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Canadian Journal of Cardiology

The Population Risks of Dietary Salt Excess Are Exaggerated

  • Andrew Mente
    Correspondence
    Corresponding author: Dr Andrew Mente, Population Health Research Institute, DBCVS Research Institute, McMaster University, 2nd Floor, Room C2-104, 237 Barton St East, Hamilton, Ontario L8L 2X2, Canada. Tel.: +1-905-527-4322 ×40443; fax: +1-905-297-3781.
    Affiliations
    Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada

    Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
    Search for articles by this author
  • Martin J. O'Donnell
    Affiliations
    Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada

    Department of Medicine, McMaster University, Hamilton, Ontario, Canada

    HRB-Clinical Research Facility, National University of Ireland, Galway, Galway, Ireland
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  • Salim Yusuf
    Affiliations
    Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada

    Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada

    Department of Medicine, McMaster University, Hamilton, Ontario, Canada

    Hamilton Health Sciences, Hamilton, Ontario, Canada
    Search for articles by this author
Published:February 18, 2014DOI:https://doi.org/10.1016/j.cjca.2014.02.003

      Abstract

      Policy positions on salt consumption (based largely on the association of sodium and blood pressure [BP]) has remained unchanged since the 1970s, until recently. However, this is beginning to change as new evidence emerges. The evidence supports a strong association of sodium with BP and cardiovascular disease events in hypertensive individuals, the elderly, and those who consume > 6 g/d of sodium. However, there is no association of sodium with clinical events at 3 to 6 g/day and a paradoxical higher rate of events at < 3 g/day. Therefore, until new evidence emerges, the optimal range of sodium consumption should be considered to be between 3 and 6 g/d. Population-wide sodium reduction is not justified in countries such as Canada.

      Résumé

      Les positions sur les politiques de consommation de sel (basées en grande partie sur le lien entre le sodium et la pression artérielle [PA]) sont demeurées inchangées depuis les années 70 jusqu'à tout récemment. Cependant, des changements s’amorcent étant donné que de nouvelles données scientifiques apparaissent. Les données soutiennent qu’il existe un lien important entre le sodium et la PA et les événements cardiovasculaires chez les individus hypertendus, les personnes âgées et les personnes qui consomment > 6 g/j de sodium. Cependant, on n'observe aucun lien entre le sodium et les événements cliniques à raison de 3 à 6 g/j, et l'incidence paradoxalement plus élevée d'événements à < 3 g/j. Par conséquent, jusqu’à ce que de nouvelles données scientifiques voient le jour, l’étendue optimale de la consommation de sodium devrait être située entre 3 et 6 g/j. La réduction de sodium à l’échelle de la population n’est pas justifiée dans des pays comme le Canada.
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