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International Journal of Epidemiology 2002;31:311-316
© International Epidemiological Association 2002

Point-Counterpoint

Salt, blood pressure and health: a cautionary tale

Michael H Alderman

Albert Einstein College of Medicine, Department of Epidemiology & Social Medicine, 1300 Morris Park Avenue, Bronx, New York 10461, USA. E-mail: alderman@aecom.yu.edu

By virtue of its central role in maintaining intravascular and extracellular volume, sodium is essential to human survival. Taste, habit, environment, genes, and behaviour probably all influence sodium intake. In view of the heterogeneity that characterizes humankind, it is remarkable that the vast majority of the world's citizens, everywhere, given free access to salt, consume between 100 and 200 mmol of sodium per 24 hours.1 Despite this uniformity of sodium intake across all dietary, cultural, environmental, and hereditary circumstances, and the fact that life spans that are steadily increasing worldwide, many authorities now contend that current salt intake is too high by half.

Advocates of universal restriction of sodium intake to <100 mmol/24-h base their case on the belief that this will produce a population-wide reduction of blood pressure which, in turn, will reduce cardiovascular morbidity and mortality. There is even stronger enthusiasm for strict control of sodium intake for . . . [Full Text of this Article]

The Link of Salt to Blood Pressure

Observational Studies of Sodium and Blood Pressure

Experimental Studies of Sodium and Blood Pressure

Other Effects of Sodium Reduction

The Overall Health Effects of Sodium Restriction

What Further Data are Needed

Conclusions

References


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