Healthy Heart Reports
Salt Restriction And High Blood Pressure
Many doctors glibly prescribe a low salt diet to treat high blood pressure. A recent study from
Finland shows that even with intense counseling and instruction, fewer than 20% are able to lower
high blood pressure (1).
A diet rich in fruits and vegetables and low in fat is far more effective in lowering high blood
pressure than a low-salt diet (2,3,4). Reducing salt intake a little does not lower high blood pressure
(5,6) and reducing salt intake a lot can raise blood pressure even higher. Severe salt restriction
causes your adrenal glands to produce large amounts of a hormone called aldosterone and your
kidneys to produce large amounts of another hormone called angiotensin that constrict blood vessels
and raise blood pressure (2,8,9). People on low-salt diets have a much higher death rate (10), and
severe salt restriction can raise blood pressure (11) and blood cholesterol (12),/ and even cause
heart attacks (13).
On the other hand, obese people are often sensitive to salt restriction because being overweight
prevents your body from responding adequately to insulin and raises insulin levels. Since Insulin,
itself, causes the body to retain salt, salt restriction raises blood levels of insulin which make a person
hungry and fatter. Eating white flour and sugar makes your body much more sensitive to salt and
restricting these food products decreases salt's ability to raise blood pressure (14). The 40% chance of
lowering blood pressure with the most popular drugs is much lower than the 60% success rate of
going on a low-fat diet and losing weight (15,16), so changing your lifestyle is far more effective in
reducing high blood pressure than just taking drugs.
1) MH Korhonen, H Litmanen, R Rauramaa, SB Vaisanen, L Niskanen, MIJ Uusitupa. Adherence to the salt
restriction diet among people with mildly elevated blood pressure. European Journal of Clinical Nutrition, 1999,
Vol 53, Iss 11, pp 880-885.
2) Appel LJ et al. A clinical trial of the effects of dietary patterns on blood pressure. NEJM 1997 (April
3) Hypertension 1991;18 (suppl 1):115-120.
4) American Journal of Hypertension 8: 11 (NOV 1995):1067-1071.
5) JAMA May 21, 1966.
6) JAMA May 6, 1998.
7) JAMA December 20, 1995.
8) JAMA May 22/289. 1996.Pages 1590-1597.
9) Hypertension 25: 6 (JUN 1995):1144-1152.
10) Hypertension 25: 6 (JUN 1995):1144-1152.
11) Klin Wochenschrift 1990;68:664-668.
12) Klin Wochenschrift 1991 69 suppl):51-57.
13) American Journal of Hypertension 7: 10 Part 1:OCT 1994:886-893.
14) TA Kotchen, JM Kotchen. Dietary sodium and blood pressure: Interactions with other nutrients. American Journal
of Clinical Nutrition 65: 2 Suppl.(FEB 1997):S708-S711.
15) Hypertension 1991;18 (suppl 1):115-120. 16) American Journal of Hypertension 8: 11 (NOV 1995):1067-1071.
Copyright 2003 www.DrMirkin.com
Dr. Mirkin's opinions and the references cited are for information only, and are not intended to diagnose or prescribe. For your specific diagnosis and treatment, consult your doctor or health care provider.
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