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Evaluation Review
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Salt and Blood Pressure

Conventional Wisdom Reconsidered

David A. Freedman

University of California, Berkeley

Diana B. Petitti

Kaiser Permanente Southern California

The salt hypothesis is that higher levels of salt in the diet lead to higher levels of blood pressure, increasing the risk of cardiovascular disease. Intersalt, a cross-sectional study of salt levels and blood pressures in 52 populations, is often cited to support the salt hypothesis, but the data are somewhat contradictory. Four of the populations (Kenya, Papua, and 2 Indian tribes in Brazil) do have low levels of salt and blood pressure. Across the other 48 populations, however, blood pressures go down as salt levels go up, contradicting the hypothesis. Experimental evidence suggests that the effect of a large reduction in salt intake on blood pressure is modest, and health consequences remain to be determined. Funding agencies and medical journals have taken a stronger position favoring the salt hypothesis than is warranted, raising questions about the interaction between the policy process and science.

Evaluation Review, Vol. 25, No. 3, 267-287 (2001)
DOI: 10.1177/0193841X0102500301
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Home page
 Int J EpidemiolHome page
D. A Freeman and D. B Petitti
Commentary: Salt, blood pressure and public policy
Int. J. Epidemiol., April 1, 2002; 31(2): 319 - 320.
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