Reducing Salt Intake by Enhanced Warning in Family Medicine

Background: Excessive salt intake is a major cardiovascular risk factor. At variance to the developed countries, the main source of sodium in transitional and developing countries is salt added while cooking and/or at the table. The objective of this trial was to examine the impact of enhanced warning on daily salt intake. Subjects and Methods: A sample of treated hypertensive (N= 150) was randomized in two intervention subgroups, one receiving just a leaflet about the harmful effects of excessive salt intake (N= 74 - group 1), and the other one receiving in addition warning stickers for household salt containers (N= 76 ? group 2). Arterial blood pressure (BP) and 24 h urinary sodium excretion (Na24) were measured in all the subjects at the start of the trial, and one month and two months later. Results: The average starting 24Na was well above 205 mmol. In all the examinees a significant Na24 decrease was observed after 2 months, by some 27 mmol (P < 0.001). The decrease in Na24 was more pronounced in group 2 (to 183 ± 63 and 176 ± 55 mmol; P<0.001) than in group 1 (203 ± 60 and 200 ± 58 mmol; P= 0.147). Moreover, a significant drop in BP, by 5.3/2.9 mm Hg was observed in group 2 as opposed to group 1 (0.4/0.9 mm Hg). Male examinees (N= 73) had significantly higher Na24 during this trial than their female counterparts (N= 77). Decrease in Na24 positively correlated with BP lowering (r? = 0.5989; P< 0.0001). Conclusions: A significant reduction in Na24 and BP is achieved with educational measures on harmful effects of excessive salt intake, in particular with the respective warning labels. Decreasing daily salt input by 35 mmol may result in an extra BP lowering by some 5-6/2-3 mm Hg.