Did you know that the average American consumes more than twice the amount of sodium recommended by the American Heart Association? And worldwide people on average consume nearly double the levels recommended by the World Health Organization. Researchers have found that this consumption contributes to 2.3 million deaths per year from cardiovascular disease, primarily from coronary heart disease, which causes heart attack, and stroke. You can’t change your age or your family history of heart disease, but your sodium intake is a heart disease risk factor that you can do something about, starting today.

Read on for information about why sodium can be harmful to your heart health as well as practical tips for reducing sodium for a more heart-healthy diet.

Salt and the “Silent Killer”

Salt, also know as sodium chloride, is the most common form of sodium in American diets. While your body needs a little sodium to keep it healthy, most of us eat much more than the 1,500 mg per day recommended by the American Heart Association, and excessive sodium often leads to high blood pressure. Too much sodium can cause the body to retain water, increasing blood volume, which can result in greater force against the walls of the blood vessels that carry blood throughout the body. This force is what is measured during a blood pressure test:  Too much force is high blood pressure (hypertension).

Hypertension is often referred to as the “silent killer” because chronic high blood pressure typically has no symptoms. When the pressure is elevated so high as to be immediately life-threatening, it may cause headache, blurred vision, chest discomfort, or shortness of breath. Normal blood pressure is measured as no higher than 120/80 mmHg. Over time, high blood pressure damages the blood vessels, making them susceptible to the disease process that causes heart attack and stroke.

If you have normal blood pressure or have successfully managed your hypertension with medication, then you may be tempted to indulge in salty foods. Beware, because too much sodium can damage the heart and kidneys independent of high blood pressure, and studies have shown that sodium can interfere with the same medications often prescribed to treat hypertension.

If you already have cardiovascular disease, managing your salt intake is critical to the quality and length of your life. This is especially true for patients with congestive heart failure (CHF), for whom higher blood volume can mean additional strain on an already struggling heart.

How Can I Reduce My Dietary Sodium?

For most people, limiting dietary sodium requires a two-pronged approach. First, try putting away the salt shaker while cooking and dining and, second, become a smart shopper, one who has learned to avoid prepackaged, processed food – the greatest sources of salt in the U.S. diet. Here are some tips for choosing heart-healthy options, whether you are dining out or at home:

• If it’s in a package, start reading. Ideally, you will eat as few prepackaged, processed foods as possible. When you do buy prepackaged foods, read the Nutrition Facts label on the product and choose items that have lower amounts of sodium.
  
  
• Start little ones out right. If you buy packaged foods for toddlers and children, check the sodium content of those foods carefully. According to a recent study, more than 70% of commercially prepared meals and 50% of savory snacks sold for toddlers had higher than recommended sodium levels.
  
  
• Watch out for hidden sources of sodium. You might be surprised by how often salt is along for the ride when you indulge your sweet tooth. Commercially baked cakes and cookies – though not commonly thought of as salty foods – can have high sodium levels.
  
  
• Be a savvy restaurant patron. When dining out, talk with your server and/or the chef about which options are low in sodium or can be altered to be healthier. Request, when possible, that high-sodium sauces be omitted or replaced with other flavor boosters, such as herbs, spices, or a squeeze of lemon juice.
  
  
• Resist pouring it on. Skip or go light on condiments such as ketchup, mustard, and soy sauce. Try lower-sodium options for enhancing flavor.
  
  
• Hang in there. Eating a diet lower in salt will take some getting used to, but with time, your palate will adjust to low-sodium dining. And your heart will thank you.

Questions to Ask Your Doctor About Salt and Your Heart Health

1. Considering my current blood pressure and family history, what is a safe daily sodium intake for me?
   
   
2. Should I be reducing dietary sodium to improve my blood pressure?
   
   
3. If I have heart disease and have already reduced sodium in my diet, what other lifestyle changes should I be making?

What Should I Do If I Have Other Questions?

Ask them. Contact your healthcare provider and ask all of your questions. Any time you have health questions, the conversations you have with your doctor are the key to successful results. Ask every question you have.

We hope you will use SecondsCount.org to learn more about your cardiovascular health and treatment options. SecondsCount.org was developed by the Society for Cardiovascular Angiography and Interventions (SCAI), the medical society for interventional cardiologists.

SecondsCount is pleased to also provide this information as a downloadable PDF. We invite you to print it and share it with others, including your healthcare providers.

To download the PDF of this information, click here.

References

Maalouf J, Cogswell ME, Gunn JP, et al. Sodium content of commercial baby and toddler foods. EPI|NPAM2013; New Orleans, LA, March 19–22, 2013. Abstract P253.

Society for Cardiovascular Angiography and Interventions. Heart-healthy eating guidelines: skip the salt and sodium. http://www.scai.org/SecondsCount/Resources/Detail.aspx?cid=da8354ce-44d8-475b-a636-9caa33e2753b#4. Accessed March 29, 2013.

Society for Cardiovascular Angiography and Interventions. Special considerations for your diet: congestive heart failure. http://www.scai.org/SecondsCount/Resources/Detail.aspx?cid=1fc4a5eb-d46f-43ed-b141-f8f4744a034d#2. Accessed March 29, 2013.

Whelton PK, Appel LJ, Sacco RL, Anderson CAM, Antman EM, Campbell N, Dunbar SB, Frohlich ED, Hall JE, Jessup M, Labarthe DR, MacGregor GA, Sacks FM, Stamler J, Vafiadis DK, Van Horn LV. Sodium, blood pressure, and cardiovascular disease: further evidence supporting the American Heart Association sodium reduction recommendations.Circulation. 2012;126:2880–2889.