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How Much Sodium Is Too Much? It Depends

Salt in the diet can cause blood pressure problems

By Mark Huffman
ConsumerAffairs.com

February 5, 2008

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While on a business visit to the office of ConsumerAffairs.com's health adviser, Dr. Henry Fishman last summer, I spied a blood pressure cuff on a nearby table.

I had battled high blood pressure for years, but nothing I did resulted in acceptable readings. I had lost weight, started exercising, but wasn't yet on any medication.

"Hey, would you take my blood pressure?" I asked.

He applied the cuff to my left arm and squeezed the bulb, forcing air into it. As the air slowly escaped, he looked me in the eye and spoke, both as a doctor and a longtime friend.

"Do you have a will?" he asked.

I must have looked startled because he added, "look, you can do something about this or you can die of a heart attack in five years, it's up to you."

Lethal level

My blood pressure, he told me, was 160/101 – a level he called "lethal." I took his advice and saw my doctor, who agreed I needed to do something and prescribed 40 minutes of exercise four days a week and put me on an ACE inhibitor.

He explained that my blood pressure should be no more than 130/80. Preferably, he said, it should be a lot less.

The higher number in a blood pressure reading is called the "systolic" pressure, and measures the pressure of the blood flowing through the veins when the heart beats. The lower number is called the "diastolic" number, and measures the pressure when the heart is at rest.

When the pressure is too great, it can cause the heart muscle to grow and enlarge, causing all kinds of problems, including heart failure. It also places strain on blood vessels, increasing the risk one of them could rupture, leading to a stroke.

I began taking the ACE inhibitor – a drug that increases flexibility in blood vessels - and worked out four days a week. I also attempted to lose a few more pounds and began monitoring my blood pressure on a daily basis.

My blood pressure came down, but not enough. A typical reading, taken early in the morning, was around 146/89. During the day, especially after a meal, it would spike even higher into the red zone.

Sodium sensitivity

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Then in early January, while researching a story for ConsumerAffairs.com, I came across some medical research that suggested some people have a hyper-sensitivity to sodium. Even normal levels of sodium consumption cause high blood pressure readings. It's unclear whether it's a genetic thing, or is triggered in other ways.

In these people, the body doesn't metabolize sodium very well, resulting in excess water in the blood stream, making the heart work harder. Removing the sodium seems to solve the problem, the research said.

Sodium. Salt. Sure, I'd heard that too much sodium could raise your blood pressure, but how much is too much and how much do you really need?

Unfortunately, there's conflicting information on the subject. The USDA minimum recommended daily amount is 2400 mg, but other sources suggest that could be excessive.

"Since the minimum physiological requirement for sodium is only 500 mg daily, Americans well exceed their sodium intake," say health experts at Northwestern University. The average adult can easily consume 3,000 milligrams or more a day if they aren't paying attention. There can be over 1,700 milligrams in one large dill pickle.

Maybe for most people, 2400 mg of sodium a day is just fine. But for me – and perhaps many others – it's way too much. I was about to reach that conclusion, and end the long, frustrating search for the cause of my high blood pressure.

A new year

On January 4, 2008 I cut as much sodium out of my diet as possible, trying to keep levels down to 500 mg or less. On the morning I started my regimen my blood pressure was 142/87. The next morning I was stunned to see it had fallen to 127/80, and 120/77 the following day.

The following week I was getting readings of 115/72. The only thing I was doing differently was drastically reducing sodium.

To do that I tried to avoid eating anything out of a box, a bag or a can. Breakfast now consists of oatmeal with raisins, walnuts and a banana. For lunch I have a salad or a baked potato. Dinner is grilled chicken or fish and steamed vegetables. I read labels, looking for products with the lowest amount of sodium.

If I go off my sodium-restricted diet for a day, usually by accident, my blood pressure spikes up again. As long as I keep sodium consumption to below 500 mg a day, I have the blood pressure of an 18-year-old.

Not for everyone

It bears repeating that my limited sodium intake may be too little for most people. But if you have a sodium sensitivity, very little sodium performs the tasks in your body that more sodium is required to perform in others. However, you shouldn't drastically alter your diet without first talking to your doctor.

Still, a sharply lower sodium intake may provide hope for many people who, like me, couldn't figure out why their blood pressure was off the chart. And more and more research emphasizes the sodium-blood pressure link.

In 2000, a study by the National Heart, Lung, and Blood Institute established a direct connection between lowering sodium intake and lowering blood pressure. In the study, the lowest sodium level tested, which produced the lowest blood pressure, was well below the currently recommended intake of 2,400 milligrams a day.

Why not eliminate sodium altogether from your diet? Because your body needs it.

Without sodium, nerves and muscles would cease to function, the absorption of major nutrients would be impaired, and the body would not be able to maintain adequate water and mineral balance.

High blood pressure can be a difficult disease to tame because there are so many factors that can influence it. But for millions of people who haven't been able to figure out what's causing it, curtailing sodium intake may provide results.

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