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February 26, 2001

Salt and Hypertension: Going to the Heart of the Matter

Arch Intern Med. 2001;161(4):505-506. doi:10.1001/archinte.161.4.505

A COMPREHENSIVE MEDLINE search from 1966 to the present using the terms "salt," "sodium," "high blood pressure," and "hypertension" revealed a total of 17 090 articles dealing with these topics. Given that the link between dietary salt and high blood pressure surfaced almost 100 years ago,1 the MEDLINE search covers only about one third of the time during which this link has been researched and discussed. It follows that a thorough and objective analysis of the literature pertaining to salt and hypertension is likely beyond the intellectual capacity of even the most skilled scientists. Such information overload either engenders helplessness and frustration or leads to a literature selection governed by personal preference (cherry picking). Apathy, uncritical thinking, and even evangelism are common consequences of attempts to penetrate this scientific fog. Not surprisingly, therefore, some of the arguments often put forward in the salt–blood pressure controversy reflect a defensive authoritarianism that seems to be more suited to medieval theologians than to contemporary clinical scientists. Since most dietary salt intake originates from processed food, the world's major food manufacturers are interested in keeping the controversy alive and in understating the effects of salt on cardiovascular disease.

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