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Education And Debate

Intersalt: hypertension rise with age revisited

BMJ 1996; 312 doi: (Published 18 May 1996) Cite this as: BMJ 1996;312:1283
  1. Richard L Hanneman, presidenta
  1. a Salt Institute, 700 North Fairfax Street, Alexandria, VA 22314-2040, USA
  • Accepted 12 February 1996

This article comes from the Salt Institute, the trade organisation of salt producers. It is a reanalysis of some of the data of the Intersalt study published in the BMJ in 1988. A much larger reanalysis of the study by the original authors is published on p 1249. We have published this paper from the Salt Institute because it is an interesting exampleof how special interest groups use data to advance their position. The paper is followed by highly critical commentaries from Malcolm Law, an epidemiologist who was not part of the Intersalt team, and by the authors of the Intersalt study. An editorial by Thelle reviews the current evidence on salt and health, while Godlee looks at the politics of the food industry and health promotion and Delamothe examines who owns data produced from large trials.

The 30 July 1988 issue of the BMJ contained the primary publication of the Intersalt study, as well as an editorial by Professor John Swales that provided important notes of caution about the interpretation of the findings in terms of salt's role in the aetiology of high blood pressure.1 2 Intersalt was an important epidemiological investigation of the relation of sodium intake, as reflected by urinary sodium excretion and blood pressure. As stated in the article's abstract, Intersalt could not identify an association between urinary sodium excretion and either mean blood pressure or the prevalence of hypertension. These two conclusions were strong evidence that, in contrast to widely held earlier beliefs, salt consumption was not predictive of increased blood …

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