Salt: I Can't Believe It's Still Controversial
Salt: I Can't Believe It's Still Controversial
Henry R. Black, MD: Hi. I'm Dr. Henry Black, Clinical Professor of Internal Medicine at the New York University School of Medicine, former President of the American Society of Hypertension, and a member of the Center for the Prevention of Cardiovascular Disease at New York University.
I'm here today with my friend and colleague, Dr. Larry Appel, from Johns Hopkins University.
Lawrence J. Appel, MD, MPH: Thanks for inviting me to participate in this program. I'm Professor of Medicine and Professor of Epidemiology at the School of Medicine and the School of Public Health at Johns Hopkins University.
Dr. Black: Larry, I'd like to shift gears a little bit to a topic that I can't believe is still controversial, which is salt or sodium intake. First of all, when we all talk about it, we ought to make it very clear that we are talking about either salt or sodium. Don't use them interchangeably because the amount recommendations depend a little bit on the chemistry, which we learned in high school or college.
The recommended dietary intake of 1500 mg/day of sodium was recently challenged. What is your feeling about that? How did we get there, and what do you think we should be doing?
Dr. Appel: Let me take a few steps back and talk about the body of evidence that links sodium with health. There is a very robust body of evidence that was not reviewed in the part of the report from the Institute of Medicine that links higher sodium levels with higher blood pressure levels. The data are very robust; they are a combination of observational studies in which populations with extremely low sodium intake don't have problems with hypertension, and clinical trials in which reduced sodium intake resulted in substantial reductions in blood pressure.
The issue surrounding sodium is the challenge of doing high-quality research in this area. Because sodium is ubiquitous in the food supply, it is very challenging for individuals to reduce their intake.
Introduction: Sodium and Hypertension
Henry R. Black, MD: Hi. I'm Dr. Henry Black, Clinical Professor of Internal Medicine at the New York University School of Medicine, former President of the American Society of Hypertension, and a member of the Center for the Prevention of Cardiovascular Disease at New York University.
I'm here today with my friend and colleague, Dr. Larry Appel, from Johns Hopkins University.
Lawrence J. Appel, MD, MPH: Thanks for inviting me to participate in this program. I'm Professor of Medicine and Professor of Epidemiology at the School of Medicine and the School of Public Health at Johns Hopkins University.
Dr. Black: Larry, I'd like to shift gears a little bit to a topic that I can't believe is still controversial, which is salt or sodium intake. First of all, when we all talk about it, we ought to make it very clear that we are talking about either salt or sodium. Don't use them interchangeably because the amount recommendations depend a little bit on the chemistry, which we learned in high school or college.
The recommended dietary intake of 1500 mg/day of sodium was recently challenged. What is your feeling about that? How did we get there, and what do you think we should be doing?
Dr. Appel: Let me take a few steps back and talk about the body of evidence that links sodium with health. There is a very robust body of evidence that was not reviewed in the part of the report from the Institute of Medicine that links higher sodium levels with higher blood pressure levels. The data are very robust; they are a combination of observational studies in which populations with extremely low sodium intake don't have problems with hypertension, and clinical trials in which reduced sodium intake resulted in substantial reductions in blood pressure.
The issue surrounding sodium is the challenge of doing high-quality research in this area. Because sodium is ubiquitous in the food supply, it is very challenging for individuals to reduce their intake.
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