December 2015
Rebecca J Suckling, consultant nephrologist and Pauline A Swift, consultant nephrologist
ABSTRACT
High salt intake is now endemic worldwide. It contributes to the generation and maintenance of high blood pressure, which is now the biggest risk factor for global disease. There is now compelling evidence to support salt reduction in hypertensives and a substantial body of evidence to support salt reduction in the general population to reduce risk of death from cardiovascular disease. In specific diseases such as heart failure and chronic kidney disease, guidelines support the World Health Organization target for reduced salt intake at 5 g daily. Achieving a diet that is lower in salt has challenges, but is more likely to be achieved through salt reduction strategies particularly focused on processed food and through educational programs. To be effective, these interventions require collaboration between industry, health agencies and governments.
Conclusions
High salt intake is endemic worldwide and contributes to the generation and maintenance of high blood pressure, the biggest risk factor for global disease. There is now compelling evidence to support salt reduction to lower blood pressure and a substantial body of evidence to support salt reduction in the general population to reduce risk of death from cardiovascular disease.
In specific diseases such as heart failure, diabetes and CKD, guidelines support the WHO target for reduced salt intake at 5 g/day, although the evidence is perhaps only now catching up with the guidance.
Further evidence from population studies would be helpful to reinforce the current guidance, but intervention studies at that level are not likely to be supported by either industry or government. Collaborations with the food industry, health agencies and government will be necessary to support salt reduction strategies.
