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What is the current thinking regarding the relation between salt intake and hypertension?

Elijah Saunders, M.D., is head of the division of hypertension at the University of Maryland School of Medicine. He gives the following answer:

Hypertension or high blood pressure is often called a silent killer and contributes to more disability and death than any other disease in the western world.

There are few early symptoms of the physical increase in pressure of blood flowing through the heart and blood vessels, but if undiagnosed, untreated or uncontrolled, hypertension places extra stress on blood vessel walls and the heart. In time, this stress can cause heart attacks or heart failure, kidney failure, stroke and premature death.

One out of four African-Americans is affected by hypertension. The condition is one and one-half to two times more prevalent in African-Americans than in their white counterparts; severe hypertension is five to seven times more common in African-Americans than in Caucasians. Similar disproportionate death rates are noted from cerebrovascular disease or stroke.

The salt industry claims that there is a lack of data linking dietary salt to hypertension, but my research and that of others show dietary salt to be a major factor associated with hypertension. Blacks, older people of any race, diabetics and obese individuals all show above average sensitivity to salt in their diets. For them, salt is a pressing health hazard, but all people in the modern western world eat more salt than their bodies need, and this can contribute to hypertension in many of these individuals.

It should be emphasized that most of the salt consumed by people in an acculturated society comes from processed foods and not necessarily from what is added in cooking or at the table. Therefore, it will take much persuasion of the food industry to reduce to achieve a significant impact on our salt consumption significantly.

Recent research indicates that people who are being treated for high blood pressure may be compromising the effect of their medication if they are overweight and use a lot of salt. Although we believe genetics plays a role in predisposing individuals to hypertension, environmental factors--including a diet high in salt, obesity, heavy alcohol consumption and a sedentary lifestyle--help to set the stage for high blood pressure problems.

Because a large amount of sodium can be hidden in processed foods, it is important to read labels carefully to avoid excess salt. Other ways to protect yourself from hypertension caused or worsened by salt include using low-salt herbs and spices in place of salt in cooking and at the table, avoiding "fast" or preprocessed foods, and increasing your intake of fresh fruits and vegetables.

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