Salt intake in hypertension

A dietary sodium intake of less than 6gms daily or less is recommended as a non-pharmacological intervention in the management of hypertension (1). This can be achieved by not adding salt to food when cooking or at table, and avoiding high salt convenience type foods and snacks.

If dietary sodium is reduced from 10g per day to 5 g per day then it would be expected that there would be an average reduction in blood pressure of 3 to 5 mmHg. Dietary sodium restriction can also increase the efficacy of certain classes of antihypertensive agents - especially ACE-inhibitors and probably beta-blockers. The optimal goal should aim for ≤1.5 g/day as the use of salt substitutes has demonstrated BP-mediated protective effects for major cardiovascular events and mortality (2,3)

Note that people who have been put onto a low sodium diet should be warned that food will appear to have reduced taste for about 4-6 weeks - however after this period their sense of taste will readjust and they will begin to taste food again (2).

References:

1. NICE. Hypertension in adults: diagnosis and management. NICE guideline NG136. Published August 2019, updated November 2023
2. Neal B, Wu Y, Feng X, et al. Effect of salt substitution on cardiovascular events and death. N Engl J Med. 2021 Sep 16;385(12):1067-77.
3. Brand A, Visser ME, Schoonees A, et al. Replacing salt with low-sodium salt substitutes (LSSS) for cardiovascular health in adults, children and pregnant women. Cochrane Database Syst Rev. 2022 Aug 10;(8):CD015207.