Effect of salt/ sodium intake on cardiovascular health

Cardiovascular Disease

• 'The evidence for adverse cardiovascular effects of sodium […] indicate an association of increased risk of morbidity and mortality from cardiovascular diseases with increasing sodium intake.'

• Because of the well-established relationship between blood pressure and cardiovascular disease outcomes,' there is moderate quality evidence that 'reduced sodium is beneficial for reducing risk of cardiovascular disease.'
• 'High and moderate-quality evidence that consuming <2 g sodium/day compared with consuming ≥2 g sodium/day is beneficial for reducing blood pressure and risk of cardiovascular disease […] in adults.'

• '… sodium intake is positively associated with an increased risk of stroke and cardiovascular events and mortality among the general adult population.'

• 'There are […] convincing data that high salt intake has an indirect effect on the risk of cardiovascular diseases, which is mediated by the level of blood pressure'.
• '…a direct associ­ation between high salt intake and the risk of cardiovascular diseases is not unambiguously clear. The evi­dence is disparate or even inconsis­tent, so that there is currently no unambiguous proof that high salt intake directly increases the risk of cardiovascular disease'.

• 'In aggregate, the data indicate a relationship between higher sodium intake and higher risk of CVD.'

Coronary Heart Disease

• '… an association of increased risk of morbidity and mortality from cardiovascular diseases, including coronary heart disease […], with increasing sodium intake.'

• 'Higher sodium intake was associated with higher risk of […] fatal coronary heart disease.'
• 'There was no association between sodium intake and […] non-fatal coronary heart disease.'
• 'High and moderate-quality evidence that consuming <2 g sodium/day compared with consuming ≥2 g sodium/day is beneficial for reducing […] risk of […] coronary heart disease in adults.'

Stroke

• 'The evidence for adverse cardiovascular effects of sodium […] indicate an association of increased risk of morbidity and mortality from cardiovascular diseases, including […] stroke, with increasing sodium intake.'

• 'Higher sodium intake was associated with higher risk of incident stroke [and] fatal stroke'
• 'High and moderate-quality evidence that consuming <2 g sodium/ day compared with consuming ≥2 g sodium/day is beneficial for reducing […] risk of […] stroke […] in adults.'

• '… sodium intake is positively associated with an increased risk of stroke and cardiovascular events and mortality among the general adult population.'

• Low strength evidence that 'higher dietary sodium intake is associated with a greater risk for fatal and nonfatal stroke.'

Blood pressure and hypertension

• '… strong evidence of a dose response relationship between increased consumption of sodium as sodium chloride and higher levels of systolic, diastolic and mean blood pressure'
• 'The major adverse effect of increased sodium intake is elevated blood pressure.'

• 'Reducing sodium intake significantly reduced systolic and diastolic blood pressure in adults and children.'
• 'Reducing sodium intake to <2 g/day was more beneficial for blood pressure than reducing sodium intake but still consuming >2 g/day.'

• 'There is convincing evidence of a causal link between high salt intake and hypertension and of the benefit of reducing salt intake at population level.'

• 'There is clear evidence that high salt intake increases the risk of suboptimal blood pressure values and hypertension.'

• 'There is a progressive dose-response relationship between sodium intake and blood pressure.'
• '… lower sodium intake will attenuate the usual age-related increase in blood pressure.'
• '… reduction of sodium decreases blood pressure and […] the effect is greater among hypertensive subjects.'

• High strength evidence that reducing sodium intake lowers blood pressure in adults.

• Strong evidence that sodium reduction is beneficial to maintaining a normal blood pressure and can lower blood pressure in hypertensive individuals.
• Adoption of the Dietary Approaches to Stop Hypertension (DASH) dietary pattern is effective in lowering blood pressure.

Serum lipids

• High-quality evidence that 'reducing sodium intake had no significant adverse effect on […] blood lipids.'

Effect of salt/sodium intake on cancer

• 'Consumption of foods preserved by salting is probably a cause of stomach cancer'.

• '… there is probable evidence for an association between salt intake and the risk of stomach cancer.'

Effect of salt/sodium intake on renal function

• 'Moderate-quality evidence that reduced sodium is consistent with a benefit to renal function in adults.'
• High-quality evidence that 'Reducing sodium intake had no significant adverse effect on […] renal function.'

• 'Several studies have indicated a positive relationship between sodium excretion and calcium excretion'. High intake of sodium might increase the risk of kidney stones.

Effect of salt/sodium intake on bone health

• 'Several studies have indicated a positive relationship between sodium excretion and calcium excretion and that sodium intake might play a role in the aetiology of osteoporosis.'

Other health effects of salt/sodium intake

• High-quality evidence that 'decreasing sodium has no harmful effect on catecholamine levels or any minor side effects (e.g. headache and dizziness) in adults.'