What is the role of sodium in the prevention of cardiovascular disease (CVD)?

Answer

The DGAC notes that the average person in the US is consuming nearly 3500 mg of sodium per day. As part of the dietary recommendations, the goal is for individuals to cut at least 1000 mg of sodium from their daily diet to reduce daily intake to 2300 mg per day, a recommendation in line with the Institute of Medicine. The advisory committee no longer recommends a daily target of 1500 mg for any individuals, even those with hypertension, diabetes, or chronic kidney disease.^[7]

In comparison, the 2012 World Health Organization (WHO) guidelines for sodium intake for adults and children recommend reducing sodium intake to below 2000 mg per day for individuals 16 years of age and older; for children 2-15 years, sodium intake should be adjusted downward from 2000 mg per day based on the energy requirements of children relative to adults. Each country should determine the energy requirements of various age categories of the pediatric population relative to adults approximately 20–50 years of age, to lower the recommended maximum intake value per day.^[8]

The recommendation includes all individuals with or without hypertension but excludes sub-populations with illnesses or taking drug therapy that may lead to hyponatremia or patients requiring physician-supervised diets (eg, patients with heart failure or type 1 diabetes).^[8]

The AHA/ACC guidelines recommend sodium intake of less than 2400 mg per day but find further restriction to 1500 mg per day desirable for greater reduction in blood pressure. Reduction by 1000 mg per day is beneficial in lowering blood pressure even if optimum levels of daily sodium intake are not achieved.{ref8)

The European guidelines recommend reducing salt intake to less than 5000 mg per day.^[4]

Did this answer your question?

Yes No

Additional feedback? (Optional)

Thank you for your feedback!

[Guideline] U.S. Preventive Services Task Force. Recommendation Summary: Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults With Cardiovascular Risk Factors: Behavioral Counseling. USPSTF. Available at http://www.uspreventiveservicestaskforce.org/Page/Topic/recommendation-summary/healthy-diet-and-physical-activity-counseling-adults-with-high-risk-of-cvd . August 2014; Accessed: December 2, 2015.
[Guideline] U.S. Preventive Services Task Force. Final Recommendation Statement: Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults: Behavioral Counseling. USPSTF. Available at http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/healthful-diet-and-physical-activity-for-cardiovascular-disease-prevention-in-adults-behavioral-counseling. June 2012; Accessed: Decem ber 2, 2015.
Artinian NT, et al; American Heart Association Prevention Committee of the Council on Cardiovascular Nursing. Interventions to promote physical activity and dietary lifestyle changes for cardiovascular risk factor reduction in adults: a scientific statement from the American Heart Association. Circulation. 2010 Jul 27. 122 (4):406-41. [Medline]. [Full Text].
[Guideline] Perk J, et al; European Association for Cardiovascular Prevention & Rehabilitation (EACPR), ESC Committee for Practice Guidelines (CPG). European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J. 2012 Jul. 33 (13):1635-701. [Medline]. [Full Text].
[Guideline] U.S. Preventive Services Task Force. Tobacco Smoking Cessation in Adults, Including Pregnant Women: Behavioral and Pharmacotherapy Interventions. USPSTF. Available at http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/tobacco-use-in-adults-and-pregnant-women-counseling-and-interventions1. September 2015; Accessed: December 2, 2015.
[Guideline] U.S. Department of Health and Human Services and U.S. Department of Agriculture. Dietary Guidelines for Americans, 2015-2020. 8th Ed. Washington DC: U.S. Government Printing Office; December 2015. [Full Text].
2015 Dietary Guidelines Advisory Committee. Advisory report to the Secretary of Health and Human Services and Secretary of Agriculture. February 2015. [Full Text].
World Health Organization. Sodium Intake for Adults and Children. Geneva, Switzerland: World Health Organization (WHO); 2012. [Full Text].
[Guideline] Eckel RH, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014 Jun 24. 129 (25 Suppl 2):S76-99. [Medline]. [Full Text].
Johnson RK, et al; American Heart Association Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism and the Council on Epidemiology and Prevention. Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association. Circulation. 2009 Sep 15. 120 (11):1011-20. [Medline]. [Full Text].
[Guideline] U.S. Department of Health and Human Services. 2008 Physical Activity Guidelines for Americans. Washington DC: U.S. Government Printing Office; October 2008. [Full Text].
[Guideline] World Helath Organization. Global Recommendations on Physical Activity for Health. Geneva, Switzerland: World Helath Organization (WHO); 2010. [Full Text].
[Guideline] Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, National Heart, Lung, and Blood Institute. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolescents: summary report. Pediatrics. 2011 Dec. 128 Suppl 5:S213-56. [Medline]. [Full Text].
[Guideline] Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville MD: U.S. Department of Health and Human Services. Public Health Service; May 2008. [Full Text].
[Guideline] Department of Veterans Affairs and Department of Defense. Recommendations for Use of Combination Therapy in Tobacco Use Cessation. Available at http://www.healthquality.va.gov/guidelines/CD/mtu/tuc_combination_therapy.pdf. April 2009; Accessed: December 2, 2015.
[Guideline] U.S. Preventive Services Task Force. Final Recommendation Statement: Obesity in Adults: Screening and Management. USPSTF. Available at http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/obesity-in-adults-screening-and-management . June 2012; Accessed: December 2, 2015.
[Guideline] Jensen MD, et al; American College of Cardiology/American Heart Association Task Force on Practice Guidelines, Obesity Society. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014 Jun 24. 129 (25 Suppl 2):S102-38. [Medline]. [Full Text].
[Guideline] Department of Veterans Affairs and Department of Defense. Clinical practice guideline for screening and management of overweight and obesity. Version 2.0. 2014. Available at http://www.healthquality.va.gov/guidelines/CD/obesity/VADoDCPGManagementOfOverweightAndObesityFINAL070714.pdf. Accessed: December 2, 2015.
[Guideline] U.S. Preventive Services Task Force. Final Recommendation Statement: Obesity in Children and Adolescents: Screening. USPSTF. Available at http://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/obesity-in-children-and-adolescents-screening. December 2014; Accessed: December 2, 2015.
US Food and Drug Administration. Citizen's petition denial response from FDA to Bayer Healthcare, LLC [letter]. FDA. Available at http://www.regulations.gov/#!documentDetail;D=FDA-1977-N-0018-0101. May 2, 2014; Accessed: December 2, 2015.
[Guideline] U.S. Preventive Services Task Force. Aspirin for the Prevention of Cardiovascular Disease: Preventive Medication. USPSTF. Available at http://www.uspreventiveservicestaskforce.org/Page/Topic/recommendation-summary/aspirin-for-the-prevention-of-cardiovascular-disease-preventive-medication . March 2009; Accessed: December 2, 2015.
[Guideline] Pearson TA, Blair SN, Daniels SR, Eckel RH, Fair JM, Fortmann SP, et al. AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update: Consensus Panel Guide to Comprehensive Risk Reduction for Adult Patients Without Coronary or Other Atherosclerotic Vascular Diseases. American Heart Association Science Advisory and Coordinating Committee. Circulation. 2002 Jul 16. 106 (3):388-91. [Medline]. [Full Text].
[Guideline] Mosca L, Banka CL, Benjamin EJ, Berra K, Bushnell C, et al. Evidence-based guidelines for cardiovascular disease prevention in women: 2007 update. Circulation. 2007 Mar 20. 115 (11):1481-501. [Medline]. [Full Text].
[Guideline] Meschia JF, Bushnell C, Boden-Albala B, Braun LT, Bravata DM, et al. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014 Dec. 45 (12):3754-832. [Medline]. [Full Text].
[Guideline] Vandvik PO, Lincoff AM, Gore JM, Gutterman DD, Sonnenberg FA, Alonso-Coello P, et al. Primary and secondary prevention of cardiovascular disease: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb. 141 (2 Suppl):e637S-68S. [Medline]. [Full Text].
[Guideline] Stone NJ, Robinson JG, Lichtenstein AH, et al, for the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014 Jul 1. 63 (25 pt B):2889-934. [Medline].
[Guideline] Goff DC Jr, Lloyd-Jones DM, Bennett G, et al, American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014 Jul 1. 63 (25 Pt B):2935-59. [Medline].
[Guideline] Bibbins-Domingo K, U.S. Preventive Services Task Force. Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2016 Jun 21. 164 (12):836-45. [Medline].
[Guideline] Smith SC Jr, Benjamin EJ, Bonow RO, et al. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation endorsed by the World Heart Federation and the Preventive Cardiovascular Nurses Association. J Am Coll Cardiol. 2011 Nov 29. 58 (23):2432-46. [Medline].
[Guideline] Greenland P, Alpert JS, Beller GA, et al, for the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2010 Dec 21. 122 (25):2748-64. [Medline].
[Guideline] Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018 May 15. 71 (19):e127-e248. [Medline].

Media Gallery

of 0

What is the role of sodium in the prevention of cardiovascular disease (CVD)?

Answer

Related Questions:

References

Tables

Contributor Information and Disclosures