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Evidence Relating Sodium Intake to Blood Pressure and CVD

  • Global Cardiovascular Health (SC Smith, Section Editor)
  • Published:
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Abstract

Sodium is an essential nutrient, mostly ingested as salt (sodium chloride). Average sodium intake ranges from 3 to 6 g per day (7.5–15 g/day of salt) in most countries, with regional variations. Increasing levels of sodium intake have a positive association with higher blood pressure. Randomized controlled trials report a reduction in blood pressure with reducing sodium intake from moderate to low levels, which is the evidence that forms the basis for international guidelines recommending all people consume less than 2.0 g of sodium per day. However, no randomized trials have demonstrated that reducing sodium leads to a reduction in cardiovascular disease (CVD). In their absence, the next option is to examine the association between sodium consumption and CVD in prospective cohort studies. Several recent prospective cohort studies have indicated that while high intake of sodium (>6 g/d) is associated with higher risk of CVD compared to those with moderate intake (3 to 5 g/d), lower intake (<3 g/day) is also associated with a higher risk (despite lower blood pressure levels). However, most of these studies were conducted in populations at increased risk of cardiovascular disease. Current epidemiologic evidence supports that an optimal level of sodium intake is in the range of about 3–5 g/day, as this range is associated with lowest risk of CVD in prospective cohort studies. Randomized controlled trials, comparing the effect of low sodium intake to moderate intake on incidence of cardiovascular events and mortality, are required to truly define optimal intake range.

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Acknowledgments

Andrew Mente has a pending grant support from the Canadian Institutes of Health Research.

Compliance with Ethics Guidelines

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Conflict of Interest

Martin O’Donnell has received a grant support from Boehringer-Ingelheim, AstraZeneca and MSD, and has received payment for lectures including service on speakers’ bureaus from Boehringer-Ingelheim and Sanofi-Aventis.

Andrew Mente declares that he has no conflict of interest.

Salim Yusuf has received a grant support from Boehringer-Ingelheim, Servier, GlaxoSmithKline, King Pharma and AstraZeneca, and he has received payment for lectures including service on speakers’ bureaus from Boehringer-Ingelheim, Sanofi, Servier, GlaxoSmithKline, King Pharma and AstraZeneca.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Canada

    Martin O’Donnell, Andrew Mente & Salim Yusuf

  2. Population Health Research Institute, DBCVS Research Institute, McMaster University, 2nd Floor, Room C2-104, 237 Barton St East, Hamilton, ON, L8L 2X2, Canada

    Martin O’Donnell

  3. HRB Clinical Research Facility, National University of Ireland, Galway, Galway, Ireland

    Martin O’Donnell

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  1. Martin O’Donnell
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Correspondence to Martin O’Donnell.

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This article is part of the Topical Collection on Global Cardiovascular Health

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O’Donnell, M., Mente, A. & Yusuf, S. Evidence Relating Sodium Intake to Blood Pressure and CVD. Curr Cardiol Rep 16, 529 (2014). https://doi.org/10.1007/s11886-014-0529-9

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