Live Heart Healthy. Live Well & Live Long

There Is No Question: Salt Kills

by | Jun 25, 2012

On 6/2/12, the New York Times ran an Op Ed piece “Salt, We Misjudged You” by medical researcher Gary Taubes which was misleading at best. As a practicing cardiac surgeon who has spent the last several years researching studies related to salt, I know without a doubt that salt kills and can leave you severely incapacitated in the process.

The evidence is conclusive. Let’s review.

      1) Salt causes chronic high blood pressure. Any possible debate about this was eliminated by the 1988 INTERSALT study which involved more than 10,000 people from 52 population groups in 32 countries. A review of the study in 1997 followed by two randomized prospective studies—“Trials of Hypertension Prevention”—involving top universities and medical institutions confirm that salt has a direct causal relationship with high blood pressure.

       In a 1997 article in the American Journal of Clinical Nutrition, cardiologist and Jeremiah Stamler, an extraordinary researcher who spent a lifetime researching the impact of salt and health and whose position was grievously misrepresented in the recent Op Ed piece said, “The INTERSALT study results…support the judgment that habitual high salt intake is one of the quantatively important, preventable mass exposures causing the unfavorable population-wide blood pressure pattern that is a major risk factor for epidemic cardiovascular disease.”

      2) Research shows that salt-induced high blood pressure, labeled the silent killer, increases the risk of heart disease and failure, stroke and dementia, and kidney failure (the latter is a particular problem for Black Americans). That’s why we treat high blood pressure so aggressively. New areas of concern include heart failure, as well as the over growth of the heart in response to salt induced high blood pressure. This is Medicine 101. Day in and day out I see patients who have high blood pressure because of salt. Only flawed studies, including those from Italy mentioned by the author of Op Ed piece, that have focused on younger populations for inadequate time periods say that eating salt isn’t dangerous because of how it raises blood pressure. Irresponsibly implying that we don’t have to worry about high blood pressure puts all those people fighting this potentially deadly condition—more than 50 million in the U.S. alone—at enormous risk.

      3) The problems with eating salt don’t stop there. As you’ll see in my book Salt Kills, additional deadly consequences of eating salt include stomach cancer, obesity and osteoporosis.

The research that supports the above points is irrefutable. The following studies provide just a sampling:

  • “INTERSALT: An international study of electrolyte excretion and blood pressure.  Results for 24-hour urinary sodium and potassium excretion. 

    ” INTERSALT Cooperative Research Group. 1988. British Medical Journal 297; 319-328.

  • “The INTERSALT Study: background, methods, findings, and implications”

    Stamler J. 1997. Am J Clin Nutr 65: S626-S642. Department of Preventive Medicine, Northwestern University Medical School, Chicago, U.S. The National Heart, Lung and Blood Institute (U.S.), The Wellcome Trust (U.K.), The International Society of Hypertension, The World Health Organization, The American Heart Association

  • “Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP)”

Cook NR et al. 2007. British Medical Journal 334:885-8. Harvard Medical School, Boston, MA; National Heart, Lung, and Blood Institute, Bethesda, MD; University of Pennsylvania, Philadelphia, PA; Johns Hopkins University, Baltimore, MD; Loyola University, Maywood, IL Hypertension is the most common reason for seeing a doctor ( not including pregnancy) ..JAMA 2010; 303:2043..EGAN et al, US trends in prevalence, awareness, treatment and control of hypertension

  • Joint National Committee report on Prevention, Detection, Evaluation and Treatment of High Blood pressure. JAMA 2003;289:2560 Chobian AV et al

Half of the more than 50 million Americans hypertension is not under control…

  • The Framingham study: American journal of hypertension 1994;7:7s Wilson PW.

Established risk factors and coronary artery disease; states: “Hypertension is quantitatively the major risk factor for premature cardiovascular disease, being more common than cigarette smoking, dyslipidemia, or diabetes”

  • JAMA 1996;275;1557 Levy et al.

Progression from hypertension to congestive heart failure. “risk of heart failure increases with the degree of blood pressure elevation

  • Stroke (the medical journal), 1996;27. 2020.The Melbourne Risk Factor Study

Risk factors for cerebral hemorrhage. Thrift AG et al “ hypertension is the most common risk factor for the development of intracranial hemorrhage.

  • Lancet 1997;350:757

Randomized double blind comparison of placebo and active treatment of older patients with systolic hypertension… “ hypertension is the most important and the most common risk factor for ischemic stroke, the incidence of which can be markedly reduced by effective antihypertensive therapy”.

  • Arch Int Med 2001; 161;1207

The third national nutrition examination survey. Prevalence of high blood pressure and elevation of serum creatinine (a measure of kidney failure).  Hypertension is a risk factor for chronic kidney disease and end-stage renal disease (dialysis).

  • Arch Int Med 2005, 923. Hsu et al.

Elevated blood pressure and risk of end stage renal disease in subjects without baseline kidney disease. “Even a relatively modest elevation is a risk factor for end stage renal failure”


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