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Hypertension/High Blood Pressure Health Center

Here's What's Shakin' With Salt

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WebMD Health News

May 12, 2000 -- Do you crave pickles, splash on the soy sauce with reckless abandon, sinfully savor each grain of salt on your pretzels? If you are like most Americans, you are probably taking in more salt than current guidelines recommend -- whether you know it, or want it.

'So what?' you think, 'Salt makes food taste good!' Besides -- you rationalize to yourself -- I don't have high blood pressure; well, at least not really high blood pressure. So, what's the big deal?

What you might not know is, that question has created a veritable storm in a saltshaker, if you will, within the medical community.

The role of salt in high blood pressure and heart disease is not as clear as it once seemed, and many experts disagree about the importance of salt intake and current recommendations for salt consumption. It is clear that some groups of patients need to carefully watch salt consumption, but whether the entire population benefits from restriction is uncertain. In addition, newer research has brought to light other factors in blood pressure control which may be even more important than salt. Some researchers argue that salt restriction has been overemphasized. But others feel that current recommendations are helpful, and should be continued.

The latest battlefield for the great salt debate is the American Journal of Clinical Nutrition, where two experts in the field argue for and against keeping the current American Heart Association (AHA) recommendation of no more than six grams of salt a day for an adult. Studies show Americans currently average about nine grams of salt a day.

Norman Kaplan, MD, is in favor of keeping the current recommendations with an eye towards lowering them in the future. Kaplan, a professor of internal medicine at the University of Texas Southwestern Medical Center in Dallas, writes that high blood pressure is a problem for about one in five Americans (including more than half of the elderly) and the problem is probably growing.

Kaplan says there is enough evidence from human and animal studies to show that excess salt intake is "intimately" involved with high blood pressure, even though a direct cause-and-effect cannot be proven. And that even modest reductions in salt intake can lead to modest reductions in blood pressure, leading to health benefits for individuals. These small individual benefits translate into big benefits for society as a whole. Kaplan also argues that a decrease in salt intake may also provide other benefits, including less bone thinning, fewer kidney stones and less thickening of the heart muscle.

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