Sodium, Blood Pressure, and Cardiovascular Disease

The relationship between sodium (Na) intake and human health indicators has been investigated in observational studies and randomized controlled trials (RCT). The most extensive body of information details the relationship between Na and blood pressure (BP). High BP was identified as the leading risk factor, among 67 studied, for worldwide mortality and disability adjusted life years1. It is also one of the best surrogate markers for cardiovascular disease (CVD), especially stroke1. Consistent with prior reports, three recent meta-analyses of RCT identified significant declines in BP following a reduction in Na intake3-5. The decrements in BP were greater in those with higher starting levels of BP, more successful intervention, older age, and African-American ethnicity. In the two meta-analyses with greatest relevance for clinical practice and public health, Na reduction was associated with a small but expected physiological increase in elements of the renin-angiotensin-aldosterone system3,4, little or no effect on total cholesterol3,4 or catecholamine levels3, and changes in urinary protein consistent with a beneficial effect on renal function3.