Salt reduction in England from 2003 to 2011: its relationship to blood pressure, stroke and ischaemic heart disease mortality

[Eddy Edson]

Salt reduction in England from 2003 to 2011: its relationship to blood pressure, stroke and ischaemic heart disease mortality | BMJ Open

Results From 2003 to 2011, there was a decrease in mortality from stroke by 42% (p<0.001) and IHD by 40% (p<0.001). In parallel, there was a fall in BP of 3.0±0.33/1.4±0.20 mm Hg (p<0.001/p<0.001), a decrease of 0.4±0.02 mmol/L (p<0.001) in cholesterol, a reduction in smoking prevalence from 19% to 14% (p<0.001), an increase in fruit and vegetable consumption (0.2±0.05 portion/day, p<0.001) and an increase in body mass index (BMI; 0.5±0.09 kg/m2, p<0.001). Salt intake, as measured by 24 h urinary sodium, decreased by 1.4 g/day (p<0.01). It is likely that all of these factors (with the exception of BMI), along with improvements in the treatments of BP, cholesterol and cardiovascular disease, contributed to the falls in stroke and IHD mortality. In individuals who were not on antihypertensive medication, there was a fall in BP of 2.7±0.34/1.1±0.23 mm Hg (p<0.001/p<0.001) after adjusting for age, sex, ethnic group, education, household income, alcohol consumption, fruit and vegetable intake and BMI. Although salt intake was not measured in these participants, the fact that the average salt intake in a random sample of the population fell by 15% during the same period suggests that the falls in BP would be largely attributable to the reduction in salt intake rather than antihypertensive medications.

Conclusions The reduction in salt intake is likely to be an important contributor to the falls in BP from 2003 to 2011 in England. As a result, it would have contributed substantially to the decreases in stroke and IHD mortality.

 

[trophywench]

I thought they'd concluded that years ago when the evidence of people not dropping dead of strokes etc quite so often presented itself?

 

[Eddy Edson]

I thought they'd concluded that years ago when the evidence of people not dropping dead of strokes etc quite so often presented itself?

Yeah, presumably this astonishes nobody. But I guess one point is that the UK launched a salt-reduction initiative in 2003, and it's good to see that it had an impact.

 

[mikeydt1]

this had such an impact on me that it resulted in me been in hospital.

i will let someone try and work out what went wrong and come back later with the answer.

 

[Eddy Edson]

this had such an impact on me that it resulted in me been in hospital.

i will let someone try and work out what went wrong and come back later with the answer.

Geebus! Reducing salt put you in hospital?? That sucks.

 

[mikeyB]

That reduction also parallels the reduction in smoking, which appears to be ignored as a confounding factor.

 

[Bruce Stephens]

Too little can also cause problems, I believe.

It can, but I believe it's quite hard to get too little. (With high enough BG over a while (or anything else where you're drinking a lot) you can: I did when I had a brain tumour. But normally it's hard since we're pretty good at regulating sodium levels.)

 

[Deleted member 21371]

I haven't put salt on my food since my 30s on the basis that there was probably enough in it already, eg in bread, baked beans, pasta sauces etc. Having said that, I've cut back or ditched so much of my old diet that I'm wondering now whether I'm actually getting enough of it? Too little can also cause problems, I believe. Must check. 6g is the adult RDA, according to what I'm reading.

Martin

I haven't used salt for years either.
I try to avoid pre made sauces as well,
I probably get my monthly supply from an occasional chinese take away though!

 

[Drummer]

If I do not have my morning coffee with a minute pinch of salt for a couple of days I get thoughts of eating crisps and then a ferocious cramp in my lower leg overnight.
If I forget the salt in coffee try to remember to take a taste of salt when making dinner as my husband likes his potatoes or pasta cooked with salt in the water, but if he has chips then I might fail at that.
When it was suggested that I reduce salt by my doctor, about a decade or so ago I laughed, and said that I don't use salt - 'ah but it is in' and she reeled off a great list. 'don't eat any of that' I responded, unwisely, and was given a strict instruction, a diet sheet and told to attend the 'health' clinic each week.

 

[Eddy Edson]

I haven't put salt on my food since my 30s on the basis that there was probably enough in it already, eg in bread, baked beans, pasta sauces etc. Having said that, I've cut back or ditched so much of my old diet that I'm wondering now whether I'm actually getting enough of it? Too little can also cause problems, I believe. Must check. 6g is the adult RDA, according to what I'm reading.

Martin

I think in the UK, 6g of salt = 2.4g of sodium is the recommended maximum, not the RDA.

Salt in your diet

Most people in the UK eat too much salt. Find out about your recommended maximum daily salt intake, and how to cut down.

www.nhs.uk

There is much less focus on minimum sodium requirements, because generally people get too much and in any case way more than the bare minimum amount needed for bodily functioning, estimated at around 500 mg per day.

 

[mikeydt1]

i reduced my salt intake but over a long period unknown to me i had reduced it too much and both my potassium and sodium levels crashed.

i was given a nice lecture in hospital but was told that if i had too much salt it could of been just as bad.

seems i couldn't win, if only there was a finger prick test for that.

a lack of both mucked around with my heart and it could of been fatal if not caught and dealt with. as soon as salt tablets were introduced i could feel the difference.

 

[Eddy Edson]

i reduced my salt intake but over a long period unknown to me i had reduced it too much and both my potassium and sodium levels crashed.

i was given a nice lecture in hospital but was told that if i had too much salt it could of been just as bad.

seems i couldn't win, if only there was a finger prick test for that.

a lack of both mucked around with my heart and it could of been fatal if not caught and dealt with. as soon as salt tablets were introduced i could feel the difference.

That totally sucks. Were you getting periodic blood tests including blood sodium and potassium before that? Most days I have 750 mg or less sodium and I worry a bit that maybe it's not enough, but my blood tests always show normal sodium and potassium levels, so hopefully I'm OK.

 

[trophywench]

I have low serum sodium - it rarely reached 130 - but my serum potassium level is always well within the limits it's supposed to be so no problem, except when thy kept trying me on different BP tablets, 99.9% of which made my feet and ankles swell for which they'd normally prescribe a diuretic tablet to counteract that, but which is absolutely contra-indicated since I have low serum sodium!

The human body works in mysterious ways, its wonders to perform!