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(Hypertension. 2004;44:609.)
© 2004 American Heart Association, Inc.

Hypertension Highlights

More on the Sodium Saga

From the Indiana University School of Medicine, Indianapolis.

Correspondence to Myron Weinberger, MD. Professor of Medicine, Indiana University School of Medicine, 541 Clinical Building, Room 423, Indianapolis, IN 46202. E-mail mweinbe@IUPUI.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The relationship between sodium (salt) intake and blood pressure has been convincingly established by epidemiological, observational, interventional, physiological, and some genetic evidence for some time. Yet the interaction remains the subject of passionate and heated debate. Even among those who are convinced of the salt–blood pressure interaction, some advocate a population-wide attempt to reduce dietary salt intake, arguing on the basis of epidemiological and interventional evidence, and others who suggest that such interventions should be targeted toward those most likely to benefit: the "salt-sensitive" subpopulation. Studies have characterized such subgroups on the basis of higher blood pressure, increased age or African-American ethnicity.¹ The issue is rendered even more compelling by the findings that salt sensitivity can be identified among "normotensive" subjects (ie, those with blood pressure <140/90) as well as those with hypertension¹ and the designation of those with blood pressure levels between 120 and 139 mm Hg systolic and 80 and 89 diastolic as prehypertensive² and at increased risk for development of fixed hypertension and for cardiovascular events compared with those with lower blood pressure.³

Observational data have provided a starting point for the quantitative considerations of dietary salt intake. The most recent (1999–2000) NHANES survey provides an estimated dietary sodium intake based on food records, excluding discretionary sodium, of 135 to 204 mmol per day for men and 100 to 135 mmol per day for women in the United States.⁴ Questionnaires are acknowledged to underestimate actual intake, and urinary sodium excretion has been shown to provide a more . . . [Full Text of this Article]

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