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November 13, 1996

Dietary Sodium and Blood Pressure

Author Affiliations

Northwestern University Medical School Chicago, Ill

JAMA. 1996;276(18):1467. doi:10.1001/jama.1996.03540180023012

To the Editor.  —According to the "Data Synthesis" section in the abstract of the meta-analysis by Dr Midgley and colleagues,1 reduction in sodium (salt) intake produces a significant decrease (P<.001) in systolic pressure in normotensive, as well as in hypertensive, persons. Nevertheless, in a total non sequitur, the sweeping "Conclusion" in the abstract is "the evidence in the normotensive population does not support current recommendations for universal dietary sodium restriction."The evidence in their specific, limited analyses in this study is qualitatively concordant—not discordant—with many other sets of evidence from every research discipline supporting the judgment that habitual high salt intake is an etiologically significant and important contributor to adverse blood pressure levels present throughout the adult population aged 35 years and older.2-6 Midgley et al say nothing about this total evidence. Instead they cite, as the basis for their conclusion, their metaanalysis results for a subgroup