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The INTERSALT Study: background, methods, findings, and implications

J Stamler1

  • 1Department of Preventive Medicine, Northwestern University Medical School, Chicago, IL 60611-4402, USA. hwe216@lulu.acns.new.edu

The American Journal of Clinical Nutrition
|February 1, 1997
PubMed
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High salt intake significantly increases blood pressure (BP) in individuals and populations. The INTERSALT study found that higher sodium excretion correlates with elevated systolic and diastolic BP, highlighting salt as a major cardiovascular disease risk factor.

Area of Science:

  • Epidemiology
  • Cardiovascular Disease Research
  • Public Health

Background:

  • Blood pressure is a critical health indicator and a major risk factor for cardiovascular disease.
  • Understanding the relationship between dietary factors, such as sodium intake, and blood pressure is crucial for public health.
  • Previous studies suggested a link between salt consumption and hypertension, but large-scale, standardized international data were needed.

Purpose of the Study:

  • To investigate the relationship between 24-hour urinary sodium excretion and blood pressure within and across diverse populations.
  • To quantify the effect of sodium intake on systolic blood pressure (SBP) and diastolic blood pressure (DBP).
  • To assess the role of habitual salt intake as a modifiable risk factor for population-wide hypertension and cardiovascular disease.

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Main Methods:

  • Conducted the INTERSALT Study, a standardized, large-scale international epidemiologic study involving 10,079 men and women aged 20-59 from 32 countries.
  • Collected 24-hour urine samples to measure sodium excretion.
  • Analyzed data using multivariate statistical methods to test within- and cross-population hypotheses, adjusting for potential confounders.

Main Results:

  • A significant, positive, and independent linear relationship was observed between 24-hour sodium excretion and SBP in individuals.
  • Increased sodium intake (100 mmol/day) was associated with an approximate 3-6/0-3 mm Hg increase in SBP/DBP, even in individuals without hypertension.
  • Cross-population analyses revealed that higher median urinary sodium excretion correlated with higher median SBP/DBP, increased hypertension prevalence, and steeper BP increases with age.

Conclusions:

  • Habitual high salt intake is a significant, preventable cause of elevated population-wide blood pressure.
  • The findings support the role of sodium reduction as a key public health strategy to combat cardiovascular disease.
  • The INTERSALT results align with a broad range of evidence, reinforcing the detrimental impact of excessive salt consumption on cardiovascular health.