# Is there any proof that salt is related to hypertension? **URL:** \ **Category:** Factual Questions\ **Created:** [October 24, 2010, 3:34pm UTC](https://boards.straightdope.com/t/is-there-any-proof-that-salt-is-related-to-hypertension/558190 "2010-10-24T15:34:58Z")\ **Posts on this page:** 14\ **Page:** 3
**Author:** ![Ferret\_Herder](https://avatars.discourse-cdn.com/v4/letter/f/e47774/32.png) [@Ferret\_Herder](https://boards.straightdope.com/u/Ferret_Herder)\ **Post date:** [November 19, 2011, 3:40am UTC](https://boards.straightdope.com/t/is-there-any-proof-that-salt-is-related-to-hypertension/558190/41 "2011-11-19T03:40:55Z")
Excellent, I’m good in both cases. Haven’t been faint-headed since high school or so. Oh, and my husband’s doctor started him on a reduced sodium, weight-reduction diet first, before adding antihypertensives. He’s doing great now with that combination. ---
**Author:** ![aruvqan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aruvqan/32/2891_2.png) [@aruvqan](https://boards.straightdope.com/u/aruvqan)\ **Post date:** [November 19, 2011, 1:27pm UTC](https://boards.straightdope.com/t/is-there-any-proof-that-salt-is-related-to-hypertension/558190/42 "2011-11-19T13:27:22Z")
I drive my cardiologist nuts - I rarely eat convenience foods, my allergies generally prevent me from using most convenience crap [palm oils, ‘natural flavors’ frequently have mushroom powder - plus they tend to taste like crap] and I can’t do diuretics [they tend to trigger flares in my psudogout] so he can’t make me change my diabetic nutritionist mandated diet, nor give me diuretics, and the joint problems seriously restrict the exercises I can do since I do not have access to a swimming pool nor will Tri-Care authorize more than 18 PT sessions per year nor do I really have access for transport to go the 30 miles to get to the Navy base so I could use the pool there for 50 cents per day/swim session. I really need a clone body [or to be popped into a [pod](http://en.wikipedia.org/wiki/Brainship)] _sigh_ ---
**Author:** ![KarlGauss](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/karlgauss/32/3713_2.png) [@KarlGauss](https://boards.straightdope.com/u/KarlGauss)\ **Post date:** [November 19, 2011, 6:52pm UTC](https://boards.straightdope.com/t/is-there-any-proof-that-salt-is-related-to-hypertension/558190/43 "2011-11-19T18:52:16Z")
> [@Hirka\_T\_Bawa](#): > > A MAP of 60mmHg is normally considered good enough to avoid problems with a low BP. > > **KarlGauss** , is that basically correct? I learned that during my Internal Med rotation, and it was the rule the MD’s there used. Though, that was with really sick patients, so the “if symptomatic” approach wouldn’t work. That sounds like a pretty good rule of thumb. In fact, and as an example, I would have said that, symptoms or not, if your BP is less than 80/50, it’s probably too low. Well, note that the MAP for an individual with a BP of 80/50 is exactly 60. So it all seems consistent. As an aside, a formula for the MAP which is pretty accurate and relatively easy to use is: MAP = 1/3 of (systolic + 2 X diastolic) or equivalently, MAP = 1/3 systolic + 2/3 diastolic > [@](#): > > Hirka T’Bawa, PharmD. Well done!! ---
**Author:** ![gazpacho](https://avatars.discourse-cdn.com/v4/letter/g/6f9a4e/32.png) [@gazpacho](https://boards.straightdope.com/u/gazpacho)\ **Post date:** [November 19, 2011, 7:29pm UTC](https://boards.straightdope.com/t/is-there-any-proof-that-salt-is-related-to-hypertension/558190/44 "2011-11-19T19:29:33Z")
> [@Qadgop\_the\_Mercotan](#): > > Me too. Though I got some free pens a few times. Cheap ones, but free. > > Also a viagra-shaped stress ball. :dubious: My sister used to work for Phizer so the whole family got viagra tee shirts and the viagra stress balls. ---
**Author:** ![Oy](https://avatars.discourse-cdn.com/v4/letter/o/bc8723/32.png) [@Oy](https://boards.straightdope.com/u/Oy)\ **Post date:** [November 19, 2011, 8:06pm UTC](https://boards.straightdope.com/t/is-there-any-proof-that-salt-is-related-to-hypertension/558190/45 "2011-11-19T20:06:40Z")
> [@WhyNot](#): > > No one, simply no one, is actually \*deficient \*in sodium in our culture unless they’ve got some really rare disorder. Even “hyponatremia” (low serum sodium level) is not because of too little sodium, but because of too much water in the blood making the sodium hang out in the wrong place in the body. Ahem. I have been warned multiple times by my doctor that my sodium level was dangerously low (as in, get drinking Gatorade right _now_ and go to the hospital immediately if you feel bad or peculiar in any way!). This has in fact been triggered by the fact that I drink a lot of fluids, and I don’t use air conditioning, so if the weather is hot, I perspire a great deal. The treatment, however, has in fact been to consume more salt. For me, it has been easiest to achieve this via salt tablets. It took me a long time to realize that I didn’t have some bizarre kind of kidney damage, and that this was triggered by a combination of drinking a lot of fluids, ambient heat, and a diet not particularly high in salt. But it is definitely possible, at least for some of us, to not eat enough salt. ---
**Author:** ![Surreal](https://avatars.discourse-cdn.com/v4/letter/s/eada6e/32.png) [@Surreal](https://boards.straightdope.com/u/Surreal)\ **Post date:** [May 16, 2013, 7:13pm UTC](https://boards.straightdope.com/t/is-there-any-proof-that-salt-is-related-to-hypertension/558190/46 "2013-05-16T19:13:33Z")
Update: the Institute of Medicine recently analyzed actual outcomes data (not some silly computer simulation) and found no evidence to support the notion that dropping sodium intake below 2,300 mg/day was beneficial. [http://www.nytimes.com/2013/05/15/health/panel-finds-no-benefit-in-sharply-restricting-sodium.html?pagewanted=all&\_r=0](http://www.nytimes.com/2013/05/15/health/panel-finds-no-benefit-in-sharply-restricting-sodium.html?pagewanted=all&_r=0) > [@](#): > > But the new expert committee, commissioned by the Institute of Medicine at the behest of the Centers for Disease Control and Prevention, said there was no rationale for anyone to aim for sodium levels below 2,300 milligrams a day. The group examined new evidence that had emerged since the last such report was issued, in 2005. > > “\*\*As you go below the 2,300 mark, there is an absence of data in terms of benefit and there begin to be suggestions in subgroup populations about potential harms,” \*\*said Dr. Brian L. Strom, chairman of the committee and a professor of public health at the University of Pennsylvania. He explained that the \*\*possible harms included increased rates of heart attacks and an increased risk of death. \*\* > [@](#): > > One 2008 study the committee examined, for example, randomly assigned 232 Italian patients with aggressively treated moderate to severe congestive heart failure to consume either 2,760 or 1,840 milligrams of sodium a day, but otherwise to consume the same diet.\*\* Those consuming the lower level of sodium had more than three times the number of hospital readmissions — 30 as compared with 9 in the higher-salt group — and more than twice as many deaths \*\*— 15 as compared with 6 in the higher-salt group. > > Another study, published in 2011, followed 28,800 subjects with high blood pressure ages 55 and older for 4.7 years and analyzed their sodium consumption by urinalysis. **The researchers reported that the risks of heart attacks, strokes, congestive heart failure and death from heart disease increased significantly for those consuming more than 7,000 milligrams of sodium a day and for those consuming fewer than 3,000 milligrams of sodium a day**. > > There are physiological consequences of consuming little sodium, said Dr. Michael H. Alderman, a dietary sodium expert at Albert Einstein College of Medicine who was not a member of the committee. As sodium levels plunge, triglyceride levels increase, insulin resistance increases, and the activity of the sympathetic nervous system increases. Each of these factors can increase the risk of heart disease. > > “Those are all bad things,” Dr. Alderman said. “A health effect can’t be predicted by looking at one physiological consequence. There has to be a net effect.” ---
**Author:** ![Smeghead](https://avatars.discourse-cdn.com/v4/letter/s/f1d935/32.png) [@Smeghead](https://boards.straightdope.com/u/Smeghead)\ **Post date:** [May 16, 2013, 7:27pm UTC](https://boards.straightdope.com/t/is-there-any-proof-that-salt-is-related-to-hypertension/558190/47 "2013-05-16T19:27:29Z")
Duly noted that this is a zombie, and fair warning that this post is only tangentially related. End disclaimer. One interesting fact I learned from that book about the history of salt - I forget the title - Salt, A History, perhaps? - - is that modern people are actually consuming record low amounts of salt compared to most of human history. This is thanks to the invention of refrigeration and canning, which means we are no longer dependent on preserving food through salting, which was just about the only option for most of that time. Carry on. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [May 16, 2013, 9:42pm UTC](https://boards.straightdope.com/t/is-there-any-proof-that-salt-is-related-to-hypertension/558190/48 "2013-05-16T21:42:46Z")
Dunno how I missed this one last time around, so…howdy, zombie **Oy!** > [@Oy](#): > > It took me a long time to realize that I didn’t have some bizarre kind of kidney damage, and that this was triggered by a combination of drinking a lot of fluids, ambient heat, and a diet not particularly high in salt. But it is definitely possible, at least for some of us, to not eat enough salt. Or you’re consuming the right amount of sodium while you’re consuming excess fluids. Tomato, tomahto, I suppose. I’d be quicker to recommend reducing fluid intake to a normal level, rather than raising the sodium intake. Not 'cause I’m a askeered of sodium (I’m not) but because you’re making your kidneys work extra hard to process all that excess fluid you’re drinking, to no benefit. But, of course, you should listen to your doctor, not some random pixels on the internet. For all you know, I’m an exceptionally literate golden retriever. Woof. 🙂 ---
**Author:** ![rsat3acr](https://avatars.discourse-cdn.com/v4/letter/r/a3d4f5/32.png) [@rsat3acr](https://boards.straightdope.com/u/rsat3acr)\ **Post date:** [May 16, 2013, 9:47pm UTC](https://boards.straightdope.com/t/is-there-any-proof-that-salt-is-related-to-hypertension/558190/49 "2013-05-16T21:47:50Z")
I take all those reports with a grain of salt. Sorry couldn’t resist. ---
**Author:** ![KarlGauss](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/karlgauss/32/3713_2.png) [@KarlGauss](https://boards.straightdope.com/u/KarlGauss)\ **Post date:** [May 16, 2013, 11:34pm UTC](https://boards.straightdope.com/t/is-there-any-proof-that-salt-is-related-to-hypertension/558190/50 "2013-05-16T23:34:55Z")
nm (for now) ---
**Author:** ![KarlGauss](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/karlgauss/32/3713_2.png) [@KarlGauss](https://boards.straightdope.com/u/KarlGauss)\ **Post date:** [May 17, 2013, 2:19am UTC](https://boards.straightdope.com/t/is-there-any-proof-that-salt-is-related-to-hypertension/558190/51 "2013-05-17T02:19:54Z")
1. > [@WhyNot](#): > > Or you’re consuming the right amount of sodium while you’re consuming excess fluids. But, if someone is consuming excess fluids, everything else being equal, they will pee out the excess water and wind up with a normal sodium concentration. Only if they’re taking in 10 or 12 liters per day of water, or more, can someone “dilute down” their blood sodium level (a bit more on this below). 2. By and large, if someone is unable to pee out excess water, and thus winds up with a low blood sodium level (hyponatremia), it is virtually diagnostic of there being too much [ADH](http://en.wikipedia.org/wiki/Adh) (with ADH being the hormone that regulates body water, for those not familiar with it). Phrasing it slightly differently: Hyponatremia indicates too much water. Too much water indicates high levels of ADH. So, when I encounter a patient with hyponatremia, a key part of my job is to determine why their ADH levels are high. The body may produce high levels of ADH for many reasons including (but definitely not limited to): - inadequate salt (sodium) intake or excess salt loss _by virtue of the low blood volume which both cause_, but NOT from salt (sodium) lack _per se_. The low blood volume stimulates ADH; indeed, low blood volume for whatever reason stimulates ADH - pain, nausea - many medications (most antidepressants of all categories, opiates, anticonvulsants, chemotherapy, . . . ) - lung disease (such as pneumonia, abscess, cancer, . . . ) - brain disease (including meningitis) Rarely, blood sodium (salt) levels can be low even in the absence of too much ADH. The two prototypes for this are 1. ingesting HUGE quantities (over 10 L per day) of water, and 2. protein malnutrition (each of these for complicated reasons that I can elaborate on if anyone is interested). ---
**Author:** ![FoieGrasIsEvil](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foiegrasisevil/32/16638_2.png) [@FoieGrasIsEvil](https://boards.straightdope.com/u/FoieGrasIsEvil)\ **Post date:** [May 17, 2013, 3:29am UTC](https://boards.straightdope.com/t/is-there-any-proof-that-salt-is-related-to-hypertension/558190/52 "2013-05-17T03:29:19Z")
Great. I’m dying, apparently. My diet sucks, I drink too much alcohol, I smoke and my blood pressure last I checked was something like 160/95 and I don’t have health insurance. Nice knowing you guys. ETA: I am 43 ---
**Author:** ![Michael63129](https://avatars.discourse-cdn.com/v4/letter/m/3da27b/32.png) [@Michael63129](https://boards.straightdope.com/u/Michael63129)\ **Post date:** [May 17, 2013, 8:01pm UTC](https://boards.straightdope.com/t/is-there-any-proof-that-salt-is-related-to-hypertension/558190/53 "2013-05-17T20:01:39Z")
> [@Smeghead](#): > > Duly noted that this is a zombie, and fair warning that this post is only tangentially related. End disclaimer. > > One interesting fact I learned from that book about the history of salt - I forget the title - Salt, A History, perhaps? - - is that modern people are actually consuming record low amounts of salt compared to most of human history. This is thanks to the invention of refrigeration and canning, which means we are no longer dependent on preserving food through salting, which was just about the only option for most of that time. > > Carry on. Given the amount of salt used in many foods though, you’d think it was for preservation, or maybe it is because people are used to eating salty food. Even reduced sodium foods are often still relatively high in sodium (e.g. 800 mg/400 mg per serving in a can of soup of the kind I often eat\*, although they do have a lot of potassium, up to 2,000 mg/can, see posts about sodium/potassium ratio like **barbitu8** ’s #23). \*Not because I have high blood pressure but because such problems occur from eating too much over a lifetime. Also, [another article for eating less sodium](http://www.mensfitness.com/nutrition/what-to-eat/salt-may-cause-even-more-harm-than-you-thought) - New study finds that a salty meal reduces blood flow in your main arteries in just 30 minutes Yeah, a SINGLE meal can cause noticeable changes in blood flow. Granted, that was with 4 grams of salt (1,600 mg sodium), but it isn’t that hard to consume that much; for example, a can of Campbell’s Chicken Noodle Soup contains an entire days worth of salt. ---
**Author:** ![bardos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bardos/32/1069_2.png) [@bardos](https://boards.straightdope.com/u/bardos)\ **Post date:** [May 17, 2013, 8:16pm UTC](https://boards.straightdope.com/t/is-there-any-proof-that-salt-is-related-to-hypertension/558190/54 "2013-05-17T20:16:37Z")
[http://www.fathead-movie.com/index.php/2013/05/16/the-american-heart-associations-ongoing-a-salt-on-science/](http://www.fathead-movie.com/index.php/2013/05/16/the-american-heart-associations-ongoing-a-salt-on-science/) a must read on salt [Previous page](https://boards.straightdope.com/t/is-there-any-proof-that-salt-is-related-to-hypertension/558190.md?page=2)