To the Editor.—
The recent article by Holden and associates1 does not contribute to the understanding of the relationship, if any, of dietary salt intake and hypertension because the methods and data are seriously flawed. The group of persons whose conditions were previously diagnosed as hypertension constituted 22% of the initial study sample but were excluded from analysis because their salt intake had been modified, presumably because of the diagnosis of hypertension. By excluding this group, the authors may have excluded many of the very persons who did become hypertensive because of an increased salt intake. Of course, there is no way of including these data because the matter being studied— salt intake—already had been modified by the diagnosis of hypertension. Furthermore, all studies of this nature must contend with the fact that the general population in our country is not naive to the dietary salt-hypertension hypothesis; this may
Serafin WE. Dietary Salt Intake and Blood Pressure. JAMA. 1984;251(11):1429. doi:10.1001/jama.1984.03340350023010
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