Medicine Corner with Dr D 

Salt Intake and atherosclerosis - High Salt Intake Linked to Atherosclerosis Even With Normal Blood Pressure

A recent study conducted in Sweden has found even closer relationship between salt intake and atherosclerosis than thought before. The researchers found that  Salt Intake can increase the risk of atherosclerosis, even in individuals with normal blood pressure. The study, published on March 30th in the European Heart Journal Open, analyzed data from the Swedish Cardiopulmonary bioImage Study, which included over 10,000 participants aged 50 to 64 years. The study found that high salt consumption was strongly linked with the development of atherosclerotic lesions in the coronary and carotid arteries.

The lead researcher of the study, Dr. Jonas Wuopio from Karolinska Institutet and Uppsala University, stated that while the link between salt and hypertension is known, the role of salt in atherosclerosis has not been studied in detail. The researchers used advanced imaging technology to study calcification changes in the arteries and atherosclerotic plaques, and the association with salt intake. The study used coronary computed tomography angiography (CCTA) to obtain 3D images of the coronary arteries and measure the degree of coronary artery calcium, as well as detect stenosis in the coronary arteries. Participants also had an ultrasound of the carotid arteries. The estimated 24-hour sodium excretion was used to measure sodium intake.

The researchers found that increasing salt consumption was linked with an increase in atherosclerosis in both the coronary and carotid arteries. Each 1000 mg rise in sodium excretion was associated with a 9% increase in the occurrence of carotid plaque, a higher coronary artery calcium score, and a 17% increase in the occurrence of coronary artery stenosis. The researchers noted that the association disappeared after adjusting for blood pressure. They suggest that the increase in blood pressure from sodium intake, even below the level that currently defines arterial hypertension, is an important factor that mediates the interplay between salt intake and the atherosclerotic process. However, they caution that no causal relationships can be drawn from this cross-sectional study. The study also found no evidence of a J-curve phenomenon, which some studies suggest that very low sodium intake is linked to an increased risk of cardiovascular disease-related events. Participants with the lowest levels of sodium excretion had the lowest occurrence of both coronary and carotid atherosclerosis. The researchers suggest that excess salt is not good and that salt intake might be a risk factor for atherosclerosis even before the development of hypertension.

According to Dr. Alon Gitig, a cardiologist at Mount Sinai Doctors-Westchester, Yonkers, New York, not all studies have suggested that high salt intake tracks with the risk for atherosclerotic disease. Most studies of salt intake in the diet are based on patient self-reports via food frequency questionnaires, which can give a general idea of salt intake but may not be accurate. The Swedish Cardiopulmonary bioImage Study used a more reliable method by measuring the participants' 24-hour sodium excretion. In conclusion, the study suggests that high salt intake increases the risk of atherosclerosis, even in individuals with normal blood pressure. The study used advanced imaging technology to study calcification changes in the arteries and atherosclerotic plaques, and the association with salt intake.

While the association disappeared after adjusting for blood pressure, the researchers suggest that the increase in blood pressure from sodium intake, even below the level that currently defines arterial hypertension, is an important factor that mediates the interplay between salt intake and the atherosclerotic process. This study highlights the need for further research into the relationship between salt intake and atherosclerosis. Atherosclerosis usually go hand in hand with diabetes. Making sure that you maintain healthy weight and stay in good physical shape will further help you prevent developing both diabetes and Atherosclerosis.