About this Resource
Decades of research has found that salt (i.e., sodium chloride) has a dose-dependent relationship with blood pressure — the higher the salt intake, the higher the systolic and diastolic blood pressure readings. This handout highlights the findings from an influential paper published in the New England Journal of Medicine which indicates that reducing daily salt intake from high (roughly 8 grams) to low (approximately 4 grams) can have a significant impact on blood pressure readings.
Grounded in the Research
“The association between dietary sodium intake and blood pressure (BP) is one of the most widely investigated and relevant issues for nutritionists and cardiovascular disease (CVD) epidemiologists. … However, the strength of the sodium–BP relationship has been challenged by some investigators, particularly in individuals without hypertension”
Excerpt from: Filippini, T., Malavolti, M., Whelton, P. K., Naska, A., Orsini, N., & Vinceti, M. (2021). Blood pressure effects of sodium reduction: dose–response meta-analysis of experimental studies. Circulation, 143(16), 1542-1567.
References
[1] Filippini, T., Malavolti, M., Whelton, P. K., Naska, A., Orsini, N., & Vinceti, M. (2021). Blood pressure effects of sodium reduction: dose–response meta-analysis of experimental studies. Circulation, 143(16), 1542-1567. https://doi.org/10.1161/CIRCULATIONAHA.120.050371
[2] Elijovich, F., Weinberger, M. H., Anderson, C. A., Appel, L. J., Bursztyn, M., Cook, N. R., … & Laffer, C. L. (2016). Salt sensitivity of blood pressure: a scientific statement from the American Heart Association. Hypertension, 68(3), e7-e46. https://doi.org/10.1161/HYP.0000000000000047
[3] Earle, W. B., Ormseth, G., Morales-Alvarez, M. C., Kaushik, M., & Juraschek, S. P. (2024). Dietary sodium reduction is best for reducing blood pressure: controversies in hypertension. Hypertension, 81(3), 510-515. https://doi.org/10.1161/HYPERTENSIONAHA.123.20544
[4] Spector, T. (2020). Spoon-Fed: Why almost everything we’ve been told about food is wrong. Random House.
[5] DiNicolantonio, J. (2020). The Salt Fix: Why the Experts Got It All Wrong and How Eating More Might Save Your Life. Harmony.
[6] He, F. J., & MacGregor, G. A. (2018). Role of salt intake in prevention of cardiovascular disease: controversies and challenges. Nature Reviews Cardiology, 15(6), 371-377. https://doi.org/10.1038/s41569-018-0004-1
[7] Sacks, F. M., Svetkey, L. P., Vollmer, W. M., Appel, L. J., Bray, G. A., Harsha, D., … & Cutler, J. A. (2001). Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. New England Journal of Medicine, 344(1), 3-10. https://doi.org/10.1056/nejm200101043440101
[8] Aburto, N. J., Ziolkovska, A., Hooper, L., Elliott, P., Cappuccio, F. P., & Meerpohl, J. J. (2013). Effect of lower sodium intake on health: systematic review and meta-analyses. BMJ, 346, f1326. https://doi.org/10.1136/bmj.f1326
[9] He, F. J., Li, J., & MacGregor, G. A. (2013). Effect of longer‐term modest salt reduction on blood pressure. Cochrane Database of Systematic Reviews, (4). https://doi.org/10.1002/14651858.CD004937.pub2
[10] Graudal, N., Jürgens, G., Baslund, B., & Alderman, M. H. (2014). Compared with usual sodium intake, low-and excessive-sodium diets are associated with increased mortality: a meta-analysis. American Journal of Hypertension, 27(9), 1129-1137. https://doi.org/10.1093/ajh/hpu028
[11] Johnson, C., Raj, T. S., Trieu, K., Arcand, J., Wong, M. M., McLean, R., … & Webster, J. (2016). The science of salt: a systematic review of quality clinical salt outcome studies June 2014 to May 2015. The Journal of Clinical Hypertension, 18(9), 832-839. https://doi.org/10.1111/jch.12877