Harvard Heart Letter

Heart Beat: Cut salt for resistant hypertension

Up to one-third of people with high blood pressure have trouble getting it under control even with three or more daily blood pressure medications. This condition, called resistant hypertension, contributes to stroke, heart failure, and other cardiovascular diseases. Adding yet another medication is an option, but that can be costly and comes with the very real possibility of additional side effects or unwanted drug interactions. Cutting back on salt intake may be another option.

In tests at the University of Alabama at Birmingham involving a dozen volunteers with resistant hypertension, a low-sodium diet reduced systolic blood pressure (the upper number of a blood pressure reading) by 22 points and diastolic pressure (the bottom number) by 9 points, compared with an average American diet (Hypertension, September 2009). The low-salt diet contained 1,150 mg of sodium (half a teaspoon of table salt), or about half the amount the average American takes in each day.

Most of the salt we consume is hidden in processed foods like bacon, canned soups, and even ready-to-eat breakfast cereals. Following a low-salt diet means carefully choosing processed and commercially prepared foods and going easy on the salt shaker when preparing meals and at the table.

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