Reduced Salt Intake Lowers BP, Improves Stroke and Heart Disease Mortality Rates in UK

April 17, 2014

LONDON, UK – Efforts to reduce salt intake in the UK are likely to have contributed to a significant reduction in blood pressure as well as ischemic heart disease (IHD) and stroke mortality over a recent eight-year period, according to a new analysis[1].

From 2003 to 2011, average salt intake declined 15% and systolic blood pressure declined by 2.7 mm Hg in individuals not taking antihypertensive medications. Over the same time period, there was a significant 42% reduction in stroke mortality and 40% reduction in IHD mortality, report investigators.

The reduced salt intake was "predominantly achieved by a gradual reduction in the amount of salt added to all processed foods, which accounts for approximately 80% of total salt intake," write Dr Feng He (University of London, UK) and colleagues in their study, published April 14, 2014 in BMJ.

The analysis is based on data from the Health Survey for England, an annual survey that tracks demographic information and data on smoking status, alcohol consumption, and fruit and vegetable intake, as well as blood pressure, body weight, and height.

From 2003 to 2011, blood pressure declined by 3.0 mm Hg, smoking prevalence declined from 19% to 14%, fruit and vegetable consumption increased by 0.2 servings/day, and body mass index (BMI) increased by 0.5 kg/m2. There was also a 0.4-mmol/L (15.5-mg/dL) reduction in total cholesterol. Among those who had a 24-hour urinary sodium test, salt intake declined by 1.4 g/day.

Among individuals not taking antihypertensive medication, systolic and diastolic blood pressure declined by 2.7 and 1.1 mm Hg, respectively (adjusted for age, sex, ethnicity, alcohol consumption, fruit and vegetable intake, and BMI.

"The fact that, after adjusting for almost all other major factors known to be associated with blood pressure, there was still a significant fall in blood pressure of 2.7/1.1 mm Hg from 2003 to 2011 would suggest that these falls in blood pressure were likely to be largely attributable to the reduction in population salt intake that occurred during this period," write He and colleagues.

These reductions, say the researchers, likely played a significant role in the decrease in stroke and IHD mortality. In 2003, there were 134 deaths from stroke and 232 deaths from IHD per 100 000 adults in England. By 2011, stroke and IHD mortality rates were 78 and 139 per 100 000 individuals, respectively. This translated into a 42% and 40% relative reduction in stroke and IHD mortality, respectively, report investigators.

He is a member of Consensus Action on Salt & Health (CASH) and World Action on Salt & Health (WASH), both nonprofit organizations. Disclosures for the other authors are listed in the article.

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