12 January - 20 June 2016

Reduced salt intake in England led to reduced mortality from stroke and heart disease

23 Apr 14

Decreased mortality from stroke and ischaemic heart disease (IHD) in England from 2003 - 2011 seems to be at least partly due to reduced salt intake in the population.

Using data from the 2003, 2006, 2008 and 2011 Health Surveys for England (HSE, which administer questionnaires to a random sample of private households) researchers from the Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London found that mean blood pressure in the population dropped from 129.3±0.20/74.2±0.12 mm Hg in 2003 to 126.3±0.25/72.8±0.16 mm Hg in 2011. Blood pressure is a risk factor for stroke/IHD, and in fact a separate population modelling study found that the biggest contributor to reduced IHD 2000 - 2007 was the substantial fall in systolic blood pressure in the population. The authors argue that it is therefore reasonable to suggest that reduced average blood pressure 2003 - 2011 is reflected in the parallel reduction in mortality by 42% and 40% for stroke and IHD, respectively.

Over the same period, average salt intake in the population fell from 9.5±0.2 g/day in 2003 to 8.1±0.2 g/day by 2011 according to data on 24hr urinary sodium from the National Diet and Nutrition Survey (NDNS). This is a decrease of 15%. Whilst it should be noted that data on salt intake and on blood pressure was not drawn from the same population, participants in the both the HSE and NDNS were randomly selected in order to make up a representative sample of the nationwide population. The authors also note that whilst the fall in average blood pressure can be partly attributed to antihypertensive medications, there was still a 2.7/1.1 mm Hg fall in blood pressure among individuals not taking such medication. Having accounted for factors such as diet, income, age, sex and ethnic groups, the authors argue that salt consumption is likely to have been an important contributor to the trends in BP and therefore in IHD/stroke mortality.

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