Dietary salt and hypertension: a scientific issue or a matter of faith?
J. Ian S. Robertson MD FRCP FRSE
Formerly Consultant Physician, Medical Research Council Blood Pressure Unit, Western Infirmary, Glasgow, UK and Visiting Professor of Medicine, Prince of Wales Hospital, Chinese University of Hong Kong
Editor's note: since this article was accepted for publication, Johnson et al. (2002) have published a paper that develops in detail the notion of progressive subtle renal injury underlying the development of salt sensitivity in hypertension, several concepts of which are in accordance with the analysis and discussion presented herein.
A review of the long-term effects of dietary salt restriction in adult subjects has confirmed the modest antihypertensive effect. Systolic was lowered by a mean of 1.1 mmHg (95% CI 1.8–0.4); diastolic by a mean of 0.6 mmHg (1.5 to −0.3) at 13 to 60 months. Degree of reduction in sodium intake and change in blood pressure were not related (Hooper et al. 2002).
Dr J. Ian S. Robertson Elmbank Manse Road Bowling Glasgow G60 5AA UK
Many workers have an overly simplistic view of the relationship between salt intake and hypertension. This article attempts a critical evaluation of some of the evidence.