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Cappuccio, Francesco P.. (2007) Salt and cardiovascular disease. BMJ, Vol.334 . pp. 859-860. ISSN 0959-535X

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Abstract

Blood pressure is the most powerful predictor of stroke and other cardiovascular events. The importance of salt (sodium chloride) intake in determining blood pressure and the incidence of hypertension is well established. Furthermore, randomised controlled clinical trials of moderate reductions in salt intake show a dose dependent cause-effect relation and lack of a threshold effect within usual levels of salt intake in populations worldwide. The effect is independent of age, sex, ethnic origin, baseline blood pressure, and body mass.

Prospective studies,2 3 4 5 with one exception,6 also indicate that higher salt intake predicts the incidence of cardiovascular events. While widespread support exists for reducing salt intake to prevent cardiovascular disease, the lack of large and long randomised trials on the effects of salt reduction on clinical outcomes has encouraged some people to argue against a policy of salt reduction in populations.

Item Type: Journal Article
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine
Divisions: Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Cardiovascular system -- Diseases, Hypertension, Salt
Journal or Publication Title: BMJ
Publisher: BMJ Publishing Group Ltd.
ISSN: 0959-535X
Official Date: 27 April 2007
Volume: Vol.334
Page Range: pp. 859-860
Identification Number: 10.1136/bmj.39175.364954.BE
Status: Peer Reviewed
Access rights to Published version: Open Access
References:

1 He FJ, MacGregor GA. How far should salt intake be reduced? Hypertension 2003;42:1093-9.
2 Sasaki S, Zhang X-H, Kesteloot H. Dietary sodium, potassium, saturated fat, alcohol and stroke mortality. Stroke 1995;26:783-9.
3 He J, Ogden LG, Vupputuri S, Bazzano LA, Loria C, Whelton PK. Dietary sodium intake and subsequent risk of cardiovascular disease in overweight adults. JAMA 1999;282:2027-34.
4 Tuomilehto J, Jousilahti P, Rastenyte D, Moltchanov V, Tanskanen A, Pietinen P, et al. Urinary sodium excretion and cardiovascular mortality in Finland: a prospective study. Lancet 2001;357:848-51.
5 Nagata C, Takatsuka N, Shimizu N, Shimizu H. Sodium intake and risk of death from stroke in Japanese men and women. Stroke 2004;35:1543-7.
6 Cohen HW, Hailpern SM, Fang J, Alderman MH. Sodium intake and mortality in the NHANES II follow-up study. Am J Med 2006;119:275.e7-14.
7 Cook NR, Cutler JA, Obarzanek E, Buring JE, Rexrode KM, Kumanyika SK, et al. Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of trials of hypertension prevention. BMJ 2007 doi: 10.1136/bmj.39147.604896.55.
8 He FJ, MacGregor GA. Effect of modest salt reduction on blood pressure: a meta-analysis of randomized trials. Implications for public health. J Hum Hypertens 2002;16:761-70.
9 Karppanen H, Mervaala E. Sodium intake and hypertension. Prog Cardiovasc Dis 2006;49:59-75.
10 Cappuccio FP, Kerry SM, Micah FB, Plange-Rhule J, Eastwood JB. A community programme to reduce salt intake and blood pressure in Ghana. BMC Public Health 2006;6:13.
11 Little P, Kelly J, Barnett J, Dorward M, Margetts B, Warm D. Randomised controlled factorial trial of dietary advice for patients with a single high blood pressure reading in primary care. BMJ 2004;328:1054-7.
12 Selmer RM, Kristiansen IS, Haglerod A, Graff-Iversen S, Larsen HK, Meyer HE, et al. Cost and health consequences of reducing the population intake of salt. J Epidemiol Community Health 2000;54:697-702.
URI: http://wrap.warwick.ac.uk/id/eprint/174

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