Salt and Cardiovascular Disease

Abstract

Heart disease is a leading cause of mortality and morbidity globally. Sedentary lifestyle, bad eating habits, and little to no exercise have led to an alarming rise of lifestyle-mediated diseases in recent times. Table salt is one of the staples of all our kitchens and dining tables. Salt contains almost 98% sodium chloride. The unregulated amount of salt in our diet has led to adverse cardiovascular consequences. Fast foods such as salted French fries and Chinese cuisine may contain as much as 7,000 mg of sodium in a single meal! The American Heart Association (AHA) recommends a daily intake of not more than 2.3 g of salt per day (roughly one teaspoon). For patients with hypertension, heart failure, or kidney disease, a lower daily cut-off of 1.5 g of salt has been proposed but is still under debate. There is conflicting evidence of going too low with salt restriction as recent studies have shown increased adverse events when salt was restricted to beyond the recommended per-day threshold. The DASH (dietary approaches to stop hypertension) diet is a novel dietary pattern that is recommended for patients with hypertension. The DASH diet is not a restrictive or short-term diet but rather a sustainable and balanced approach to eating. It promotes a wide variety of foods, focusing on whole, unprocessed options, and encourages portion control. Adhering to a DASH eating pattern by itself can lower the systolic blood pressure by 6–11 mm Hg. Reducing salt intake can be challenging, as salt is present in many processed and packaged foods, restaurant meals, and fast food. More than 70% of the salt we eat, according to the AHA, comes from processed, prepackaged, and restaurant foods. “Salt Lite” is often marketed as a healthier alternative for individuals looking to lower their sodium intake. It typically contains a blend of potassium chloride with sodium chloride and is hence not totally “sodium free.” Individuals considering the use of “Salt Lite” should be aware of its higher potassium content and should not use it if they have a kidney disease or are on drugs that can cause hyperkalemia. There is a common misconception that pink Himalayan salt is lower in sodium than regular table salt. However, both types consist of approximately 98% sodium chloride. Research has not shown that Himalayan salt has any unique health benefits compared to other dietary salts. It is hence imperative for all individuals to restrict dietary salt intake to the recommended levels—as a measure toward a healthy lifestyle as well as a therapeutic modality for those with established cardiovascular diseases.