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BMJ 2010; 340 doi: http://dx.doi.org/10.1136/bmj.c441 (Published 26 January 2010) Cite this as: BMJ 2010;340:c441

Controlling salt intake would saves lives and cut costs

A regulatory intervention that reduced the salt intake of US adults by 3 g a day would save between $10bn (£6.2bn; €7.1bn) and $24bn a year in healthcare costs, through reductions in blood pressure and knock-on reductions in rates of coronary heart disease (including heart attacks) and strokes, according to recent projections. It would also save between 44 000 and 92 000 lives a year, with benefits across all age groups and in both sexes.

These estimates come from a computer simulation that made key assumptions about the link between salt intake and blood pressure, and about the cardiovascular benefits of lower blood pressure, informed by randomised trials and other published data. The assumptions were tested in a series of sensitivity analyses that confirmed the main findings: even modest reductions in salt intake achieved over the next decade or so would prevent morbidity from cardiovascular disease, prolong lives, and save money.

The simulations suggest that controlling dietary salt would be as good for public health as controlling obesity, reducing smoking, and giving antihypertensive drugs to everyone with hypertension.

Adults in the US eat a lot of processed foods packed with salt. The average daily intake for men was 10.4 g in 2006—almost twice the recommended allowance (maximum of 5.8 g), and well over twice the intake recommended for adults over 40, black people, and anyone with hypertension (3.7 g). The authors and a linked editorial (doi:10.1056/nejme0910352) agree that urgent action is needed, starting with policies to control the salt content in everyday processed foods.

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