In 15 studies of hypertensive adults,* a lower sodium or sodium chloride intake was associated with significantly lower blood pressure (BP) (-1.3mmHg to -16.8mmHg SBP; -1.9mmHg to -10.7mmHg DBP). Factors that affect this relationship included dietary pattern, race, ethnicity and age of subjects. In studies comparing blood pressure response to varying levels of sodium or sodium chloride intake, lowered blood pressures were noted with reduction in sodium intakes from (120mmol to 350mmol to 30mmol to 330mmol). A greater BP-lowering response was observed in the following groups: Those consuming a low-sodium diet with their usual dietary pattern vs. a DASH dietary pattern in black subjects and in older subjects.

* Definition of hypertension varied by study, country or version of JNC report.

See Table: Sodium and Blood Pressure Response

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

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• Worksheets
  • Appel LJ, Espeland MA, Easter L, Wilson AC, Folmar S, Lacy CR. Effects of reduced sodium intake on hypertension control in older individuals:  results from the Trial of Nonpharmacologic Interventions in the Elderly (TONE). Arch Intern Med. 2001 Mar 12; 161 (5): 685-693.
  • Bray GA, Vollmer WM, Sacks FM, Obarzanek E, Svetkey LP, Appel LJ. A further subgroup analysis of the effects of the DASH diet and three dietary sodium levels on blood pressure: Results of the DASH-sodium trial. AM J Cardiol. 204 Jul 15; 94(2): 222-227.
  • Coruzzi P, Brambilla L, Brambilla V, Gualerzi M, Rossi M, Parati G, Di Rienzo M, Tadonio J, Novarini A. Potassium depletion and salt sensitivity in essential hypertension. J Clin Endocrinol Metab. 2001 Jun; 86(6): 2,857-2,862.
  • He FJ, MacGregor GA. Effect of longer-term modest salt reduction on blood pressure. Cochrane Database Syst Rev. 2004; (1): CD004937. PMID: 15266549 
  • He FJ, Markandu ND, MacGregor GA. Importance of the renin system for determining blood pressure fall with acute salt restriction in hypertensive and normotensive whites. Hypertension. 2001 Sep; 38 (3): 321-325.
  • Jürgens G, Graudal NA. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride. Cochrane Database Syst Rev. 2003; (1): CD004022. Review. Update in: Cochrane Database Syst Rev. 2004; (1): CD004022
  • Radhika G, Sathya RM, Sudha V, et al. Dietary salt intake and hypertension in an urban south Indian population. J Assoc Physicians India. 2007; 55: 405-411.

Consuming a diet rich in fruits and vegetables and low-fat dairy products and low in sodium and saturated fat will decrease blood pressure. Reductions have been 4 – 12 mm Hg in systolic and 1 – 3 mm Hg in diastolic. This dietary pattern enhanced by weight loss and increased physical activity will also have beneficial effects (4 - 10 mm Hg in systolic and 3 - 5 mm Hg in diastolic).

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.