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April 1, 1976Circulation485 citationsOpen Access

Salt, volume and the prevention of hypertension.

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EFE. D. FreisBoston Medical Center

Key Points

  • The aim is to determine if reducing dietary salt prevents hypertension based on various evidence sources.
  • Analyzed epidemiological data from unacculturated peoples regarding salt intake and hypertension prevalence.
  • Conducted hemodynamic studies on chronic experimental hypertension related to extracellular fluid volume changes.
  • Reviewed investigations in hypertensive patients on low-salt diets or diuretic therapy and their blood pressure outcomes.
  • Evidence shows an inverse correlation between salt intake and hypertension prevalence.
  • Patients who reduced salt to below 2 g/day demonstrated notable reductions in blood pressure.
  • Chronic hypertension appears to be linked to increased extracellular fluid volume.

Abstract

The evidence supporting the thesis that hypertension can be prevented by eliminating salt from the diet is based on four principal sources: (1) epidemiological studies in unacculturated peoples showing that the prevalence of hypertension is inversely correlated with the degree of salt intake; (2) hemodynamic studies suggesting that the development of chronic experimental hypertension is a homeostatic response to a maintained increase in extracellular fluid volume (ECF); (3) evidence that the ECF of "salt eaters" is expanded in comparison to that of "no-salt eaters"; and (4) investigations in hypertensive patients receiving either diets greatly restricted in salt or continuous diuretic therapy which correlate the fall in blood pressure with a reduction in ECF. Although this mechanism of essential hypertension is still obscure the evidence is very good if not conclusive that reduction of salt in the diet to below 2 g/day would result in the prevention of essential hypertension and its disappearance as a major public health problem.

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Cite This Study

E. D. Freis (1976) studied this question.

synapsesocial.com/papers/6a1255b3e407b2669634a6a0https://doi.org/10.1161/01.cir.53.4.589
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