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SALT RESTRICTION AND HIGH BLOOD PRESSURE

Many doctors glibly prescribe a low salt diet to treat high blood pressure. A recent study from Finland shows that even with intense counseling and instruction, fewer than 20% are able to lower high blood pressure (1).

A diet rich in fruits and vegetables and low in fat is far more effective in lowering high blood pressure than a low-salt diet (2,3,4). Reducing salt intake a little does not lower high blood pressure (5,6) and reducing salt intake a lot can raise blood pressure even higher. Severe salt restriction causes your adrenal glands to produce large amounts of a hormone called aldosterone and your kidneys to produce large amounts of another hormone called angiotensin that constrict blood vessels and raise blood pressure (2,8,9). People on low-salt diets have a much higher death rate (10), and severe salt restriction can raise blood pressure (11) and blood cholesterol (12),/ and even cause heart attacks (13).

On the other hand, obese people are often sensitive to salt restriction because being overweight prevents your body from responding adequately to insulin and raises insulin levels. Since Insulin, itself, causes the body to retain salt, salt restriction raises blood levels of insulin which make a person hungry and fatter. Eating white flour and sugar makes your body much more sensitive to salt and restricting these food products decreases salt's ability to raise blood pressure (14). The 40% chance of lowering blood pressure with the most popular drugs is much lower than the 60% success rate of going on a low-fat diet and losing weight (15,16), so changing your lifestyle is far more effective in reducing high blood pressure than just taking drugs. Many doctors just tell recommend salt restriction, but you will have more success with the DASH diet.

1) MH Korhonen, H Litmanen, R Rauramaa, SB Vaisanen, L Niskanen, MIJ Uusitupa. Adherence to the salt restriction diet among people with mildly elevated blood pressure. European Journal of Clinical Nutrition, 1999, Vol 53, Iss 11, pp 880-885.

2) Appel LJ et al. A clinical trial of the effects of dietary patterns on blood pressure. NEJM 1997 (April 17);336:1117-1124.

3) Hypertension 1991;18 (suppl 1):115-120.

4) American Journal of Hypertension 8: 11 (NOV 1995):1067-1071.

5) JAMA May 21, 1966.

6) JAMA May 6, 1998.

7) JAMA December 20, 1995.

8) JAMA May 22/28\9. 1996.Pages 1590-1597.

9) Hypertension 25: 6 (JUN 1995):1144-1152.

10) Hypertension 25: 6 (JUN 1995):1144-1152.

11) Klin Wochenschrift 1990;68:664-668.

12) Klin Wochenschrift 1991 69 suppl):51-57.

13) American Journal of Hypertension 7: 10 Part 1:OCT 1994:886-893.

14) TA Kotchen, JM Kotchen. Dietary sodium and blood pressure: Interactions with other nutrients. American Journal of Clinical Nutrition 65: 2 Suppl.(FEB 1997):S708-S711.

15) Hypertension 1991;18 (suppl 1):115-120. 16) American Journal of Hypertension 8: 11 (NOV 1995):1067-1071.

Checked 5/10/04

May 29th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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