Healthnotes Newswire (March 15, 2001)—A reduced salt intake can lower blood pressure and the need for blood pressure-lowering drugs among older people with hypertension (high blood pressure), according to a study published in the current issue of Archives of Internal Medicine.¹

Although salt restriction is widely advocated to help manage hypertension,^{2 3} evidence for the efficacy of this approach in older people has been limited.^{4 5} The new data represent an important advance in the case for salt-restriction to control hypertension in the elderly.

The effects of salt restriction on blood pressure were evaluated in 681 people aged 60 to 80 years with hypertension, who were randomly assigned to a low-salt diet group or a usual lifestyle group. All participants had had their blood pressure under control by using a blood pressure-lowering medication. Even while on these drugs, reducing salt in the diet significantly lowered blood pressure. Three months after beginning the low-salt diet, the drugs were withdrawn. In the group following a usual lifestyle (i.e., no salt-restriction), 73% had a relapse of high blood pressure, a health problem related to hypertension (such as a heart attack or stroke), or any other medical need to resume their blood-pressure-lowering medication. In the group following the low-salt diet, only 59% of participants had one of these outcomes after discontinuing drug therapy.

Hypertension is particularly widespread among elderly Americans. Among people over the age of 60 who are not residing in nursing homes, the prevalence of the disease exceeds 50%, with even higher rates among African Americans (e.g., 79% of African-American women aged 60 to 69 years have hypertension).⁶ Hypertension increases the risk of other cardiovascular diseases, including stroke, heart failure, and atherosclerosis.

Salt intake has been definitively linked to hypertension in Western societies.⁷ Eliminating salt from the diet lowers blood pressure in most people.⁸ Thus, low-salt diets are important to all people with hypertension, not just the elderly. A new study, to be published in The Lancet on Saturday, will show that high salt intake predicts death from all causes, and also predicts the risk of cardiovascular disease, even independent of blood pressure.⁹ These results provide further, direct evidence of the harmful effects of high salt intake in the adult population.

With the prevalence of salted processed and restaurant food, simply avoiding the salt shaker is not enough to reduce salt intake for most people. The American Heart Association and other organizations advise that, to maintain health, people should limit their salt intake to the equivalent of no more than 6 grams each day. The average American now consumes almost 10 grams of salt per day. The more salt is restricted, the greater the blood pressure-lowering effect.¹⁰