instrument developed was valid and reliable, allowing effective measurement of community health workers' knowledge on breastfeeding.

Resumo Objetivos: elaborar e analisar propriedades psicométricas de um questionário para avaliação do conhecimento de agentes comunitários de saúde sobre amamentação. Métodos: trata-se de estudo metodológico de elaboração de instrumento e análise de validade e confiabilidade. Para a elaboração dos itens e identificação das dimensões, realizou-se revisão da literatura. Os itens foram submetidos à apreciação de comitê de juízes, para análise aparente e de conteúdo. A validação de construto foi conduzida pelo teste de hipóteses, com participação de 282 agentes comunitários de saúde e 19 pediatras e enfermeiras obstetras. Para comparação dos escores, utilizou-se o teste U de Mann-Whitney, assumindo-se um nível de significância de 5%. A confiabilidade foi aferida por meio do coeficiente alfa de Cronbach e a consistência temporal do instrumento por meio do teste-reteste e análise de Kappa. Resultados: o instrumento final apresentou parecer favorável do comitê de juízes. O teste de hipóteses evidenciou que o instrumento tem poder discriminatório para aferir profissionais com maior nível de conhecimento (p<0,001). O teste Kappa revelou que 63% dos itens apresentaram concordância de substantiva a quase perfeita. O questionário, com 32 itens, apresentou um alfa de Cronbach de 0,794. Conclusão: o instrumento apresentou-se válido e confiável que permitirá mensurar de forma eficaz o conhecimento de agentes comunitários de saúde sobre amamentação.

Inferência baseada em magnitude: um olhar para análise individual / Magnitude-based inference: looking at the individual analysis

Os testes de hipótese são amplamente empregados para análise de dados na área de ciência do esporte. Porém, existe um questionamento em relação a utilização desse método e a comunidade científica ainda procura soluções mais adequadas para a análise dos dados. De fato, esse tipo de análise não permite uma interpretação prática das mudanças observadas ao longo do tempo. Por conta disso, o cálculo da "in ferência baseada em magnitude" (IBM) vem sendo cada vez mais utilizado por pesquisadores e analistas de desempenho. Em uma perspectiva aplicada, a IBM permite avaliar a probabilidade de se encontrar diferenças relevantes (i.e., meaningful differences) nas variáveis investigadas. Da mesma forma, a IBM permite examinar com precisão as variações individuais e importantes no desempenho esportivo. O objetivo desse ponto de vista é apresentar e discutir a aplicação da IBM a partir das análises individuais. Para tanto o trabalho aborda os seguintes temas: 1) utilização da análise de dados no "mundo real"; 2) inferência baseada em magnitude: conceitos básicos; 3) aplicando a IBM no contexto do esporte; 4) classificações qualitativas com base nas mudanças observadas; 5) formas de se obter a mínima mudança válida importante e o erro típico; 6) análise e interpretação dos dados. Esperamos que o conteúdo apresentado encoraje pesquisadores e profissionais do esporte a implementar esse novo método de análise em suas rotinas diárias e, ao mesmo tempo, lhes auxilie na interpretação dos dados provenientes das avaliações e testes de desempenho.(AU)

Null hypothesis tests are widely used for data analysis in sport science. However, the scientific community has been questioning this method and is still looking for alternative approaches for data analyses. In fact, this type of analysis does not allow practical interpretation of the changes observed in athletic performance over time. Therefore, the magnitude-based inference (MBI) method has been increasingly used by researchers and performance analysts. From an applied perspective, this method allows examining the probability of finding meaningful differences in assessed variables. In addition, the MBI enables precise assessment of individual changes, which may be releva nt to sport performance. The aim of this article is to present and discuss the application of the individual MBI analysis. Based on this purpose, the manuscript covers the following topics: 1) utilization of data analysis in real world settings; 2) basic concepts of the MBI; 3) applying the MBI approach in sport science; 4) qualitative classifications based on observed changes; 5) different methods to determine the smallest worthwhile change and the typical error; 6) data analysis and interpretation. We hope that this study will encourage practitioners and r esearchers to implement this novel statistical approach in their daily routines, for analysis and interpretation of data collected during physical performance measurements.(AU)

Dos ejemplos de replicación Bayesiana para estimar el grado de evidencia de las pruebas de significancia estadística / No disponible

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Sustancia P, citocinas proinflamatorias, receptor de potencial transitorio vaniloide tipo 1 y COVID-19: una hipótesis de trabajo / Substance P, proinflammatory cytokines, transient receptor potential vanilloid subtype 1 and COVID-19: A working hypothesis

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Verbal baselining: within-subject consistency of CBCA scores across different truthful and fabricated accounts / La línea base verbal: la congruencia intrasujeto de las puntuaciones del CBCA en diferentes relatos veraces e inventados

Statement Validity Assessment (SVA) proposes that baseline statements on different events can serve as a within-subject measure of a witness' individual verbal capabilities when evaluating scores from Criteria-based Content Analysis (CBCA). This assumes that CBCA scores will generally be consistent across two accounts by the same witness. We present a first pilot study on this assumption. In two sessions, we asked 29 participants to produce one experience-based and one fabricated baseline account as well as one experience-based and one fabricated target account (each on different events), resulting in a total of 116 accounts. We hypothesized at least moderate correlations between target and baseline indicating a consistency across both experience-based and fabricated CBCA scores, and that fabricated CBCA scores would be more consistent because truth-telling has to consider random event characteristics, whereas lies must be constructed completely by the individual witness. Results showed that differences in correlations between experience-based CBCA scores and between fabricated CBCA scores took the predicted direction (cexperience-based = .44 versus cfabricated =.61) but this difference was not statistically significant. As predicted, a subgroup of event-related CBCA criteria were significantly less consistent than CBCA total scores, but only in experience-based accounts. The discussion considers methodological issues regarding the usage of total CBCA scores and whether to measure consistency with correlation coefficients. It is concluded that more studies are needed with larger samples

El Statement Validity Assessment (SVA) propone que las declaraciones sobre diferentes eventos pueden servir como una línea base intrasujeto de la medida de las capacidades verbales individuales de un testigo al evaluar las puntuaciones del Criteria Based Content Analysis (CBCA). Esto implica que las puntuaciones del CBCA serán congruentes en dos relatos del mismo testigo. Presentamos un primer estudio piloto sobre este supuesto. Se pidió a 29 participantes en dos sesiones que elaboraran un relato verdadero (línea base) y otro inventado, además de un relato verdadero y otro inventado (cada uno en situaciones diferentes), arrojando un total de 116 relatos. Se planteó la hipótesis de una correlación al menos moderada entre la declaración fabricada y la verdadera, que indicaría una consistencia entre las puntuaciones en el CBCA de relatos inventados y experimentados y que las puntuaciones en el CBCA inventadas serían más consistentes porque la verdad incluye las características aleatorias de los hechos, mientras que las mentiras las construye totalmente el testigo. Los resultados mostraron que las diferencias en las correlaciones entre las puntuaciones en el CBCA de relatos experimentados y fabricados iban en la dirección predicha (cvivido = .44 frente a cinventado = .61), pero esta diferencia no fue significativa. Como se predijo, un subgrupo de criterios de CBCA relacionados con los hechos fue menos congruente que las puntuaciones totales de CBCA, pero sólo en los relatos de hechos experimentados. Se discuten las implicaciones metodológicas relacionadas con el uso de las puntuaciones totales del CBCA y si se debe medir la consistencia mediante el coeficiente de correlación. Se concluye que se necesitan otros estudios con muestras más grandes

El SRAA y el SARS-CoV-2: el acertijo a resolver / The RAAS and SARS-CoV-2: ariddle to solve

El 31 de diciembre de 2019 se reportó el primer caso de COVID-19 en Wuhan, China, y desde entonces ha habido un interés creciente y sin precedentes por conocer todos los aspectos vinculados con esta nueva enfermedad. Uno de los temas que ha generado debate se vincula con la asociación entre la terapia antihipertensiva con inhibidores del sistema renina-angiotensina-aldosterona (SRAA) y la infección por el virus SARS-CoV-2. Si bien muchas preguntas siguen hoy día sin poder ser respondidas, la intención de este comunicado es informar a los profesionales de la salud acerca del estado actual de conocimiento. Dado que este es un tema en constante evolución, se recomienda su actualización a medida que se presenten nuevas evidencias. A continuación, daremos revisión a los estudios preclínicos y clínicos que relacionan el coronavirus con el SRAA

The first case of COVID-19 was reported on 31 December 2019 in Wuhan, China. Ever since there has been unprecedented and growing interest in learning about all aspects of this new disease. Debate has been generated as tothe association between antihypertensive therapy with renin-angiotensin-aldosterone system (RAAS) inhibitors and SARS-CoV-2 infection. While many questions as yet remain unanswered, the aim of this report is to inform healthprofessionals about the current state of knowledge. Because this is an ever-evolvingtopic, the recommendation is that it be updated as new evidence becomes available. Below, we provide a review of pre-clinical and clinical studies that link coronavirus to the RAAS

Como leer y generar publicaciones científicas: hipótesis y objetivos de un proyecto de investigación clínica / How to read and generate scientific publications: hypothesis and objectives of a clinical research project

In the clinical research process, the formulation of a well-founded hypothesis and objectives concordant with the research question are key to the proper conduct of the project. The following article reviews the fundamental principles for the adequate formulation of hypotheses and objectives of clinical research projects, providing practical recommendations and examples.

En el proceso de investigación clínica, la formulación de una hipótesis bien fundamentada y objetivos concordantes con la pregunta de investigación, son claves para la adecuada conducción del proyecto. El siguiente artículo revisa los principios fundamentales para la formulación adecuada de hipótesis y objetivos de proyectos de investigación clínica, proporcionando recomendaciones prácticas y ejemplos.

Teste de hipóteses: perguntas que você sempre quis fazer, mas nunca teve coragem / Hypothesis testing: questions you have always wanted to ask, but never had the courage to

Dando continuidade aos artigos da série "Perguntas que você sempre quis fazer, mas nunca teve coragem", que tem como objetivo responder e sugerir referências para o melhor entendimento das principais dúvidas dos pesquisadores do Hospital de Clínicas de Porto Alegre sobre estatística, este segundo artigo se propõe a responder às principais dúvidas levantadas sobre Teste de Hipóteses. São discutidas questões referentes à metodologia de um teste de hipóteses na concepção clássica de Inferência Estatística, bem como tamanho de efeito, tipos de erros, valor de p e poder. Os conceitos são abordados numa linguagem acessível ao público leigo e diversas referências são sugeridas para os curiosos em relação ao tema. (AU)

Continuing the series of articles "Questions you have always wanted to ask, but never had the courage to", which aims to answer the most common questions of researchers at Hospital de Clínicas de Porto Alegre regarding statistics and to suggest references for a better understanding, this second article addresses the topic of hypothesis testing. The hypothesis testing method is discussed from a classical conception of statistical inference, including effect size, type of errors, p-value and power. The concepts are explained in plain language for lay readers and several references are suggested for those curious about the topic. (AU)

Efectividad de una intervención psicoeducativa en la reducción de la sobrecarga del cuidador informal del paciente con esquizofrenia (EDUCA-III-OSA) / Effectiveness of a psychoeducational intervention in reducing burden in informal caregivers of schizophrenic patients (EDUCA-III-OSA)

Los familiares de pacientes con esquizofrenia o trastorno esquizoafectivo frecuentemente padecen consecuencias negativas derivadas de su labor como cuidadores. El objetivo del estudio EDUCA-III-OSA es evaluar la efectividad de un programa de intervención psicoeducativa (PIP) en la reducción de la sobrecarga del cuidador informal tras la intervención a los 4 meses y 16 meses después. Se llevó a cabo un estudio multicéntrico con diseño cuasi-experimental de grupo único. La variable dependiente principal fue la sobrecarga, medida a través del Inventario de Sobrecarga de Zarit (ZBI) y el Cuestionario de Evaluación de Repercusión Familiar (IEQ). Las variables secundarias fueron la ansiedad (STAI-X), la salud mental del cuidador (GHQ-28) y la depresión (CES-D). 39 cuidadores de 5 centros diferentes participaron en el estudio. Tras la intervención (4 meses), las variables de sobrecarga (d de Cohen = 0.26), depresión (d = 0.42), salud mental (d = 0.76) y ansiedad-estado (d = 0.59) experimentaron una mejora moderada. Esta mejora se vio incrementada a los 16 meses en las variables de sobrecarga (d = 0.56) y ansiedad-estado (d = 0.89), mientras que la variable de salud mental experimentó un descenso (d = 0.39). Tras la aplicación de la intervención psicoeducativa manualizada se produjo una mejoría en el estado psicológico de los cuidadores informales. Estos cambios se mantuvieron un año después

Families of patients with schizophrenia usually experience negative consequences. The aim of the EDUCA-III-OSA study is to test the effectiveness of a psychoeducational intervention program (PIP) to reduce the caregiver burden at post-intervention (4 months) and at follow-up (16 months). A multicentre quasi-experimental study design with a unique group of informal caregivers who received intervention was used. The intervention consisted of 12 weekly group sessions. The primary outcome variable was burden, measured through the Zarit Burden Interview (ZBI) and the Involvement Evaluation Questionnaire (IEQ). Secondary outcome variables were anxiety (STAI-X), mental health (GHQ-28), and depression (CES-D). 39 caregivers from 5 research sites participated in the study. After the intervention (4 months), the variables of burden (Cohen's d = 0.26), depression (d = 0.42), mental health (d = 0.76), and anxiety-state (d = 0.59) showed a moderate decrease. These improvements increased 16 months later in the variables of burden (d = 0.56) and anxiety-state (d = 0.89), while the mental health variable decreased (d = 0.39). After the application of the intervention program a marked improvement in the psychological status of informal caregivers was produced. These changes held one year later

¿Sería conveniente reducir el valor p considerado significativo? / Should we reduce the p value considered significant?

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Confidence interval for difference between coefficients of content validity (Aiken’s V): A SPSS syntax / Intervalos de confianza para la diferencia entre coeficientes de validez de contenido (V Aiken): Una sintaxis SPSS

Analysis of content validity usually includes measures to summarize the ratings of expert judges. However, differences between groups of judges have not been previously raised, and it is plausible that these differences occur. The present manuscript raises the comparison between-groups of the coefficient V (Aiken, 1980), as a strategy that must be implemented in the analysis of the content validity. We present a method based on the construction of confidence intervals for the difference between coefficients V, for two independent groups. Finally, a free SPSS syntax is also included

l análisis el de la validez de contenido usualmente incluye medidas para cuantificar sumariamente las calificaciones de jueces expertos. Sin embargo, las diferencias entre grupos de jueces no han sido previamente planteadas, y es plausible que estas diferencias ocurran. El presente manuscrito plantea la comparación entre-grupos del coeficiente V Aiken, 1980), como una estrategia que debe ser implementada en el análisis de la validez de contenido. Se presenta un método basado en la construcción de intervalos de confianza para la diferencia entre coeficientes V, para dos grupos independientes. Finalmente, también se incluye un programa en sintaxis SPSS de libre distribución para su implementación

Addictive salt may not be solely responsible for causing hypertension: A sweet and fatty hypothesis / La adicción a la sal no es la única responsable de causar hipertensión: hipótesis sobre azúcares y grasas

In literature, since many decades, it is often believed and condoned that excessive common salt (Nacl) ingestion can lead to hypertension. Hence, every health organisation, agencies and physicians have been advising salt restriction to hypertensive patients. However, there is no concrete evidence suggesting that salt restriction can reduce the risk of hypertension (HTN). The present article is based on the current literature search which was performed using MEDLINE, EMBASE, Google Scholar and PubMed. The meta-analysis, randomised control trials, clinical trials and review articles were chosen. The present review article suggests that consumption of high salt diet does not lead to hypertension and there are other factors which can lead to hypertension, sugar and fats being the main reasons. Salt can however lead to addiction and generally, these salty food items have a larger proportion of sugar and fats, which if over-consumed has a potential to cause obesity, hyperlipidaemia and subsequently, hypertension and other cardiovascular disorders. Hence, through the present review, I would like to suggest all the physicians to ask the hypertensive patients to cut down the intake of sugar and fat containing food items and keep a check on addiction of salty food items

En la literatura, desde hace décadas, ha existido la creencia, y se ha justificado a menudo, que la ingesta excesiva de sal (NaCl) puede originar hipertensión. Por ello, cada organización y agencia sanitaria, al igual que los médicos, han recomendado la restricción del consumo de sal a los pacientes hipertensos. Sin embargo, no existe evidencia concreta acerca de que la restricción del consumo de sal pueda reducir el riesgo de hipertensión. El presente artículo se basa en la búsqueda en la literatura actual, realizada en MEDLINE, EMBASE, Google Scholar y PubMed. Se seleccionaron metaanálisis, ensayos controlados aleatorios, ensayos clínicos y artículos de revisión. El presente artículo de revisión sugiere que el consumo de una dieta rica en sal no origina hipertensión, y que existen otros factores que pueden dar lugar a dicha situación, como son el azúcar y las grasas. Sin embargo, la sal puede causar adicción y consumo excesivo de los mismos productos alimenticios con contenido de azúcares y grasas, originando obesidad, hiperlipidemia y, por añadidura, hipertensión y otros trastornos cardiovasculares. En consecuencia, a través de la presente revisión, nos gustaría sugerir a todos los médicos que soliciten a los pacientes hipertensos la reducción del consumo de alimentos con contenido de azúcares y grasas, y revisar la adicción a los productos alimenticios con alto contenido en sal