January 23, 2008

Does Salt Affect Blood Pressure?

My doctor told me to cut back on salt because I have a family history of high blood pressure, and my pressure is borderline high. Is salt the problem, or my genetic makeup?

Nearly half of the cardiovascular deaths worldwide are caused by high blood pressure. Approximately 16.7 million die each year from cardiovascular problems,1 and 8 million of these are because of high blood pressure.2 This is more than double the number dying as a result of AIDS.
It has been estimated that more than 26 percent of the world’s population has hypertension. Salt has been directly implicated in these large numbers of hypertension.
Some salt is essential in the diet, and Ellen White recognized this in advising a reduction in its consumption but not its elimination from the diet. Today, one should purchase iodinated salt because iodine, in some areas, is not adequately present in the food stuffs one eats.
The recommendation of the U.S. National Heart, Lung, and Blood Institute’s National High Blood Pressure Education Program is a sodium intake of fewer than 2,400 milligrams per day. This is not very much! Only about 20 percent of the population takes this little.3
2008 1503 page16In June 2006 the Council on Science and Public Health of the American Medical Association detailed the harm associated with excess sodium intake and recommended a 50 percent reduction of salt in processed and restaurant foods.
The United Kingdom, Finland, Australia, and New Zealand have all addressed the problem of excessive sodium (salt) intake.
Sodium is found in large amounts in soy sauce, pizza, frozen pot pies, spaghetti sauce, and tomato juice. Sausage—both vegetarian and regular—has high sodium, as do many processed vegetarian meat analogs. Breakfast cereals, and even bread, should be watched for sodium content. Read the labels! Cheese is often loaded with salt.
Your doctor is giving you great advice! It doesn’t really matter whether you are predisposed genetically or not to high blood pressure, excess sodium will be an independent hazard. So watch that salt shaker—we are getting far too much of what, in tiny amounts, is a good thing.
It has been estimated that a 50 percent reduction in sodium intake would result in a 5 percent lowering of blood pressure—and this would mean a 20 percent lower prevalence of hypertension. Mortality rates from coronary heart disease would drop 9 percent; stroke, 14 percent; and death from all causes, 7 percent.
Perhaps these do not seem like large numbers to you, but when one considers the huge numbers of people involved, we are talking massive reductions in death rates. Havas et al., in the American Journal of Public Health, 2004:94(1):19-22, estimated that cutting sodium by 50 percent could save 150,000 lives a year in the United States alone.
It’s time we all—ourselves included!—cut down on our salt.
1Mackay et al., The Atlas of Heart Disease and Stroke, Geneva, Switzerland, WHO 2004.
2Lopez et al., “Global and Regional Burden of Disease and Risk Factors, 2001: Systematic Analysis of Population Health Data,” Lancet, 2006; 367(9524): pp. 1747-1757.
3Havas, Dickinson, and Wilson, “The Urgent Need to Reduce Sodium Consumption,” JAMA, Sept. 26, 2007, vol. 298, no. 12, p. 1439.
Allan R. Handysides, M.B., Ch.B., FRCPC, FRCSC, FACOG, is director of the General Conference Health Ministries Department; Peter N. Landless, M.B., B.Ch., M.Med., F.C.P.(SA), F.A.C.C., is ICPA executive director and associate director of Health Ministries.