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Systematic review and meta-analysis
Dietary salt reduction; further lowering of target lowers blood pressure but may increase risk
  1. Franz H Messerli1,
  2. Sripal Bangalore2
  1. 1 St. Luke's-Roosevelt Hospital Center, New York , New York , USA;
  2. 2 Columbia University College of Physicians and Surgeons, New York , New York , USA
  1. Correspondence to Dr Franz H Messerli, St. Luke's-Roosevelt Hospital Center, 1000 Tenth Avenue, New York, NY 10019, USA; messerli.f{at}

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Numerous studies have shown that a high dietary salt intake increases blood pressure (BP) and the risk of cardiovascular events.1 ,2 Conversely, a moderate and even low-level salt intake lowers BP in a dose-dependent way.


He and colleagues have performed a thorough and comprehensive meta-analysis of 34 randomised controlled trials (RCTs) assessing the impact of modest reduction in salt intake with a trial duration of at least 4 weeks.


The present study corroborates the findings showing that a ‘modest’ reduction in salt intake from 9.4 to 4.4 g/day caused a significant fall in BP in hypertensive as well as normotensive individuals (systolic change −4.18 mm Hg (95% CI −5.18 to −3.18; p<0.0001)). This fall in BP was associated with a ‘small physiological increase in plasma renin, aldosterone and norepinephrine’. The authors stated that the current recommendations to reduce salt intake to 5–6 g/day …

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  • Competing interests None.