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Salt Intake in the Diet and Hardening of the Arteries: Are They Related

A high intake of salt raises blood pressure and the risk of cardiovascular disease.

Previous studies have reported on the association between salt intake and carotid stenosis, but the association with coronary artery disease (CAD) has not been reported.

The present project was aimed at studying the association between salt intake and both carotid atherosclerosis and CAD in a contemporary community-based cohort.


As a means of assessing dietary sodium intake, a population in Sweden over 10,000 subjects were analyzed. The amount of dietary salt was estimated by a 24-hour sodium excretion (est24hNa) was calculated.

The study subjects were in a study were they underwent a coronary computed tomography (CCTA) for the amount of CAD (n = 9623) and measurement of coronary artery calcium score (CACS, n = 10 289). Carotid ultrasound was used to detect carotid plaques (n = 10 700).

Increased estimated 24h our sodium was associated with increased occurrence of carotid plaques, higher CACS, and CAD on CCTA.


Higher sodium intake in the diet, as measured by a 24 hour urinary sodium measurement,  was associated with both coronary and carotid atherosclerosis.

The association seemed mainly mediated by blood pressure but to some degree also influenced by other established cardiovascular risk factors.

The authors commented in a scientific press release that:

“The results show that the more salt people eat, the higher the burden of atherosclerotic plaques in the arteries of the heart and neck. The increase in blood pressure due to a high salt intake seems to be an important underlying mechanism for these findings. Interestingly, the results were consistent when we restricted our analyses to participants with normal blood pressure (below 140/90 mm Hg) or to those without known cardiovascular disease. This means that it’s not just patients with hypertension or heart disease who need to watch their salt intake.”

WHO recommends that salt intake be limited to 1 teaspoon per day, he said.

“It’s hard to estimate how much salt we eat, so I have two tricks to help lower consumption. No. 1 is to limit the use of table salt, as this has been linked with cardiovascular health. No. 2 is to replace salt, which is 100% sodium chloride, with a salt substitute containing 70% to 80% sodium chloride and 20% to 30% potassium chloride”.  I would add, use spices not salt, as trick number 3.