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Salt and High Blood Pressure: The Truth

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For decades, conventional doctors have preached a low-sodium diet for high blood pressure, popularized as the DASH diet. With the rise of heart disease, many countries have pushed food industries to use less salt. But the story around salt is not as straightforward as you may think. 

Excessive salt intake can indeed increase blood pressure. But a low-sodium diet is not a fix-all solution, and it may present harmful consequences for your blood pressure and overall health. 

The origins of the salt controversy

Concerns about salt gained traction in the 1970s when scientist Lewis Dahl induced high blood pressure in rats by feeding them 500 grams of sodium per day. This is an extreme level of sodium intake. For reference, most average Americans consume only 3.4 grams of sodium per day. 

Dahl argued that populations with higher sodium intake, such as Japan, tend to have higher blood pressure and risk of stroke. Because of Dahl’s research, the United States Senate released a report in 1977 recommending Americans cut back on salt intake. Since Dahl’s work, more research has been done on the effect of salt on blood pressure, and the results are mixed. 

The INTERSALT study was an observational study done in 1988 that looked at the link between salt and blood pressure, sampled from 52 populations. One of the groups was the Yanomami Indians, who have very minimal salt in their diets. Researchers found that this population had low average blood pressure, findings that aligned with Dahl’s research. 

However, a conflicting study was done with the indigenous Kuna in Panama – another population with low average blood pressure. In this study, researchers added more salt to the Kuna’s diet while keeping the rest of their indigenous diet the same. Simply adding salt did not result in increased blood pressure. 

Some of the Kuna moved to an urban setting in Panama City and adopted more of a Western diet and lifestyle. These individuals did show increased rates of high blood pressure. This study shows that diet and environmental factors play a much bigger role in blood pressure regulation than salt intake alone. 

How exactly does salt affect blood pressure?

Salt contributes to a rise in blood sodium, which increases fluid volume. It makes sense that this would lead to higher blood pressure. But it seems that for every study that supports this theory, there is another one that contradicts it. 

How can there be such conflicting evidence out there?

Human beings have bio-individual responses to salt, affected by many different factors, particularly kidney function. The kidneys are responsible for eliminating sodium from the body and regulating fluid balance. 

Kidney function is complex and varies greatly depending on age, genetics, and lifestyle factors. This may explain why the link between blood pressure and salt intake isn’t so clear.

The truth about low-sodium diets and high blood pressure

A low-sodium diet may decrease blood pressure in many individuals, but that’s not the most critical issue. Lower blood pressure doesn’t necessarily mean that you’re at a lower risk for poor health outcomes. The real concern is how a low-sodium diet affects the risk for serious health outcomes, such as heart attack, stroke, and death. 

It’s more likely that the link between salt intake and cardiovascular disease may be a “J-shaped relationship”. Both low-sodium diets and very high-sodium diets may carry a higher risk.

The real consequences of a low-sodium diet

Sodium is an essential electrolyte for regulating hormones, fluid balance, muscle, and nerve function. It also helps control the rhythm of the heart. Hyponatremia, or low sodium levels in the blood, may alter the functioning of the Renin-Angiotensin-Aldosterone system and the sympathetic nervous system. This can throw many functions in your body out of balance, leading to other health problems.

Contrary to the conventional narrative, a low-sodium diet increases the risk of cardiovascular disease. A worldwide study of 130,000 people showed that low sodium intake (less than 3 grams per day) increased the risk of heart attacks, strokes, and death compared with average sodium intake. 

In this study, about half of the participants had high blood pressure, and half did not. In the hypertensive group, the risk for heart attack and stroke increased by 34 percent. For those without hypertension, the risk was increased by 23 percent. 

Another smaller-scale study looked at sodium excretion levels in urine, a good indicator of sodium intake. Low sodium levels were linked with lower systolic blood pressure. Again, low sodium levels increased the risk of death.

Low sodium levels in the blood can also lead to other health problems, including insulin resistance, increased oxidized LDL and triglycerides, and increased risk of death for individuals with diabetes. Acute and severe cases of hyponatremia may cause headaches, seizures, coma, and death. This evidence suggests that a low-sodium diet could be more dangerous than beneficial. 

At Natural Heart Doctor, we believe that moderation is key. If you have high blood pressure, you should indeed avoid getting too much sodium in your diet. But be careful not to swing too far in the other direction. Aim for a moderate amount of salt to avoid the health risks associated with a low-sodium diet. 

More importantly, make sure you eat an organic diet, exercise regularly, get enough sleep, and address any environmental toxins. 

The important role of potassium

Potassium is another essential electrolyte that may play an important role in the relationship between sodium and blood pressure. Potassium helps the body eliminate sodium and lowers blood pressure by helping relax blood vessel walls. As a result, potassium can lower the risk of heart attack and stroke. Low potassium levels can cause an abnormal heart rhythm and worsen heart disease.

The recommended daily intake of potassium is around 4700mg. Most people don’t get this amount in their diet, especially if they eat a lot of processed food. If you’re not getting enough potassium in your diet, you may consider supplementing with Potassium Boost.

The best types of salt for high blood pressure

Not all salt is equal. It won’t benefit your blood pressure to eat large amounts of sodium in TV dinners and other processed foods. However, high-quality salt can be beneficial when added to healthy, home-cooked meals. Just make sure you choose the best salt for your blood pressure. Let’s take a closer look at a few different types of salt.

Table salt

Table salt is a household staple and is found in many processed foods. It is refined, meaning it’s altered from its original state. Many beneficial minerals are processed out of table salt, so there are no added health benefits. You will want to swap out table salt for a healthier option, especially if you have high blood pressure. 

Sea salt

Sea salt is a form of unrefined salt made by evaporating water from the ocean. It’s a better option than table salt because it contains other vital minerals, such as potassium and iron. Unfortunately, sea salt may contain toxins, as our oceans are full of environmental contaminants such as mercury and microplastics

If you’re going to use sea salt, find one that’s toxin-free and from a trustworthy brand.

Pink Himalayan salt

This type of salt is another excellent choice. It comes from the Himalayan mountains and is free of environmental toxins. Like sea salt, it contains other minerals, such as potassium, magnesium, and calcium. 

Himalayan salt has a more potent taste, meaning that you can use less and achieve the same amount of saltiness. This may be beneficial for those trying to moderate their salt intake.

Next steps

High blood pressure is a complex condition with many moving parts and underlying risk factors. The link between salt intake and high blood pressure isn’t clear-cut. At Natural Doctor, we don’t believe the solution is to vilify salt. 

Despite what your doctor may have told you, adding a moderate amount of toxin-free salt can boost minerals and benefit your blood pressure! Just make sure that you’re also addressing the bigger picture of your diet and lifestyle. Schedule a 20 minute health coaching strategy call with a Natural Heart Doctor health coach who can help you determine what minerals you may need and give you further tools to pursue those big-picture lifestyle changes.

Eat Well · Live Well · Think Well 

Medical Review 2022: Dr. Lauren Lattanza NMD


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Frequently Asked Questions

I’d like to receive an online second opinion from Natural Heart Doctor. What do I do next?

You can initiate a second opinion online through our website at any time. To begin, select the team member you’d like to speak with and open an account.

Click here for cardiologist Dr. Jack Wolfson.

Naturopathic Medical Doctor Dr. Lauren Lattanza. Get details.

Naturopathic Medical Doctor Dr. Tonia Rainier. Get details.

Click here for  Natural Heart Doctor Health Coach.

Alternatively, you can email health@naturalheartdoctor.com. A member of our care team will help guide you through the process of starting a second opinion.

What is the cost of a Natural Heart Doctor Online Second Opinion?

The cost for most second opinions varies by team member. This fee includes information collection, a phone or video consultation, a second opinion from a Natural Heart Doctor specialist and guidance throughout the process from your personal Care Team at Natural Heart Doctor.

Cardiologist Dr. Jack Wolfson’s Second Opinion Fee is $1500.

Holistic Physician’s Dr. Lauren Lattanza’s Second Opinion Fee is $250.

Naturopathic Physician Dr. Tonia Rainier’s Second Opinion Fee is $250.

Note: We apply the Online Second Opinion Call fee as a credit to any future consultations with Natural Heart Doctor, should you choose them.

Will my insurance cover the cost of a Natural Heart Doctor Online Second Opinion?

Most likely, no. Most health plans do not cover online second opinions or consultations. You are responsible for the cost of our second opinion. Natural Heart Doctor cannot file a claim with your insurance carrier, nor can we provide a procedure (CPT) code for this service.

What is the timeline to receive an online second opinion?

We do our best to schedule your second opinion as quickly as possible. Typically, it takes 5 to 7 business days after your information has been collected to receive your phone or video online second opinion.

What information do you need in advance of our call?

Our office will send you a short questionnaire to complete and return. We DO NOT need your complete medical records.

How many questions can I ask the expert during our call?

You may ask a maximum of five questions. This is to ensure that the expert has sufficient time to devote to each question. All questions must be finalized before your online meeting.

What should I expect to receive once my second opinion is complete?

You will receive a summary of our discussion along with our second opinion. The second opinion will be in written form. After you have reviewed the second opinion, a Natural Heart Doctor clinician will follow up with you by phone to address general medical questions about the information provided in the second opinion.

What if I have follow-up questions for the expert after I have reviewed my second opinion?

If you have a clarifying question about an expert’s response to one of the questions in your second opinion, and the Natural Heart Doctor clinician is unable to address it, then you may request a follow up session for an additional fee. 

Is my medical and payment information secure?

Natural Heart Doctor is strongly committed to protecting the privacy and security of all our patients. Our website meets all federal requirements for protecting personal health information under the Health Insurance Portability and Accountability Act (HIPAA). All financial transactions are processed by Natural Heart Doctor securely using industry standard payment processing tools.

I would rather visit Natural Heart Doctor for an in-person appointment. What should I do next?

If you would prefer an in-person appointment at Natural Heart Doctor instead of an online second opinion, please call (480) 535-6844 for details and scheduling.

Can I schedule a follow up appointment with the specialist who provided my online second opinion?

Yes, we’re happy to help you on an extended basis. Our clinician can discuss options with you when presenting our second opinion summary.