How low salt reduction okay for CVD prevention ?

There exists a strong evidence about the reduction of salt intake being associated with lowered blood pressure and reduced risk of cardiovascular disease (CVD).

In this study, Feng J. He and Graham A. MacGregor, from Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK, conducted a review of the previous studies that defined the relationship between decreased salt intake and reduced risk of cardiovascular disease.

The study was published in the journal Nature Reviews Cardiology.

Several studies, including cohort studies, have challenged the WHO's global target of reducing the population salt intake from the current level of approximately 10 g daily to <5 g daily. These studies indicate a J-shaped relationship between CVD risk and salt intake. However, these studies had severe methodological problems such as reverse measurement and causality error due to salt intake assessment by spot urine. Consequently, findings referred by these studies cannot be used for determining the public health policy.

WHO recommendation of gradual, stepwise salt reduction remains an important, effective and affordable strategy for prevention of CVD worldwide. But seeking the ways to reduce population salt intake is still a challenge. In most developed countries, the salt reduction can be achieved by a gradual and sustained reduction in the amount of salt added to food by the food industry. The UK has pioneered a successful salt-reduction programme by setting incremental targets for >85 categories of food; many other developed countries are following the UK’s lead. Public health campaigns have a major role in developing countries where most of the salt is added by consumers. Every country should adopt a coherent, workable strategy. Even a modest reduction in salt intake across the whole population can lead to a major improvement in cost savings and public health.

Key Takeaways from the Study:

• Salt reduction causes a dose-dependent reduction in blood pressure: within the range of 3–12 g daily, the lower the salt intake, the lower the blood pressure.


• Prospective cohort studies with salt intake measured by multiple 24-h urine collections demonstrate a direct linear relationship between cardiovascular events and all-cause mortality, down to a daily salt intake of 3 g.


• The totality of the evidence strongly supports a population-wide reduction in salt intake; paradoxical J-shaped findings from studies with methodological problems should not derail action to reduce salt consumption.


• Every country should implement a strategy to reduce daily salt intake to the WHO target of 5 g; this action will result in major public health improvements and cost savings.

For further information click on the link: 10.1038/s41569-018-0004-1