Is Lower Salt Intake Dangerous?

Salt intake has been correlated directly with blood pressure (BP) in short-term intervention trials. These data inform the premise that decreased salt intake should substantially prevent cardiovascular disease (CVD). Belgian investigators tested this theory among 3681 patients without CVD (26% with hypertension) who were assessed for CVD outcomes in two European prospective cohort studies (median follow-up, 8 years).

In the overall cohort, a significant but inverse relation was noted between urinary sodium excretion and fatal or nonfatal CVD events. For example, the CVD death rate was 4.1% versus 0.8% in the lowest versus highest tertiles of sodium excretion.

Two subgroups were created. In the first subgroup, 2096 patients who were normotensi…