What You Need To Know About Sodium And High Blood Pressure

The increased availability and affordability of convenience foods are transforming our dietary patterns. All over the world, especially in the US, people are consuming increasing amounts of energy-dense foods with excess salt, sugar, and saturated fats¹.  Salt is the main source of sodium, and its increased consumption equates to a higher risk for stroke and heart disease.

Similarly,  shifting eating patterns have people consuming less fruit, vegetables, and dietary fiber, all of which are vital components of a healthy diet. Those food groups also tend to be rich in potassium which can help relax blood vessel walls and lower your blood pressure².

This article will help you learn about hypertension prevention and management and answer the question, "How much sodium per day is ideal if you have high blood pressure?"

First, what is the definition of high blood pressure?

According to the American Heart Association, high blood pressure or hypertension Stage 1, is a systolic blood pressure level over 130/80mmHg³.  High blood pressure is the leading cause of stroke and heart attacks worldwide. 

The following table provides an overview of blood pressure level ranges:

How does sodium intake increase your blood pressure?

Usually, your kidneys do an excellent job regulating sodium and water levels in your blood. However, if you consume excessive amounts of salt, you can disturb the balance and increase your blood sodium level.

As a result, your body holds more water in the blood and the fluid surrounding your cells. A subsequent increase in blood volume causes a rise in blood pressure, which makes your heart work harder to circulate blood throughout your body. Over time, this strain leads to stiffer blood vessels, higher blood pressure, and the risk of stroke or heart disease.

What's the difference between salt and sodium?

The terms salt and sodium are often used interchangeably. However, sodium is a component of salt. Sodium plus chloride is the mineral recipe that creates salt. Sodium is the ingredient responsible for increasing blood pressure when consumed beyond recommended amounts.

Estimating the amount of sodium in salt

With packaged foods, the amount of sodium is always indicated on the label in milligrams. To determine the exact amount of salt an item contains, multiply the sodium value by 2.5.  For example, 1000mg sodium = 2.5g of salt. Table salt is nearly 40% sodium.

Here are some estimates to help you under your exact sodium intake:

• 1/4 teaspoon is equivalent to 575mg sodium

• 1/2 teaspoon is equivalent to 1150mg sodium

• 3/4 teaspoon of sodium carbonate to 1725mg sodium

• One tablespoon of salt is equivalent to 2302mg sodium

According to the Center for Disease Control (CDC), the average adult should not consume more than 2,300 mg of sodium per day⁴.

If you have high blood pressure, do not exceed 1500 mg of sodium a day.

If you have been diagnosed with hypertension, it’s ideal to reduce this amount to 1000 mg per day to limit the risk of heart disease.

Which salt is good for high blood pressure?

When it comes to managing high blood pressure, the type of salt you choose isn’t as important as using salt sparingly.

In the US, it’s common to use iodized table salt or kosher salt to season your food. Sea salt and pink Himalayan salt are also popular options, and they feature trace minerals that regular table salt does not have.

However, even though sea salt and pink Himalayan salt include heart health-supporting minerals like potassium and magnesium, research indicates⁵ that the amounts are too insignificant to have nutritional value, and the amounts can also vary widely depending on where the salt comes from.  Not all pink salt comes from the Himalayas. It might originate from Australia or Peru.

Also, it can be misleading that a teaspoon of sea salt or other coarse salt has less sodium than a teaspoon of table salt. The lower sodium is only by volume because the grains are bigger. In other words, you can’t fit as many grains of sea salt in a spoon as you can fine-grain table salt.  So, in that sense, it is “low-sodium.” By weight, the two have the same sodium content.

Researchers haven’t found a variety of salt that is definitively good for hypertension, so your wisest option is to use it with discretion.

Is salt bad for you?

Our bodies need a certain amount of salt to function, so, no, salt is not inherently bad.

However, the amount of salt that is naturally present in our food is adequate to meet our daily needs. So, technically, there is no need to add salt to food, during processing, cooking, or when you’re at the table.

Research does clearly indicate that eating too much salt⁶ leads to increased blood pressure and a higher risk for heart disease. The World Health Organization suggests that if the global population reduced their average sodium intake to the recommended values, we would save an estimated 2.5 million lives⁷ annually.

High sodium foods

One of the best ways of limiting your sodium intake is to closely monitor what you eat. Be on the lookout for foods that are high in salt and avoid them in your diet, especially if you are hypertensive. If you want to enjoy something to eat that contains high levels of sodium, be sure to consume only small amounts, infrequently.

High-sodium foods include:

• Cured meats like ham, bacon, or salami

• Olives

• Processed cheese

• Prawns

• Salted fish

• Soy sauce

• Smoked meat and fish

• Yeast extract

Typically high-sodium prepared foods

The sodium content will vary widely depending on the brand. It’s crucial to check the nutritional labels to know the exact sodium content, especially with the following items:

• Frozen entrées

• Canned soups

• Pizza

• Sandwiches

• Chips

• Sausages

• Ready meals

• Pasta sauces

• Breakfast cereal

• Mayonnaise

• Ketchup

FDA guidelines on voluntary sodium reduction

In October of 2021, the US Food and Drug Administration released guidelines⁸ intended to reduce sodium in packaged, processed, and prepared foods. The guidance covers about 160 categories for restaurants, food manufacturers, and foodservice businesses. The main aim of the sodium reduction campaign is to reduce the average sodium intake in America from 3400 mg to 3000 mg a day in the next two and a half years.

How quickly can reducing sodium lower your blood pressure?

Evidence suggests that reducing your daily salt intake by 3-5 g⁹ can significantly reduce your blood pressure¹⁰. Clinical research indicates¹¹ that if you follow the DASH diet,  you may be able to lower your blood pressure in as little as a week.

Results of sodium reduction vary from person to person depending on several factors such as genetics, starting blood pressure, medication in use, and disease status. It's also vital to remember that other factors influence our blood pressure, not just salt.

Other contributors may include your level of physical activity, potassium intake, body weight, and whether or not you smoke or consume alcohol.

It’s also important to note that everyone’s “salt sensitivity” varies. For instance, some people experience high blood pressure upon increasing salt intake. For others, there is no noticeable change. Nearly 50% of people in the world are salt sensitive¹². The elderly, those living with diabetes, and African Americans are the most salt sensitive.

Tips for reducing sodium intake

If you want to lower salt intake, you can try implementing the following tips:

• Minimize intake of processed foods: Manufacturers add salt to different foods during processing. This extra sodium affects your high blood pressure.

• Read information on food labels: Select low sodium foods and beverages when shopping. 

• Don't add salt to your food: As we've seen before, one teaspoon of salt is equivalent to 2300 mg of sodium. Instead of adding salt to your food, consider using spices and herbs to add flavor. 

• Cut your sodium intake gradually: For most people, it's next to impossible to reduce sodium intake suddenly. The best option is to reduce sodium in your foods gradually. 

What are the advantages of reducing sodium intake?

Consuming less sodium minimizes the risk for high blood pressure, stroke, and heart disease. Also, you can save money and lives by reducing sodium in food. For example, if Americans consumed an average sodium intake of 1500 mg per day, this would translate to a 25.6% decrease in blood pressure¹³. The reduction in cardiovascular disease and death would save an estimated $18 billion in healthcare costs. 

The balancing act: sodium vs. potassium

It's worth noting that both sodium and potassium affect your blood pressure¹⁴. Adequate potassium intake can help counter the effects of high sodium intake. People who increase potassium and reduce sodium intake tend to have lower blood pressure and reduce the risk of other severe health problems. Evidence suggests that high potassium intake¹⁴ can lower blood pressure in most people.

So, a  diet rich in potassium¹⁵ may help you control your blood pressure. Such a diet includes fruits, vegetables, whole grains, and foods with low cholesterol, such as low-fat dairy products.

If you have any kidney health issues or take diuretics, discuss best dietary practices with your doctor. Your medications may increase or lower your potassium levels.

What is the DASH diet?

DASH is an acronym for Dietary Approaches to Stop Hypertension. Healthcare professionals developed this eating plan specifically to prevent and treat high blood pressure. It includes foods rich in potassium, magnesium, and calcium. These nutrients are essential for controlling blood pressure. The DASH diet limits sodium, added sugars, and saturated fats. Research shows that the DASH diet¹⁶ can start to lower your blood pressure in about two weeks. 

DASH diet and sodium

The DASH diet allows for much less sodium than average American consumption (roughly 3,400 mg of sodium a day). The DASH diet reduces sodium intake to about 2300 mg per day. Some versions limit daily sodium to 1500 mg.

DASH diet recommendations

This diet is a flexible eating plan that enables healthy eating habits. The diet also limits processed foods high in saturated fats, full-fat dairy products, and fatty meats.

The lowdown

High sodium intake is a recipe for high blood pressure. One of the best ways to limit your sodium is to eat whole, unprocessed foods whenever you can.  Also, ask your doctor if a high potassium diet is an appropriate way to balance your sodium levels.

If you have challenges monitoring your sodium intake, work with your doctor. Remember, consistently monitoring your blood pressure lowers the risk of developing stroke, hypertension, and heart disease.