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Sodium, Blood Pressure, and Cardiovascular Disease: Further Evidence Supporting the American Heart Association Sodium Reduction Recommendations
Open accessAbstract
Recent reports of selected observational studies and a meta-analysis have stirred controversy and have become the impetus for calls to abandon recommendations for reduced sodium intake by the US general population. A detailed review of these studies documents substantial methodological concerns that limit the usefulness of these studies in setting, much less reversing, dietary recommendations. Indeed, the evidence base supporting recommendations for reduced sodium intake in the general population remains robust and persuasive. The American Heart Association is committed to improving the health of all Americans through implementation of national goals for health promotion and disease prevention, including its recommendation to reduce dietary sodium intake to <1500 mg/d.
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“The American Heart Association recommends no more than 1500mg of sodium/day as ideal.”
From Reducing Dietary Sodium to 1000 mg per Day Reduces Neurovascular Transduction Without Stimulating Sympathetic Outflow (2019) · cites this paper as [3]
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“there is a large body of literature suggesting that long-term reductions in sodium elicit reductions in BP at the population level.2, 3”
From Reducing Dietary Sodium to 1000 mg per Day Reduces Neurovascular Transduction Without Stimulating Sympathetic Outflow (2019) · cites this paper as [3]
In the citing paper
“Together, these findings support the recommended target intakes in current national and international dietary guidelines, which range from 1200 to 2400 mg/d.110, 313, 320-323”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [313]
In the citing paper
“Some studies have also observed a potential J-shaped relationship, with increased CVD risk at low intakes (e.g., <3000 g/d).311-313”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [313]
In the citing paper
“Higher dietary sodium intake is incontrovertibly linked to increases in arterial BP.153–155”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [155]
In the citing paper
“For the time being, the available studies (albeit of short-term duration) support that sodium restriction, even to low levels <65 to 100 mmol/d (1.5–3.0 g/d), yields significant linear reductions in BP among patients with high BP153–155,349 and RH.58,161”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [155]
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Cited by
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Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association
Benjamin, E. J., Blaha, M. J., Chiuve, S. E., Cushman, M., Das, S. R., Deo, R., de Ferranti, S. D., Floyd, J., Fornage, M., Gillespie, C., et al. (2017) · Circulation · doi:10.1161/cir.0000000000000485 · Cited by 12,591
Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association
Virani, S. S., Alonso, A., Benjamin, E. J., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Delling, F. N., et al. (2020) · Circulation · doi:10.1161/cir.0000000000000757 · Cited by 9,175
Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association
Benjamin, E. J., Muntner, P., Alonso, A., Bittencourt, M. S., Callaway, C. W., Carson, A. P., Chamberlain, A. M., Chang, A. R., Cheng, S., Das, S. R., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000659 · Cited by 9,036
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Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Anderson, C. A. M., Arora, P., Avery, C. L., Baker-Smith, C. M., Beaton, A. Z., Boehme, A. K., Buxton, A. E., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001123 · Cited by 8,300
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Self-citation
Metadata
- Authors
- Whelton, P. K., Appel, L. J., Sacco, R. L., Anderson, C. A. M., Antman, E. M., Campbell, N., Dunbar, S. B., Frohlich, E. D., Hall, J. E., Jessup, M., Labarthe, D. R., MacGregor, G. A., Sacks, F. M., Stamler, J., Vafiadis, D. K., & Van Horn, L. V.
- ORCID
- Venue
- Circulation
- Published
- 2012-12-11
- Volume
- 126
- Issue
- 24
- Pages
- 2880-2889
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2172022569
- Semantic Scholar
- 106413488fdcdfcaf65145a86aa70d9a2a6ab3f9
- Cited by
- 463
- References
- 86
- Citations by year
- 2026: 18 · 2025: 30 · 2024: 21 · 2023: 27 · 2022: 20 · 2021: 35 · 2020: 33 · 2019: 22 · 2018: 36 · 2017: 36 · 2016: 35 · 2015: 56 · 2014: 57 · 2013: 35 · 2012: 1
- FWCI
- 44.51
- Type
- journal article
- Language
- en
- Update notices
- correction (2013-01-01)
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Heart Association
- Brigham and Women's Hospital
- University of Miami
- University of Pennsylvania
- Emory University
- Northwestern University
- Harvard University
- Tulane University
- Johns Hopkins University
- Queen Mary University of London
- National Institutes of Health
- National Heart, Lung, and Blood Institute (K01HL092595)
- National Institute of Nursing Research
- 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
- sodium intake, blood pressure, cardiovascular disease, meta-analysis critique, American Heart Association guidelines, hypertension prevention
- MeSH terms
- American Heart Association, Blood Pressure, Cardiology, Cardiovascular Diseases, Diet, Sodium-Restricted, Humans, Risk Factors, United States, Practice Guidelines as Topic, Sodium Chloride, Dietary
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