From the Guidelines
The target sodium intake for patients with hypertension should be less than 2,300 mg per day, with an ideal target of 1,500 mg per day for most adults with high blood pressure, as recommended by the most recent and highest quality study 1.
Importance of Sodium Reduction
Reducing sodium intake is crucial for patients with hypertension, as it can lower systolic blood pressure by 2-8 mmHg, potentially reducing the need for medication or enhancing the effectiveness of antihypertensive drugs. This is especially important for individuals who are more sensitive to sodium's blood pressure-raising effects, including older adults, African Americans, and those with chronic kidney disease or diabetes.
Achieving Target Sodium Intake
To achieve the target sodium intake, patients should:
- Read nutrition labels and choose fresh foods over processed options
- Use herbs and spices instead of salt for flavoring
- Rinse canned foods before consumption
- Request meals be prepared without added salt when dining out
- Gradually reduce sodium intake to allow taste buds to adapt over time
Additional Considerations
It's also important to note that reducing sodium intake can be challenging, but even a small decrement in sodium consumption is likely to be safe and beneficial, especially in those whose blood pressure is salt sensitive 1. Additionally, a potassium-rich diet may help to reduce blood pressure, but it's essential to avoid potassium supplements in patients with chronic renal failure or those taking potassium-sparing diuretics 1.
From the Research
Target Sodium Intake for Hypertension
The target sodium intake for patients with hypertension (HTN) is a crucial aspect of managing the condition. Based on the available evidence, the following points can be considered:
- The American Heart Association recommends no more than 2400 mg of sodium intake per day for healthy adults 2.
- Reducing sodium intake by at least 1000mg per day is generally recommended, with a target of 2400mg/d being accepted as beneficial 3.
- However, whether further reductions to 1500mg/d are useful, feasible, and safe among specific subgroups in the population who are at increased risk of hypertension or stroke remains controversial and requires individualized consideration 3.
- Some studies suggest that a moderate range of dietary sodium (3 to 5 g/day) is associated with the lowest risk of cardiovascular disease and mortality, and that the risk of adverse health outcomes increases when sodium intakes exceed 5 g/day or are below 3 g/day 4.
- A mean target of below 5 g/day in populations may be reasonable, while awaiting the results of large randomized controlled trials of sodium reduction on cardiovascular disease and death 4.
Key Considerations
- Patients with hypertension should aim to reduce their sodium intake to less than 2400mg/d, with further reductions to 1500mg/d being considered on an individual basis 2, 3.
- Dietary sources of sodium and eating patterns that offer nutritiously sound approaches to nutrient-dense, reduced sodium intake should be considered 3.
- The use of combination antihypertensive drugs, including diuretics, beta blockers, ACE inhibitors, and calcium channel blockers, may be necessary to achieve adequate blood pressure control 5, 6.