Advice to reduce the amount of salt eaten reduces blood pressure but there is insufficient evidence to confirm the predicted reductions in people dying prematurely or suffering cardiovascular disease

Cardiovascular disease includes heart attacks, strokes, and the need for heart surgery and is a major cause of premature death and disability. This review set out to assess whether intensive support and encouragement to cut down on salt in foods reduced the risk of death or cardiovascular disease. This advice did reduce the amount of salt eaten which led to a small reduction in blood pressure by six months. There was not enough information to detect the expected effects on deaths and cardiovascular disease predicted by the blood pressure reductions found.  There was limited evidence that dietary advice to reduce salt may increase deaths in people with heart failure. Our review does not mean that asking people to reduce salt should be stopped. People should continue to strive to do this.  However, additional measures - reducing the amount of hidden salt in processed foods, for example – will make it much easier for people to stick to a lower salt diet. Further evidence of measures to cut dietary salt is needed: (1) randomised controlled trials of advice to reduce salt in individuals with heart failure assessing mortality and cardiovascular events and (2) experimental or observational studies of population based interventions to reduce salt in hypertensives or healthy individuals assessing mortality and cardiovascular events.