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February 3, 2010

Reducing Dietary Sodium: The Case for Caution

Author Affiliations

Author Affiliations: Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, New York.

JAMA. 2010;303(5):448-449. doi:10.1001/jama.2010.69

Authoritative recommendations, sometimes sanctioned by government, routinely call for reduced dietary sodium. However, when the strength of evidence is made explicit, it is generally acknowledged to be opinion or common “practice.”1 Advocates contend that the recommendation is justified because sodium restriction has been convincingly proven to lower blood pressure and that this will surely prevent stroke and myocardial infarction. Skeptics argue that modification of this single surrogate end point does not guarantee a health benefit as measured by morbidity or mortality. Instead, they note that salt restriction capable of reducing blood pressure also unfavorably affects other cardiovascular disease surrogates.