To review the evidence that relates salt intake to blood pressure and cardiovascular disease.
Raised blood pressure throughout the range seen in developed countries is the major cause of cardiovascular disease, responsible for 62% of strokes and 49% of coronary heart disease. There is overwhelming evidence that dietary salt is a major cause of raised blood pressure, and a modest reduction in salt intake lowers blood pressure, which is predicted to reduce cardiovascular disease. Several lines of evidence including ecological, population and prospective cohort studies, as well as follow-up studies of individuals who participated in short-term salt reduction trials, have consistently shown a direct relation between salt intake and cardiovascular risk, and a reduction in population salt intake is associated with a reduction in cardiovascular mortality in the population.
The evidence for universal salt reduction is strong, and reducing salt from the current intake of 10–12 g/day to the recommended level of 5–6 g/day will have a major effect on blood pressure and cardiovascular mortality. Additionally, this will result in considerable savings on health expenditure as, not only is raised blood pressure the biggest cause of death, but the second biggest cause of disability worldwide.
Blood Pressure Unit, Cardiac and Vascular Sciences, St George's University of London, London, UK
Correspondence to Professor Graham A. MacGregor, Blood Pressure Unit, Cardiac and Vascular Sciences, St George's University of London, Cranmer Terrace, London SW17 0RE, UK Tel: +44 20 8725 5774; fax: +44 20 8725 2959; e-mail: firstname.lastname@example.org