People should continue to lower their sodium intake to improve their health despite new research questioning the effectiveness of large-scale sodium-reduction efforts, said Elliott Antman, M.D., the president-elect of the American Heart Association.

Significant research shows too much sodium can increase blood pressure and risks for heart disease, stroke and other health problems, and that’s the important message people need to remember, Antman said. 

“In the United States, we have solid evidence that reducing daily sodium intake is an effective way to lower your blood pressure,” Antman said.

The authors of the new study, released this week at the European Society of Cardiology Congress in Amsterdam, said they found North Americans consume between 4,200 and 4,800 milligrams of sodium per day, similar to sodium consumption in Europe, South Asia, Africa and South America. They also found that just 3.1 percent of study subjects consumed 2,300 milligrams a day and less than 1 percent of the subjects took in the American Heart Association-recommended 1,500 milligrams.

“Saying that most people are consuming more than the recommended levels of sodium does not justify giving up on our efforts,” Antman said. “In fact, the study is in line with other research showing that reduced sodium in the diet is associated with lower blood pressure.”

In some people, sodium increases blood pressure because it holds excess fluid in the body, creating an added burden on the heart. Too much sodium in the diet may also have other harmful health effects, including increased risk for stroke, heart failure, osteoporosis, stomach cancer and kidney disease.

The study, known as the PURE-Sodium trial, examined sodium intake in relation to blood pressure in nearly 100,000 men and women ages 35 to 70 from 628 rural and urban communities in 17 countries.

The study authors said their analysis showed that an increase in sodium consumption was associated with an increase in systolic blood pressure. A 1,000-milligram increase in sodium consumption was associated with systolic blood pressure increases of 2.7 points for those consuming 5,000 milligrams or more, 1.7 points for those consuming 3,000-5,000 milligrams and 1.1 points for those consuming less than 3,000 milligrams.

But the authors concluded that systolic blood pressure response was important for some people with hypertension – those who are elderly and those consuming more than 5 grams a day of sodium – but not all subjects. They recommended that it would be better to target strategies at specific groups rather than entire populations.

Even if sodium reduction strategies were targeted to those most affected — people with hypertension, who are elderly or consume above 5,000 milligrams a day — they still apply to millions of people worldwide, said Emily Ann Miller, who heads the sodium reduction initiative for the American Heart Association.

“Furthermore, one-third of Americans have high blood pressure, approximately 90 percent of all Americans will develop hypertension over their lifetime, and people who don’t currently have high blood pressure will benefit from following the recommendation to consume less than 1,500 milligrams of sodium daily,” she said. “Less sodium in the diet will significantly blunt the rise in blood pressure that occurs as we age, and will also reduce the risk of developing other conditions associated with excess sodium consumption.”

A recent report from the Centers for Disease Control and Prevention supports national efforts such as those of the American Heart Association to lower blood pressure through sodium restriction, recognizing the need for sodium reduction in schools, restaurants and other locations. The report said that nearly one in four deaths from cardiovascular disease is preventable and control of blood pressure through reductions in sodium intake is helpful advice for patients to follow.

For more information:

American Heart Association on sodium 

American Heart Association scientific statement: Cutting Sodium to Prevent CVD and Stroke



Image courtesy of Carlos Porto /