Hypertension is a leading risk factor for death and disability globally. High dietary salt intake is a major lifestyle risk factor that contributes to hypertension. Excessive sodium intake can increase blood pressure both acutely and chronically by various renal mechanisms. Multiple studies have shown that reducing salt intake lowers systolic blood pressure and the risk of cardiovascular diseases in a dose-dependent manner. International health organizations recommend limiting sodium intake to less than 2,300mg per day for general health benefits.

1. Role Of Salt In Hypertension

2. Hypertension :
A leading risk factor for death
and disability

4. Prevalence Of Hypertension In India
India: prevalence of hypertension by age and gender 2021 | Statista

5. Organ Damage Related To Hypertension

6. Lifestyle Risk Factors For Hypertension
• High dietary salt intake
• Obesity
• High alcohol intake
• Physical inactivity
• Smoking
• Inadequate vegetable and fruit intake
• Inadequate milk product intake

7. Does Salt Have Any Role In Hypertension?

8. Sodium Intake, Life Expectancy And All-Cause Mortality
European Heart Journal (2021) 42, 2013-2112, doi:10.1093/euheartj/ehaa947

9. Sodium Intake And Blood Pressure Values
BMJ1988 Jul 30; 297(6644): 319–328.
Mente A., O’Donnell M.J., Rangarajan S., McQueen M.J., Poirier P., Wielgosz A., Morrison H., Li W., Wang X., Di C.,
et al. Association of urinary sodium and potassium excretion with blood pressure. N. Engl. J. Med. 2014;371:601–
611. doi: 10.1056/NEJMoa1311989

10. Relationship Between High Salt Intake With Diet, Blood
Pressure And Arterial Stiffness

11. Hypertension And Salt-Sensitivity
It is a physiological trait present in rodents and other mammals,
including humans, by which the blood pressure (BP) of some members
of the population exhibits changes parallel to changes in salt intake

12. Renal Mechanisms For Salt Dependent Hypertension
• Acute high salt intake
- Renal retention of fluid blood pressure
• Chronic high salt Intake
- Resets renal threshold for salt excretion less salt excretion
- Peripheral resistance
- Subnormal vasodilation to salt load
Nat. Med. 2008 14:64

13. Causes Of Salt Sensitivity Of Blood Pressure
Intrauterine growth retardation
Low nephron mass
Renal diseases
Genetic abnormalities
Exogenous agents (e.g. DOCA)
Ageing- salt secretion

14. Lower Salt Reduces Systolic Blood Pressure
He FJ, MacGregor GA. J Hum Hyptens. 2002;16:761-70

15. Salt Induced Effects On Microvascular Function
Marketou ME, Maragkoudakis S, Anastasiou I, Nakou H, Plataki M, Vardas PE, Parthenakis FI. Salt-induced effects on microvascular function: A critical factor in hypertension mediated organ damage. J Clin
Hypertens (Greenwich). 2019 Jun;21(6):749-757. doi: 10.1111/jch.13535. Epub 2019 Apr 19. PMID: 31002481; PMCID: PMC8030330.

16. Role Of Salt And Gut Microbiota On The Regulation
Of Blood Pressure
Jose and Raij, Curr Opin Nephrol Hypertens 2015;24(5):403-9

17. International Target Recommendations For Sodium Intake

18. Mean Systolic Blood Pressure According To Sodium
Excretion In PURE Study
Mente et al, N Engl J Med 2014;371:601-11

19. Response of the Body to Step Changes in Salt Intake during
the Mars 105 and the Mars 520 Balance Studies
Rakova et al, Cell Metabolism. 2013, 17 (1): 125-131

20. Effects of low sodium diet versus high sodium diet on
blood pressure: a Cochrane analysis
Gradual et al. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Cochrane Database Syst Rev. 2017 Apr 9;4:CD004022

21. Effects of sodium reduction on systolic blood pressure in
randomized controlled trials, by age (103 trials)
Supplement to: Mozaffarian D, Fahimi S, Singh GM, et al. Global sodium consumption and death from
cardiovascular causes. N Engl J Med 2014;371:624-34.

22. Relation of Dietary Sodium (Salt) to Blood Pressure and Its
Possible Modulation by Other Dietary Factors: The
INTERMAP Study
Stamler J. et al. Hypertension. 2018;71:631-637

23. Mean Systolic and Diastolic Blood Pressure according to
Sodium and Potassium Excretion in the PURE Study.
Mente et al, NEJM, 2014

24. Salt intake and CV events in ONTARGET
O’Donnell, JAMA. 2011;306(20):2229-2238

25. The Effect on Systolic BP and Diastolic BP of Reduced
Sodium Intake and the DASH Diet.
Sacks et al, NEJM, 2001; Jan 4;344(1):3-10

26. Effect of sodium restriction on ambulatory BP in
patients with resistant hypertension
Pimenta, E. et al. Hypertension 2009;54:475-481

27. Therapeutic Approaches In Resistant Hypertension

28. Comparative Health Benefits of Physical Activity And Aalt
Reduction
Turner and Avolio. International Journal of Sport Nutrition and Exercise Metabolism, 2016, 26, 377 -389

29. Salt In Patients With Orthostatic Hypotension
Brignole et al, European Heart Journal (2018) 39, 1883–1948

30. Dietary Approaches To Stop Hypertension (DASH)

31. Conclusion
• Dietary salt is an important contributor to high blood pressure
• Reducing salt lowers blood pressure and prevents cardiovascular diseases
• Policies to reduce population-wide salt intake are most effective and can have a
high impact
• Healthcare professionals can play a key role in educating people of all ages
regarding their optimal dietary salt intake