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ARTICLE |

Dietary Sodium and Blood Pressure FREE

Jeremiah Stamler, MD
[+] Author Affiliations

Edited by Margaret A. Winker, MD, Senior Editor, and Phil B. Fontanarosa, MD, Senior Editor.


JAMA. 1996;276(18):1467-1467. doi:10.1001/jama.1996.03540180023012
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To the Editor.  —According to the "Data Synthesis" section in the abstract of the meta-analysis by Dr Midgley and colleagues,1 reduction in sodium (salt) intake produces a significant decrease (P<.001) in systolic pressure in normotensive, as well as in hypertensive, persons. Nevertheless, in a total non sequitur, the sweeping "Conclusion" in the abstract is "the evidence in the normotensive population does not support current recommendations for universal dietary sodium restriction."The evidence in their specific, limited analyses in this study is qualitatively concordant—not discordant—with many other sets of evidence from every research discipline supporting the judgment that habitual high salt intake is an etiologically significant and important contributor to adverse blood pressure levels present throughout the adult population aged 35 years and older.2-6 Midgley et al say nothing about this total evidence. Instead they cite, as the basis for their conclusion, their metaanalysis results for a subgroup

REFERENCES

Midgley JP, Matthew AG, Greenwood CMT, Logan AG.  Effect of reduced dietary sodium on blood pressure: a meta-analysis of randomized controlled trials . JAMA . 1996;;275:1590-1597.
National Research Council Committee on Diet and Health, Food and Nutrition Board, Commission on Life Sciences. Diet and Health: Implications for Reducing Chronic Disease . Washington, DC: National Academy Press; 1989;.
Cutler JA, Kotchen TA, Obarzanek E, eds.  The National Heart, Lung, and Blood Institute Workshop on Salt and Blood Pressure . Hypertension . 1991;;17( (suppl 1) ):1-221.
Working Group on Primary Prevention of Hypertension.  National High Blood Pressure Education Program Working Group report on primary prevention of hypertension . Arch Intern Med . 1993;;153:186-208.
Dietary Guidelines Advisory Committee. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans. Washington, DC: US Government Printing Office; 1995.
Elliott P, Stamler J, Nichols R, et al, for the Intersalt Cooperative Research Group.  Intersalt revisited: further analysis of the 24 hour sodium excretion and blood pressure within and across populations . BMJ . 1996;;312:1249-1253.

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Midgley JP, Matthew AG, Greenwood CMT, Logan AG.  Effect of reduced dietary sodium on blood pressure: a meta-analysis of randomized controlled trials . JAMA . 1996;;275:1590-1597.
National Research Council Committee on Diet and Health, Food and Nutrition Board, Commission on Life Sciences. Diet and Health: Implications for Reducing Chronic Disease . Washington, DC: National Academy Press; 1989;.
Cutler JA, Kotchen TA, Obarzanek E, eds.  The National Heart, Lung, and Blood Institute Workshop on Salt and Blood Pressure . Hypertension . 1991;;17( (suppl 1) ):1-221.
Working Group on Primary Prevention of Hypertension.  National High Blood Pressure Education Program Working Group report on primary prevention of hypertension . Arch Intern Med . 1993;;153:186-208.
Dietary Guidelines Advisory Committee. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans. Washington, DC: US Government Printing Office; 1995.
Elliott P, Stamler J, Nichols R, et al, for the Intersalt Cooperative Research Group.  Intersalt revisited: further analysis of the 24 hour sodium excretion and blood pressure within and across populations . BMJ . 1996;;312:1249-1253.
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