[Is a salt-restricted diet now up for discussion?]

Abstract

A recent meta-analysis published in The Lancet related sodium excretion to mortality in both hypertensive and normotensive subjects. High salt excretion, measured in a spot urine test, was related to increased mortality in hypertensive subjects only, whereas low sodium excretion was related to increased mortality in both hypertensive and normotensive subjects. Here we discuss practical consequences of this analysis. The data underline the importance of salt restriction in hypertension; the analysis also shows that there is a lower limit to salt restriction. Since salt intake cannot be assessed adequately from the sodium content of a single urine sample, 24-hour urine collection is advised in subjects on a salt-restricted diet. A 24-hour urine collection allows checking for unnecessarily strict salt restriction or, as will more often be the case, shows the patient that adequate salt restriction has not yet been attained.