Cited by 589Sodium Intake and HealthBlood Pressure and Hypertension StudiesNutritional Studies and Diet

Salt Reduction to Prevent Hypertension and Cardiovascular Disease

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He, Feng J., Tan, Monique, Ma, Yuan, MacGregor, Graham A.·2020·Journal of the American College of Cardiology

Abstract

There is strong evidence for a causal relationship between salt intake and blood pressure. Randomized trials demonstrate that salt reduction lowers blood pressure in both individuals who are hypertensive and those who are normotensive, additively to antihypertensive treatments. Methodologically robust studies with accurate salt intake assessment have shown that a lower salt intake is associated with a reduced risk of cardiovascular disease, all-cause mortality, and other conditions, such as kidney disease, stomach cancer, and osteoporosis. Multiple complex and interconnected physiological mechanisms are implicated, including fluid homeostasis, hormonal and inflammatory mechanisms, as well as more novel pathways such as the immune response and the gut microbiome. High salt intake is a top dietary risk factor. Salt reduction programs are cost-effective and should be implemented or accelerated in all countries. This review provides an update on the evidence relating salt to health, with a particular focus on blood pressure and cardiovascular disease, as well as the potential mechanisms.

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Crossref · 10.1016/j.jacc.2019.11.055

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  • In people with cardiovascular disease and type 2 diabetes, reducing sodium intake may reduce systolic blood pressure by an average of 5.8 mmHg in hypertensive patients and 1.9 mmHg in normotensive patients.

    “People with CVD and T2DM are encouraged to reduce sodium intake, as this may reduce systolic BP by, on average, 5.8 mmHg in hypertensive patients and 1.9 mmHg in normotensive patients.94,95”
  • In a meta-analysis, in hypertensive and normotensive people, reducing salt intake by 2.5 g/day resulted in a 20% relative reduction of atherosclerotic cardiovascular disease events.

    “In a meta-analysis, in hypertensive and normotensive people, reducing salt intake by 2.5 g/day resulted in a 20% relative reduction of ASCVD events.95”

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1 of the 182 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Mimran A, Ribstein J, Jover B. Aging and so- dium homeostasis. Kidney Int Suppl 1992;37: S107-13.
  2. de Wardener HE. The hypothalamus and hy- pertension. Physiol Rev 2001;81:1599-658.
  3. DiNicolantonio JJ, Di Pasquale P, Taylor RS, Hackam DG. Low sodium versus normal sodium diets in systolic heart failure: systematic review and meta-analysis. Retraction notice. Heart 2013. Available at: http://heart.bmj.com/content/ early/2013/03/12/heartjnl-2012-302337.short? rss¼1. Accessed July 30, 2014.

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Authors
He, F. J., Tan, M., Ma, Y., & MacGregor, G. A.
Affiliations
  • Queen Mary University of London (GB)
  • Harvard University (US)
Corresponding author
He, Feng J.
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2020-02
Volume
75
Issue
6
Pages
632-647
ISSN
0735-1097 (ISSN-L)
OpenAlex
W3005813910
Cited by
589
References
182
Citations by year
2026: 71 · 2025: 125 · 2024: 123 · 2023: 86 · 2022: 97 · 2021: 64 · 2020: 22 · 2014: 1
FWCI
8.29
Type
journal article
Language
en
Open access
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • Queen Mary Research Online (Queen Mary University of London) (submittedVersion, cc-by-nc-nd)
Funders
  • National Institute for Health and Care Research (16/136/77)
  • Medical Research Council (MR/P012590/1, MR/J015903/1)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords
salt reduction, dietary sodium, hypertension, blood pressure, cardiovascular disease, all-cause mortality, kidney disease, gastric cancer, osteoporosis, fluid homeostasis, inflammation, gut microbiota, immune response, dietary risk factors, cost-effectiveness
MeSH terms
Blood Pressure, Humans, Hypertension, Legislation, Food, Sodium Chloride, Dietary

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