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Wolfson Institute of Population Health

Clear linear association between salt intake and cardiovascular disease

Published:
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A pooled analysis of individual-participant data from six prospective cohorts of 10,709 adults across the USA and Europe who had multiple 24h urine collections assessing dietary salt intake shows a clear linear association between salt intake and cardiovascular disease (CVD). The relation between sodium intake and CVD has been controversial, partly due to inaccurate sodium intake assessment, but measuring 24-hour urinary excretion over multiple days is considered the gold standard. Findings from the study, co-authored by Feng He and Graham MacGregor (Centre for Public Health and Policy) and published in NEJM, showed that higher sodium intake was significantly associated with higher CVD risk in a dose-response manner with a daily sodium intake of around 2000-5000 mg, and that lower potassium intake and higher sodium-to-potassium ratio were also associated with higher CVD risk. Author Feng He said: “These results support reducing sodium intakes to the WHO recommended level of <2,000 mg/day (ie. <5 g/d salt) and increasing potassium intake to lower CVD risk.”

 

24-Hour Urinary Sodium and Potassium Excretion and Cardiovascular Risk. Yuan Ma, Feng J. He, Qi Sun, Changzheng Yuan, Lyanne M. Kieneker, Gary C. Curhan, Graham A. MacGregor, Stephan J.L. Bakker, Norm R.C. Campbell, Molin Wang, Eric B. Rimm, JoAnn E. Manson, Walter C. Willett, Albert Hofman, Ron T. Gansevoort, Nancy R. Cook, Frank B. Hu. 24-Hour Urinary Sodium and Potassium Excretion and Cardiovascular Risk. N Engl J Med. 13 November 2021. 10.1056/NEJMoa2109794