A perspective on reducing salt intake.

Epidemiological, clinical, and experimental evidence links excessive salt consumption to hypertension; there appears to be no evidence that it is beneficial. I conclude that it should be public policy to advise and help Americans to reduce their salt intake. Because even mild hypertension increases risk, the overall problem does not appear to be amenable to treatment, although treatment for those with clinical hypertension will always be needed. There appears to be little likelihood that identification of those "at risk" will be successful, nor does it appear that we have the capacity at this time to conduct successful preventive field trials. It is difficult for the individual to modify his diet alone. The successful strategy is to modify the food supply by changing public demand. The public responds to dietary advice if acceptable and identifiable products are available. Because most of the salt is in commercially prepared foods and because their consumption will increase in the future, the major responsibility for lowering salt consumption will fall on the food manufacturers. They are beginning to respond, and there appears to be ample opportunity for them to reduce the salt content of foods markedly. Our temporary objectives, however, should be modest, because unrealistic objectives only discourage those who attempt to follow them.