European Primary Care Cardiovascular Society

Low-sodium diet significantly lowers SBP within a week

News - Nov. 28, 2023

Effects of Dietary Sodium on Systolic Blood Pressure in Middle-Aged Individuals: A Randomized Order Cross-Over Trial

Presented at the AHA Scientific Sessions 2023 by: Deepak Gupta, MD - Nashville, TN, US

Introduction and methods


Dietary sodium is a major contributor to hypertension. The average sodium consumption in the US is estimated to be around 3,500 mg/day. This far exceeds the AHA, WHA and DHHS recommendations of 1,500 – 2,300 mg/day. The DASH-sodium trial showed in 2001 that sodium reduction leads to a decrease in SBP. However, it remains unclear whether dietary sodium reduction lowers BP among individuals on hypertension medications and what proportion of individuals experience lowering of BP with dietary sodium reduction. The Coronary Artery Risk Development in Young Adults (CARDIA)-SSBP study was conducted to address these questions.


The CARDIA study included individuals in the US between 50 and 75 years old. Individuals with SBP<90 or >160 mmHg or DBP <50 or > 100 mm Hg were excluded. Other exclusion criteria were resistant hypertension or contraindications to high-sodium or low-sodium diet or special dietary requirements.

After enrollment, participants (n=213) first continued their usual diet for 7 days and where then randomized to first a high-sodium diet or low-sodium diet for 7 days. Participants on the high-sodium diet then crossed over to the low-sodium diet and vise versa. The high-sodium diet consisted of the usual diet + 2,200 mg sodium added/day. The low-sodium diet consisted of standardized meals with 500 mg sodium/day.

Main results


In middle-aged individuals, a low-sodium diet significantly lowered SBP already within a week compared to the participants’ usual diet. Addition of sodium did not raise systolic BP compared with the usual diet. A reduction in SBP with the low-sodium diet was observed in approximately 75% of individuals and the reduction in SBP with a low-sodium diet was independent of hypertension status and anti-hypertensive medication use.

- Our reporting is based on the information provided at the AHA Scientific Session 2023 -

The results of this study were simultaneously published in JAMA

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