In Clinical

Follow this topic

Bookmark

Record learning outcomes

Reduced salt intake, rather than antihypertensives, drove the falls in blood pressure between 2003 and 2011 in England, according to a new study.

Analysis of the Health Survey for England suggests that between 2003 and 2011, mortality from stroke and ischaemic heart disease declined by 42 and 40 per cent respectively. Average body mass index (BMI) rose by 0.5kg/m2 over this time.

Meanwhile, several other risk factors improved, which probably contributed to the declining mortality. For instance, average blood pressure declined by 3.0/1.4mmHg and cholesterol by 0.4mmol/L. The proportion of the population that smoked fell from 19 to 14 per cent, while fruit and vegetable consumption increased by 0.2 portions daily and salt intake decreased by 1.4g a day (a 15 per cent reduction).

In people not taking antihypertensives, blood pressure fell by 2.7/1.1mmHg, after adjusting for age, sex, ethnic group, education, household income, alcohol consumption, fruit and vegetable intake, and BMI.

The authors suggest that the fall in blood pressure is €largely attributable to the reduction in salt intake rather than antihypertensive medications€. The gradual reduction in salt added to processed foods, which accounts for approximately 80 per cent of total salt intake, probably accounted for most of the fall in consumption.

Nevertheless, pharmacists still need to promote healthy eating. In 2011, average consumption of fruit and vegetables was 3.8 portions a day, while the mean salt intake (8.1g/day) was still 35 per cent higher than recommended 6g/day. The authors say that €continuing and much greater efforts are needed to achieve further reductions in salt intake€. (BMJ Open 2014; 4:e004549)