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Salt Reduction to Prevent Hypertension and Cardiovascular Disease
Open accessAbstract
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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“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”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [95]
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“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”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [95]
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Self-citationTh1 and Th17 Cells Induce Proliferative Glomerulonephritis
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- DiNicolantonio, 2013, Low sodium versus normal sodium diets in systolic heart failure: systematic review and meta-analysis. Retraction notice, Heart
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2021 ESC Guidelines on cardiovascular disease prevention in clinical practice
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2024 ESC Guidelines for the management of elevated blood pressure and hypertension
McEvoy, J. W., McCarthy, C. P., Bruno, R. M., Brouwers, S., Canavan, M. D., Ceconi, C., Christodorescu, R. M., Daskalopoulou, S. S., Ferro, C. J., Gerdts, E., et al. (2024) · European Heart Journal · doi:10.1093/eurheartj/ehae178 · Cited by 2,298
2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes.
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Metadata
- 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
- FWCI
- 8.29
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- 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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