Population reduction in salt intake for the prevention of cardiovascular disease: the “Four Imperatives”

Salt consumption is now much greater than needed for survival. High salt intake increases blood pressure in both animals and humans. Conversely, a reduction in salt intake causes a dose-dependent reduction in blood pressure in men and women of all ages and ethnic groups, and in patients already on medication. The risk of strokes and heart attacks rises with increasing blood pressure, and a reduction of blood pressure with drugs reduces the risk. However, most events occur in individuals with ‘normal’ blood pressure levels. Non-pharmacological prevention is therefore the only option to reduce such events in the population at large. Reduction in population salt intake reduces the number of vascular events. It is one of the most important public health measures to reduce the global cardiovascular burden. Salt reduction policies are feasible and effective (preventive imperative), cost-saving (economic imperative), powerful, rapid, equitable (political imperative) and life-saving (moral imperative). The World Health Organization recommends reducing salt consumption by 30% globally by 2025, aiming to reduce salt consumption to less than 5g per day, eventually.