Dietary salt and cardiovascular disease

Abstract

I take exception to the Comment, “Salt reduction lowers cardiovascular risk…” by Feng He and Graham MacGregor.1He FJ MacGregor GA Salt reduction lowers cardiovascular risk: meta-analysis of outcome trials.Lancet. 2011; 378: 380-382Summary Full Text Full Text PDF PubMed Scopus (276) Google Scholar Both authors are members of the advocacy group World Action on Salt and Health (WASH)—a single-purpose activist organisation whose goal is worldwide salt reduction. Their response to every paper that counters the WASH agenda is immediate and consistently negative, reflecting ideology far more than objective science. Although they might believe their mission to be just, this does not excuse them from declaring a conflict of interest based on intellectual passion.He and MacGregor seem concerned with the timing of any publication that might run counter to the salt-reduction agenda. Colleagues at WASH did not want any publication to interfere with the plan to use the UN High-Level Meeting on Non-communicable Diseases in New York in September as a means to further their goal of worldwide salt reduction. However, even the outcome of the High-Level Meeting cannot trump nature. Modern societies during the past 200 years have never experienced levels of salt consumption as low as those being recommended by WHO—a dietary regimen that would, without doubt, result in chronically increased renin/aldosterone concentrations population-wide.Even the US Institute of Medicine admitted in its “Strategies to reduce sodium intake”2Institute of MedicineStrategies to reduce sodium intake in the United States.http://www.iom.edu/Reports/2010/Strategies-to-Reduce-Sodium-Intake-in-the-United-States.aspxGoogle Scholar that a stepwise approach should be taken and at each step an analysis should be done to check for unintended consequences. In other words, shoot first and ask questions later. Human physiology answers to a far higher authority than WHO, WASH, or the Salt Institute.I am employed by the Salt Institute. I take exception to the Comment, “Salt reduction lowers cardiovascular risk…” by Feng He and Graham MacGregor.1He FJ MacGregor GA Salt reduction lowers cardiovascular risk: meta-analysis of outcome trials.Lancet. 2011; 378: 380-382Summary Full Text Full Text PDF PubMed Scopus (276) Google Scholar Both authors are members of the advocacy group World Action on Salt and Health (WASH)—a single-purpose activist organisation whose goal is worldwide salt reduction. Their response to every paper that counters the WASH agenda is immediate and consistently negative, reflecting ideology far more than objective science. Although they might believe their mission to be just, this does not excuse them from declaring a conflict of interest based on intellectual passion. He and MacGregor seem concerned with the timing of any publication that might run counter to the salt-reduction agenda. Colleagues at WASH did not want any publication to interfere with the plan to use the UN High-Level Meeting on Non-communicable Diseases in New York in September as a means to further their goal of worldwide salt reduction. However, even the outcome of the High-Level Meeting cannot trump nature. Modern societies during the past 200 years have never experienced levels of salt consumption as low as those being recommended by WHO—a dietary regimen that would, without doubt, result in chronically increased renin/aldosterone concentrations population-wide. Even the US Institute of Medicine admitted in its “Strategies to reduce sodium intake”2Institute of MedicineStrategies to reduce sodium intake in the United States.http://www.iom.edu/Reports/2010/Strategies-to-Reduce-Sodium-Intake-in-the-United-States.aspxGoogle Scholar that a stepwise approach should be taken and at each step an analysis should be done to check for unintended consequences. In other words, shoot first and ask questions later. Human physiology answers to a far higher authority than WHO, WASH, or the Salt Institute. I am employed by the Salt Institute. Dietary salt and cardiovascular disease – Authors' replyWe disagree with Rod Taylor and colleagues that normotensive and hypertensive individuals should be treated separately. Blood pressure is a continuous risk factor starting from 115/75 mm Hg1 and the cutoff point (ie, 140/90 mm Hg) for separating hypertensive people from normotensive people is arbitrary. Full-Text PDF