Our findings add to growing evidence that current recommendations for sodium intake may be misguided. The importance of dietary potassium is also underlined in this study. The team found that individuals with the lowest blood pressure were those who had the highest intake of sodium and potassium.

Conversely, those with the highest blood pressure had the lowest intake of sodium and potassium. Similar effects were also seen when magnesium and calcium intakes were analysed; higher levels were linked to lower blood pressure, and vice versa.

This study does support the finding of a clear inverse association between potassium, magnesium, and calcium and blood pressure change over time. Moore wants her study to play a part in shifting dietary decisions throughout the U.

Moore also makes it clear that there may be certain people who are particularly sensitive to sodium and who might, therefore, benefit from reducing salt in their diet. Perhaps in the future, methods of screening for salt sensitivity might help to establish which individuals need to be more careful.

This changing field of nutrition science is one to watch. Learn why potassium is as important as sodium for healthy blood pressure. High blood pressure is known as the silent killer as it rarely has symptoms.

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Medical News Today. Health Conditions Health Products Discover Tools Connect. High blood pressure: Sodium may not be the culprit. By Tim Newman on April 25, Share on Pinterest Is salt as bad for our health as we thought?

A new look at sodium and blood pressure. Potassium as important as sodium. Share this article. An African diet has a high salt content which is maybe one of the reasons why hypertension is highly prevalent on the continent [6].

Nowadays, in European countries, the daily dietary salt intake among most adults ranges from 7 to 13 g, which far exceeds the recommended daily dose of sodium salts [5]. In many Western countries, the high dietary salt content comes from processed food while in African countries, it comes mostly from bread, salted fish, salt added during cooking, and seasoning and spicing foods [6].

These types of food are called energy dense, nutrient poor EDNP foods [3]. The awareness and the attitude towards salt restriction was evaluated in a study by Menyanu et al [6] who surveyed people from Ghana and South Africa.

They discovered that one third of respondents did not know that a high salt intake could cause cardiovascular problems, which may explain why no actions were taken to reduce their dietary salt intake. Authors also reported that high salt consumption was mainly observed in the younger population and in males.

They also noted that frequent alcohol consumption was associated with a lower desire for salt intake [6]. Another study in Austria found that most salt intake was related to table salt, cereals, meat and dairy products.

They also observed that salt intake was higher in males and in obese subjects [7]. Data from the National Health and Nutrition Examination Survey NHANES indicated that Americans consume on average 3.

The words sodium and salt are not synonymous; salt which is commonly called table salt is a chemical compound consisting of sodium and chloride. People often use these two words interchangeably, yet it is important to know the difference because the recommended daily doses of sodium and of salt are not the same.

There are many other sodium-containing food additives that are used in food production, mainly in processed and canned foods, like monosodium glutamate MSG , sodium bicarbonate baking soda and sodium benzoate.

Salt is an important constituent in our daily foods. It makes bland food tasty, and it is used as a preservative for different types of processed and canned foods. Processed food includes all foods that undergo any changes to their natural state like bread, cheese and other dairy and meat products [7].

Some foods have a high salt content, yet do not taste salty, e. Accordingly, taste alone cannot be used to determine the level of salt content in food. It is important to know how to read the nutrition fact labels to identify sodium content in packaged food.

The nutrition fact label is usually printed on the back of the food packaging and it lists the number of calories as well as the different constituents in the product. It is crucial to understand that the nutrition information list is usually based on a certain amount of food one serving or g , not necessarily the whole amount contained in the package.

People who consume high salt-containing foods tend to be more obese than people who consume less salt in their diet. It was found that a high dietary salt intake is somehow related to increased weight gain, partly because of the high energy and fat content of salty food, and partly because salty food tastes better and this increases the desire to eat larger quantities of food [7].

Sodium is the main cation positively charged ion in the extracellular fluid while chloride is the main anion negatively charged ion. Sodium is important for many cellular functions and together with chloride, they are responsible for the osmolarity of the extracellular fluid.

In addition, sodium is essential for the excitation of nerve and muscle cells, acid-base balance and the secretion of some digestive enzymes.

A low-sodium diet can activate the renin-angiotensin-aldosterone system RAAS , which consequently leads to salt retention and restoration of fluid balance [5]. Excessive intake of sodium defined by the World Health Organization [WHO] as more than 2 g of sodium or more than 5 g of sodium chloride per day [3] is directly linked to high blood pressure and it was found that the higher the daily salt intake, the higher the systolic blood pressure [1].

In addition, high salt intake was found to blunt the physiologic nocturnal blood pressure dipping and to increase the daytime heart rate in ambulatory blood pressure monitoring [10].

In salt-sensitive individuals, the physiologic pressure-natriuresis mechanism is impaired and the kidney becomes unable to excrete a sufficient amount of sodium in response to a high sodium intake [1]. Salt sensitivity is more prevalent in elderly people, females, obese subjects, and patients with chronic kidney disease [5].

Ethnic-specific salt sensitivity was also recognised, as salt sensitivity is more common in people of African descent and people from East Asian regions [17]. The mechanisms behind salt sensitivity are multiple. They include: the retention of sodium caused by abnormal renal excretory response to high urinary sodium, blunted suppression of RAAS, stimulation of the sympathetic nervous system, insulin resistance, genetic polymorphism, and inflammatory processes [1, 5].

Despite the clear association between salt sensitivity and pathophysiological mechanisms of hypertension, physicians cannot not use this fact in everyday clinical practice, simply because of the lack of a practical diagnostic test for salt sensitivity [16].

It is difficult for individual patients to express their daily salt intake. Studies which measured hour urinary sodium excretion and then related these findings to the self-reported salt intake of the individual patients found that there was an underestimation in self-reported sodium consumption due to the difficulty of quantifying salt content hidden in processed foods.

It has been shown that salt restriction can lower blood pressure, where a reduction of about 1. There was a more pronounced effect 5. Many trials suggest that reducing salt intake to moderate amounts is associated with a lower risk of cardiovascular events, yet no definitive evidence has been provided by prospective randomised controlled trials about the optimal sodium intake to reduce cardiovascular events and mortality [2].

Generally, salt reduction to moderate amounts daily sodium 2. It is worth mentioning that non-compliance to salt restriction is considered one of the most important causes of difficult-to-control and resistant hypertension.

A recent metanalysis showed that a calcium channel blocker combined with a hydrochlorothiazide were the most effective antihypertensive drugs in reducing blood pressure in salt-sensitive individuals [19]. Prospective cohort studies reported that reducing dietary sodium intake below 2 g of sodium per day could reduce blood pressure but was associated with an increased risk of adverse events all-cause and cardiovascular mortality in both normotensive and in hypertensive people, suggesting a J-shaped curve phenomenon [2, 20].

On the contrary, epidemiologic studies did not show any adverse effects of low salt in diet. Many studies have shown the direct relationship between high sodium and hypertension and the inverse relationship between high potassium and hypertension [11].

It has also been repeatedly shown that a reduction in sodium salt and an increase in potassium salt consumption can reduce blood pressure, improve general physical health, and reduce salt sensitivity [21], which is why it is advisable to replace sodium salts with potassium salts.

Foods rich in potassium include dried fruits raisins, apricots , lentils, beans, potatoes, spinach, broccoli, avocados and bananas. The International Society of Hypertension Global Hypertension Practice Guidelines recommend reducing the quantity of salt added when cooking and at the table, and to avoid or limit the consumption of high salt containing foods, such as fast foods, soy sauce and processed food including breads and cereals.

They also recommend population-based efforts to reduce salt intake and encourage consumption of fresh vegetables and fruits [17]. A reduction in salt consumption should be a public health priority that requires collaborative efforts between governments, food manufacturers and the general population [2].

To achieve this target, they recommend introducing regulations for food manufacturers to produce healthier and lower salt containing food and they also recommend increasing consumer awareness about the risks of high salt consumption and the healthier alternatives [3].

High salt intake is deleterious to the cardiovascular system both in normo- as well as in hypertensive individuals. Many food products contain salt, and one should be aware of the salt content in their diet to avoid high consumption.

The association between high salt intake and hypertension is well established and all guidelines recommend reducing dietary salt as one of the proven measures to reduce high blood pressure.

It is recommended to limit salt consumption to moderate amounts as too little salt in a diet may lead to adverse cardiovascular events. Population-based campaigns should increase the public awareness about the risks of high dietary salt and about the available measures to replace an unhealthy diet with a healthier one.

Assistant Professor Ghada Youssef, Cardiology Department, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt. Our mission: To reduce the burden of cardiovascular disease. Help centre Contact us. All rights reserved. Did you know that your browser is out of date? To get the best experience using our website we recommend that you upgrade to a newer version.

Learn more. Show navigation Hide navigation. Sub menu. e-Journal of Cardiology Practice. Salt and hypertension: current views Vol. Ghada Sayed Youssef. Topic s : Hypertension.

Introduction Salt, in addition to sugar, are known to be the notorious white killers. The habit of high salt intake Salt consumption varies in different countries across the world, with the highest levels found in Northern China [4] and Japan where the daily salt intake exceeds 10 g and the lowest level found in an isolated tribe Yanomami Indians inhabiting the tropical equatorial rainforest of northern Brazil and southern Venezuela consuming as low as 0.

High salt-containing foods The words sodium and salt are not synonymous; salt which is commonly called table salt is a chemical compound consisting of sodium and chloride. Table 1. Examples of some high salt-containing foods. Types of food Examples Meat Smoked, salted, or canned, bacon, frankfurters, sausage Fish Smoked, salted, or canned, sardines Poultry Smoked, salted, or canned Dairy Products Regular and processed cheese, cottage cheese Vegetables Regular canned vegetables and vegetable juices, olives, pickles Bakery Bread, biscuit, pancake, waffle mixes, pizza Sauces Tomato sauces, soy sauce, seasoning salt, and other sauces and marinades Pasta Processed mixes of pasta, commercially prepared pasta, cup of noodles Others Rice, salted nuts, carbonated beverages Salt and Hypertension Sodium is the main cation positively charged ion in the extracellular fluid while chloride is the main anion negatively charged ion.

There are many mechanisms that link high salt intake and hypertension: Water retention - this was explained by the classic concept of Guyton [12], who demonstrated that high salt intake leads to more water retention, which leads to an expansion in the circulating volumes, an increase in cardiac output, and a rise in kidney perfusion pressure.

When the kidney perfusion pressure is increased, the glomerular filtration rate increases and sodium excretion increases aiming to restore the fluid balance in the body. This physiological response to a high salt intake is called the pressure-natriuresis mechanism, Figure 1. When the sodium excretory ability of the kidney is compromised, hypertension may develop [1].

Yet, some other studies showed that the circulating volumes and the cardiac output were similar among salt-sensitive and salt-insensitive individuals.

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Governance What we do Our work Our campaigns. Our policies Using this website Contact us Leave your feedback. Blood Pressure UK BPUK Your Blood Pressure How to lower your blood pressure Healthy eating Salt and your blood pressure. Salt and your blood pressure.

Eating too much salt is the single biggest cause of high blood pressure. The more salt you eat, the higher your blood pressure will be.

How does salt raise your blood pressure? Salt and your kidneys Your kidneys play an important role in removing fluid and waste products from your body and in controlling your blood pressure. How much salt is too much?

How to eat less salt By learning some simple food swaps, understanding food labels and adding different flavours while cooking, you can slash your salt intake and still eat delicious food. Tips for eating less salt These ideas will help you get started.

Try adding different flavours and allow a little time for your taste buds to adjust. Avoid very salty flavourings. Ready-made sauces, soy sauce, stock cubes and gravy granules can all be very salty, look out for low salt options or try some new flavourings.

Get extra flavour into your recipes. Add herbs, spices and seasonings like chilli, pepper, ginger, lemon or lime juice. Taste food before you add salt. Sometimes people add salt out of habit, remember to taste your meals first. Take the salt shaker off the table.

So you're less likely to be tempted. Be careful of condiments. Try a salt alternative. If you really can't do without a salty favour, try using a small amount of a low-sodium salt substitute. Make your own marinades. Marinating meat or fish in lemon or lime, or with yogurt and spices, avoids the need to add salt for flavour.

Cut down on high salt foods. Cooking sauces, table sauces such as ketchup and mustard, cheese, bacon, olives and pickles can contain a lot of salt. Check the labels. Salt contents vary greatly. Choose low salt bread and breakfast cereals.

They can contain a lot of salt and add a lot to our diet — as we eat so much of them. Check the labels to compare brands. Avoid smoked and processed meats and These contain a lot of salt, so limit how much you eat.

Call ahead when you eat out. If you are eating out, ask if your meal can be made with less salt. Many food products contain salt, and one should be aware of the salt content in their diet to avoid high consumption. The association between high salt intake and hypertension is well established and all guidelines recommend reducing dietary salt as one of the proven measures to reduce high blood pressure.

It is recommended to limit salt consumption to moderate amounts as too little salt in a diet may lead to adverse cardiovascular events. Population-based campaigns should increase the public awareness about the risks of high dietary salt and about the available measures to replace an unhealthy diet with a healthier one.

Assistant Professor Ghada Youssef, Cardiology Department, Kasr Al Ainy School of Medicine, Cairo University, Cairo, Egypt. Our mission: To reduce the burden of cardiovascular disease. Help centre Contact us. All rights reserved. Did you know that your browser is out of date?

To get the best experience using our website we recommend that you upgrade to a newer version. Learn more. Show navigation Hide navigation. Sub menu. e-Journal of Cardiology Practice.

Salt and hypertension: current views Vol. Ghada Sayed Youssef. Topic s : Hypertension. Introduction Salt, in addition to sugar, are known to be the notorious white killers.

The habit of high salt intake Salt consumption varies in different countries across the world, with the highest levels found in Northern China [4] and Japan where the daily salt intake exceeds 10 g and the lowest level found in an isolated tribe Yanomami Indians inhabiting the tropical equatorial rainforest of northern Brazil and southern Venezuela consuming as low as 0.

High salt-containing foods The words sodium and salt are not synonymous; salt which is commonly called table salt is a chemical compound consisting of sodium and chloride. Table 1. Examples of some high salt-containing foods.

Types of food Examples Meat Smoked, salted, or canned, bacon, frankfurters, sausage Fish Smoked, salted, or canned, sardines Poultry Smoked, salted, or canned Dairy Products Regular and processed cheese, cottage cheese Vegetables Regular canned vegetables and vegetable juices, olives, pickles Bakery Bread, biscuit, pancake, waffle mixes, pizza Sauces Tomato sauces, soy sauce, seasoning salt, and other sauces and marinades Pasta Processed mixes of pasta, commercially prepared pasta, cup of noodles Others Rice, salted nuts, carbonated beverages Salt and Hypertension Sodium is the main cation positively charged ion in the extracellular fluid while chloride is the main anion negatively charged ion.

There are many mechanisms that link high salt intake and hypertension: Water retention - this was explained by the classic concept of Guyton [12], who demonstrated that high salt intake leads to more water retention, which leads to an expansion in the circulating volumes, an increase in cardiac output, and a rise in kidney perfusion pressure.

When the kidney perfusion pressure is increased, the glomerular filtration rate increases and sodium excretion increases aiming to restore the fluid balance in the body. This physiological response to a high salt intake is called the pressure-natriuresis mechanism, Figure 1.

When the sodium excretory ability of the kidney is compromised, hypertension may develop [1]. Yet, some other studies showed that the circulating volumes and the cardiac output were similar among salt-sensitive and salt-insensitive individuals.

They explained these findings by the non-osmotic storage of sodium, meaning that sodium may be stored in the body without water retention [13]. Increase in systemic peripheral resistance as high sodium triggers remodelling in small resistant arteries - The effect of sodium on the vascular remodelling of small resistant arteries can occur both in normotensive as well as in hypertensive individuals.

It was found that the risk of developing hypertension was higher among salt-sensitive normotensive individuals when compared to salt-insensitive ones [1]. Endothelial dysfunction - it was found that high salt intake can cause marked reduction in the endothelial nitric oxide NO which is responsible for endothelium-dependent vascular dilatation.

Reduction of NO leads to not only elevation of blood pressure, but also to many blood pressure-independent cardiovascular complications [14]. Changes in the structure and function of large elastic arteries - it was found that high salt intake could affect the properties of large elastic arteries leading to an increase in vascular stiffness [15].

Modulation in the autonomic neuronal supply and the sympathetic activity of the cardiovascular system [1]. Figure 1. The pressure-natriuresis mechanism. Salt restriction and blood pressure reduction It has been shown that salt restriction can lower blood pressure, where a reduction of about 1.

Salt and antihypertensive medications A recent metanalysis showed that a calcium channel blocker combined with a hydrochlorothiazide were the most effective antihypertensive drugs in reducing blood pressure in salt-sensitive individuals [19].

Low salt intake: is it really dangerous? Sodium salt versus potassium salt Many studies have shown the direct relationship between high sodium and hypertension and the inverse relationship between high potassium and hypertension [11].

Current recommendations in different guidelines The International Society of Hypertension Global Hypertension Practice Guidelines recommend reducing the quantity of salt added when cooking and at the table, and to avoid or limit the consumption of high salt containing foods, such as fast foods, soy sauce and processed food including breads and cereals.

Plan of action A reduction in salt consumption should be a public health priority that requires collaborative efforts between governments, food manufacturers and the general population [2]. Conclusion High salt intake is deleterious to the cardiovascular system both in normo- as well as in hypertensive individuals.

References Grillo A, Salvi L, Coruzzi P, Salvi P, Parati G. Sodium Intake and Hypertension. J Hypertens. World Health Organization. Salt reduction Tan M, He FJ, Wang C, MacGregor GA. Twenty-Four-Hour Urinary Sodium and Potassium Excretion in China: A Systematic Review and Meta-Analysis.

J Am Heart Assoc. Rust P, Ekmekcioglu C. Impact of Salt Intake on the Pathogenesis and Treatment of Hypertension. Advances in experimental medicine and biology. Most sodium comes from processed and restaurant foods.

How to Reduce Sodium Intake. Sodium, Potassium and Health. Health Professional Resources. Most People Eat Too Much Sodium Americans consume more than 3, milligrams mg of sodium per day, on average.

Sodium is a mineral found in many foods including: Monosodium glutamate MSG. Sodium bicarbonate baking soda. Sodium nitrate a preservative.

View Larger. Download Image [JPG]. Last Reviewed: June 6, Source: National Center for Chronic Disease Prevention and Health Promotion , Division for Heart Disease and Stroke Prevention. Facebook Twitter LinkedIn Syndicate. home Sodium Intake and Health.

Because blood pressure can fluctuate, home monitoring and recording of blood pressure readings can provide your health care professional with valuable information to determine whether you really have high blood pressure and, if you do, whether your treatment plan is working.

High blood pressure can be a lifelong disease. By partnering with your health care team , you can successfully reach your treatment goals and enjoy the benefits of better health.

Written by American Heart Association editorial staff and reviewed by science and medicine advisors. See our editorial policies and staff. High Blood Pressure. The Facts About HBP. Understanding Blood Pressure Readings. Why HBP is a "Silent Killer".

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Play without Auto-Play Play Video Text. Knowing the facts can help you make smart choices. Myth: High blood pressure runs in my family. There is nothing I can do to prevent it. Myth: I use kosher or sea salt when I cook instead of regular table salt. They are low-sodium alternatives.

Myth: I feel fine. Myth: I read that wine is good for the heart, which means I can drink as much as I want. Even foods that may not taste salty can be major sources of sodium.

Americans consume more than 3, milligrams mg of sodium each day, on average. This is well above the Dietary Guidelines for Americans recommendation. Skip directly to site content Skip directly to search. Español Other Languages. Sodium, Potassium and Health.

Minus Related Pages. What We Eat in America, National Health and Nutrition Examination Survey, Page last reviewed: August 23, Content source: National Center for Chronic Disease Prevention and Health Promotion , Division for Heart Disease and Stroke Prevention.

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