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Salt and hypertension: what do we know?

DiNicolantonio, James, J.; O’Keefe, James, H.

Current Opinion in Cardiology: July 2018 - Volume 33 - Issue 4 - p 377–381
doi: 10.1097/HCO.0000000000000525
HYPERTENSION: Edited by Hector O. Ventura and Carl J. Lavie

Purpose of review To evaluate the evidence for population-wide sodium restriction.

Recent findings The recommendations for population-wide sodium restriction largely rely on one surrogate marker (blood pressure). However, recent evidence suggests that when looking beyond blood pressure (e.g. heart rate, aldosterone, renin, cholesterol, triglycerides, noradrenaline and adrenaline), the net effect of sodium restriction is likely harmful. Prospective studies support the notion that those consuming the lowest amounts of salt are at the highest risk of cardiovascular events and premature death.

Summary There is no definitive proof that sodium restriction reduces cardiovascular events or death. It is time for the dietary guidelines to look at the totality of the evidence and reconsider the advice around population-wide sodium restriction.

Saint Luke's Mid American Heart Institute, Kansas City, Missouri, USA

Correspondence to James J. DiNicolantonio, PharmD, Saint Luke's Mid American Heart Institute, 4321, Washington Street, Suite 2100, Kansas City, MO 64111, USA. Tel: +1 816 751 8480; fax: +1 816 751 8665; e-mail:

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