Sodium Intake and Cardiovascular Health
Open accessAbstract
Sodium is an essential nutrient. Increasing sodium intake is associated with increasing blood pressure, whereas low sodium intake results in increased renin and aldosterone levels. Randomized controlled trials have reported reductions in blood pressure with reductions in sodium intake, to levels of sodium intake <1.5 g/d, and form the evidentiary basis for current population-wide guidelines recommending low sodium intake. Although low sodium intake (<2.0 g/d) has been achieved in short-term feeding clinical trials, sustained low sodium intake has not been achieved by any of the longer term clinical trials (>6-month duration). It is assumed that the blood pressure–lowering effects of reducing sodium intake to low levels will result in large reductions in cardiovascular disease globally. However, current evidence from prospective cohort studies suggests a J-shaped association between sodium intake and cardiovascular events, based on studies from >300 000 people, and suggests that the lowest risk of cardiovascular events and death occurs in populations consuming an average sodium intake range (3–5 g/d). The increased risk of cardiovascular events associated with higher sodium intake (>5 g/d) is most prominent in those with hypertension. A major deficit in the field is the absence of large randomized controlled trials to provide definitive evidence on optimal sodium intake for preventing cardiovascular events. Pending such trials, current evidence would suggest a recommendation for moderate sodium intake in the general population (3–5 g/d), with targeting the lower end of the moderate range among those with hypertension.
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Higher dietary sodium intake is incontrovertibly linked to increases in arterial blood pressure.
“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 [153]
Available studies 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 BP and resistant hypertension.
“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 [153]
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- Authors
- O’Donnell, M., Mente, A., & Yusuf, S.
- Affiliations
- From the Department of Medicine (M.O.D., S.Y.), and Department of Clinical Epidemiology and Biostatistics (A.M.), Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Canada; and HRB-Clinical Research Facility Galway, NUI Galway, Galway, Ireland (M.O.D.).
- Ollscoil na Gaillimhe – University of Galway (IE)
- Venue
- Circulation Research
- Published
- 2015-03-13
- Volume
- 116
- Issue
- 6
- Pages
- 1046-1057
- ISSN
- 0009-7330 (ISSN-L)
- 1524-4571
- OpenAlex
- W2153504598
- Cited by
- 208
- References
- 73
- Citations by year
- 2026: 12 · 2025: 15 · 2024: 15 · 2023: 23 · 2022: 19 · 2021: 28 · 2020: 23 · 2019: 20 · 2018: 22 · 2017: 12 · 2016: 13 · 2015: 6
- FWCI
- 17.01
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- cc-by-nc-nd
- Locations
- Circulation Research (publishedVersion)
- PubMed (publishedVersion)
- ARAN (University of Galway Research Repository) (Ollscoil na Gaillimhe – University of Galway) (submittedVersion, cc-by-nc-nd)
- 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 › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Keywords
- sodium intake, cardiovascular disease, blood pressure, hypertension, renin-angiotensin-aldosterone system, J-shaped association, dietary sodium reduction, cardiovascular risk
- MeSH terms
- Blood Pressure, Cardiovascular Diseases, Diet, Sodium-Restricted, Humans, Hypertension, Kidney, Lipids, Natriuresis, Renin-Angiotensin System, Sodium, Dietary, Global Health, Practice Guidelines as Topic, Genetic Predisposition to Disease
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