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"Slow"ing Cardiovascular Risk in Type 2 Diabetics by Restricting Dietary Salt Intake.

See related article, pp 1189–1195 

In this issue of Hypertension , Suckling et al1 make an important new contribution toward understanding the potential clinical benefit of reducing dietary salt intake in patients with type 2 diabetes mellitus. A significant amount of data suggests that dietary salt restriction is an important clinical step toward blood pressure control in both normotensive and hypertensive populations, and especially in African Americans where the prevalence of salt-sensitive hypertension is high.2 Nevertheless, whether it is appropriate to use population-wide strategies to reduce salt intake has remained a subject of debate over the past several decades. Adding to the debate, a recent meta-analysis of 269 reports set out to assess whether dietary salt reduction lowered all-cause mortality and risk for cerebro-cardiovascular disease.3 Although 55% of those studies supported the concept of salt reduction to reduce mortality and cerebro-cardiovascular risk, 46% either contradicted the idea or were not conclusive. Moreover, the analysis showed that studies were significantly more likely to only cite papers that were in agreement with the results of the study, suggesting that sweeping conclusions about population-wide salt restrictions still need to be made with caution.

From the continued discussion surrounding population-wide salt restriction, the importance of dietary salt restriction to provide health benefits beyond cardiovascular risk is also becoming evident. For example, the potential exists for dietary salt restriction to reduce risk for developing gastric cancer.4 In experimental autoimmune encephalitis (a mode of multiple sclerosis), salt restriction seems to attenuate disease progression through a serum glucocorticoid–regulated kinase 1–mediated polarization …