[The salt-free diet].
The debate about the importance of salt in the pathogenesis and treatment of hypertension is still ongoing. The importance of salt is rooted on several factors. First, salt is one of the first factors who has been identified to be of potential importance in blood pressure regulation. Second, during the last decades several other pathogenetic risk factors for essential hypertension have been identified, however, without the identification of one single predominant risk factor. These risk factors include different genetic factors and predispositions as well as modifiable environmental factors. For the development of hypertension usually several of these risk factors have to be present. In miscellaneous disease conditions, such as heart failure, salt induces a sodium and volume retention. Accordingly it is often falsely concluded that salt will lead to a volume retention and hypertension in all subjects and that a salt restriction will lead to a normalization of an elevated blood pressure. Although about 40% of the patients with essential hypertension are salt sensitive, the concept of salt sensitivity is not valid for all subjects of a population. Accordingly one can not conclude that a general salt restriction would be a cure for hypertension. The therapeutic priority in the non-pharmacological prevention and/or therapy of hypertension lies usually in the control of other risk factors than salt intake. These risks include overweight and obesity, alcohol consumption and physical inactivity. These concepts are supported by several recent meta-analysis.
Drüeke
T B
TB
Unité 507 de l'INSERM, Hôpital Necker, Paris.
Suter
P M
PM
D004039:Diet, Sodium-Restricted; D006801:Humans; D006973:Hypertension / Q000178:diet therapy* / Q000209:etiology; D012307:Risk Factors; D017673:Sodium Chloride, Dietary / Q000009:adverse effects*
D017673:Sodium Chloride, Dietary