In Reply: We agree with Dr Alderman and colleagues
that there were meaningful differences in the methods used in our study and
theirs.1 However, in contrast to their claims,
we believe that our findings are more generalizable. We excluded participants
consuming low-salt diets because they had restricted their salt intake due
to health concerns. As such, estimates derived from a 24-hour recall at baseline
would not have represented their habitual dietary intake of sodium. Similarly,
patients with CVD might have reduced their dietary sodium intake because of
their diagnosis. This assumption was well supported by our finding of an inverse
association between dietary sodium intake and CVD prevalence at baseline.
In addition, incident cases provide the best estimate of disease risk associated
with an exposure.2 We included coronary
heart disease, stroke, hypertensive heart disease, and heart failure as the
study outcomes, because they were the most common and biologically appropriate
blood pressure–related CVD outcomes.
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