Sodium and Your Health

By Joel Fuhrman, M.D.

Hypertension Is Only One Of A Host Of Serious Problems You Can Expect!

If you live in the United States, your lifetime probability of developing high blood pressure is around 90%.9 This is a sobering statistic since high blood pressure increases a person’s risk of developing heart disease (heart failure, heart attack, or sudden cardiac death), as well as kidney failure and stroke. Treatment that lowers high blood pressure greatly decreases the risk of stroke and heart failure.10

After many years of high salt exposure, blood pressure starts to rise. By the time this occurs, cutting down on salt does not so easily resolve the problem. When high levels of salt are consumed, more fluid is retained in the body and must be carried by the blood vessels. This increases both blood pressure and the load on the heart. With a higher circulatory volume, more pressure is exerted on the blood vessel walls. After decades, the walls react to this stress by thickening and narrowing, leaving less space for the fluid already cramped in the blood compartment, raising “resistance,” and requiring higher pressure to move blood to the organs.

Extra Work For Your Heart

The heart has to pump against this high pressure system. Lifting heavy weights in the gym causes muscles to become larger. This same phenomenon happens to the heart with one notable exception—unlike when you exercise; there are no periodic rest periods. The heart has to work 24/7 without stopping. After years and years of excessive salt consumption, this 24/7 effort causes the heart to enlarge dangerously (called hypertrophy) and become more prone to heart failure. High salt intake also promotes cardiac fibrosis, increasing risk of arrhythmias (irregular heartbeat). More and more disease mechanisms associated with sodium continue to be defined.11 Your kidneys contain around one million tiny delicate filters comprised of blood vessels that lose their function from the excessive pressure, leading to a disorder known as “hypertensive nephrosclerosis,” a major cause of kidney disease.

Numerous observational studies and randomized controlled trials document that high sodium intake increases blood pressure.12 This evidence implicating excess sodium intake as a major cause of high blood pressure levels has been called “overwhelming”.13,14

A recently published large, long term lifestyle intervention study showed that a 25–35% reduction in dietary sodium over 10–15 years results in 25–30% lower risk of cardiovascular outcomes.15 It is estimated that a 50% decrease in sodium consumption in the United States could prevent at least 150,000 deaths annually.16

According to a meta analysis of 61 studies, the lower an individual’s blood pressure—at least down to 115/75 mm Hg), the lower the risk of stroke or heart attack.17 There was no “threshold” below which the risk did not decrease.

Multiple Problems With Salt

High blood pressure is not the only harm that comes from excess sodium intake. The interesting finding from many different studies is that high salt intake is linked to increases in all cause mortality and that the death hastening effects occur even in those people who are not sodium sensitive enough to develop elevated blood pressure.18 High sodium intake predicts overall mortality and risk of coronary heart disease, independent of other cardiovascular risk factors, including high blood pressure.19

Inadequate Advice

Unfortunately, most members of the medical community only give lip service to preventing or treating high blood pressure with improved diets, weight loss, and exercise. The most often used approach is to prescribe drugs for those identified with hypertension.

Offering a prescription tends to make the patient think that the blood pressure problem has been adequately addressed and that there is no need to discontinue the disease-causing diet and lifestyle that caused the high blood pressure to begin with. The conditions of patients on medications inevitably worsen; salt intake continues, cardiovascular deterioration continues, and aging is accelerated. Maybe if drugs were not available, people would be forced to curtail their dietary indiscretions, dramatically reduce their salt intake, lose weight, and exercise.

Similarly, if drugs were not marketed as the only solution to high blood pressure, maybe the entire population would learn about superior nutrition and salt avoidance at a young age. At minimum, patients deserve to be given a chance to really protect themselves with a low-sodium, cardio-protective diet and appropriate exercise. If they knew how much more effective this approach is compared with drug therapy, maybe more people would choose it.


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