Intended for healthcare professionals


Salt and cardiovascular disease

BMJ 2007; 334 doi: (Published 26 April 2007) Cite this as: BMJ 2007;334:859
  1. Francesco P Cappuccio, chair of cardiovascular medicine and epidemiology
  1. Warwick Medical School, Coventry
  1. cvme{at}

    Reducing intake improves cardiovascular outcomes but few countries have effective policies

    Blood pressure is the most powerful predictor of stroke and other cardiovascular events. The importance of salt (sodium chloride) intake in determining blood pressure and the incidence of hypertension is well established. Furthermore, randomised controlled clinical trials of moderate reductions in salt intake show a dose dependent cause-effect relation and lack of a threshold effect within usual levels of salt intake in populations worldwide.1 The effect is independent of age, sex, ethnic origin, baseline blood pressure, and body mass.

    Prospective studies,2 3 4 5 with one exception,6 also indicate that higher salt intake predicts the incidence of cardiovascular events. While widespread support exists for reducing salt intake to prevent cardiovascular disease, the lack of large and long randomised trials on the effects of salt reduction on clinical outcomes has encouraged some people to argue against a policy of salt reduction in populations.6

    In this week's BMJ, Cook and colleagues …

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