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(Hypertension. 2006;48:818.)
© 2006 American Heart Association, Inc.

Editorial Commentaries

Salt Reduction for Preventing Hypertension and Cardiovascular Disease

A Population Approach Should Include Children

Jeffrey A. Cutler; Edward J. Roccella

From the Division of Epidemiology and Clinical Applications and the Office of Prevention, Education, and Control, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md.

Correspondence to Jeffrey A. Cutler, 6701 Rockledge Dr, MSC-7938, Bethesda, MD 20892. E-mail cutlerj@nhlbi.nih.gov

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

Many lines of investigation have led to overwhelming evidence for a causal relationship between dietary salt intake and blood pressure levels in adults. Importantly, these include numerous randomized clinical trials of salt reduction that have been the subject of several meta-analyses.¹ In children age 2 years, a previous review of 37 observational and intervention studies concluded, "the results suggest that higher sodium intake is related to higher BP in children and adolescents."² He and MacGregor³ have now conducted the first meta-analysis of salt reduction trials in children and adolescents and have clearly demonstrated that "modest reduction in salt intake causes immediate falls in blood pressure." They conclude that such effects "if continued, may well lessen the subsequent rise in blood pressure with age."

One may ask, why does any of this matter? The reductions in blood pressure were modest, and no hard disease end point results were documented. The importance is based on 3 relationships: (1) the moderately strong correlation of blood pressure in childhood with blood pressure in adulthood⁴; (2) the association of blood pressure with early atherosclerosis during the second decade of life⁵; and (3) intriguing evidence for a specific early programming effect between salt intake in infancy and blood pressure later in life.⁶ The latter relationship is supported by experimental evidence in animal models, but more research is needed.

Furthermore, in virtually every population throughout the world except those totally unacculturated to an industrialized lifestyle, blood pressure rises with increasing age. This results in rising . . . [Full Text of this Article]

Related Article:

Importance of Salt in Determining Blood Pressure in Children: Meta-Analysis of Controlled Trials

Feng J. He and Graham A. MacGregor
Hypertension 2006 48: 861-869. [Abstract] [Full Text] [PDF]

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				S. Havas, B. D. Dickinson, and M. Wilson The Urgent Need to Reduce Sodium Consumption JAMA, September 26, 2007; 298(12): 1439 - 1441. [Full Text] [PDF]