Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Reply to ‘Salt intake, cardiovascular disease, and physiology’

Nature Reviews Cardiology volume 15, pages 497–498 (2018)Cite this article

Subjects

We are grateful to Simon Thornton for his Correspondence (Salt intake, cardiovascular disease, and physiology. Nat. Rev. Cardiol. https://doi.org/10.1038/s41569-018-0047-3; 2018)1 on our Review (Role of salt intake in prevention of cardiovascular disease: controversies and challenges. Nat. Rev. Cardiol. 15, 371–377; 2018)2. However, our Review was focused on the evidence that salt intake is a major determinant of population blood pressure, not on the mechanisms by which salt can cause high blood pressure.

We and others have published several papers on the potential mechanisms3,4,5 but we did not think that this information was directly relevant to public health. When humans consume more salt, plasma levels of sodium and chloride increase, which causes increased thirst and fluid consumption. At the same time, this increase in the sodium and chloride concentrations increases extracellular fluid volume. Under normal circumstances, this increase in extracellular volume suppresses the renin–angiotensin–aldosterone system and also increases release of atrial natriuretic peptide (ANP), which to some extent mitigates the rise in blood pressure that would have occurred. However, long-term small increases in extracellular — or, more accurately, intrathoracic — volume slowly raise blood pressure.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

References

  1. Thornton, S. Salt intake, cardiovascular disease, and physiology. Nat. Rev. Cardiol. https://doi.org/10.1038/s41569-018-0047-3 (2018).

  2. He, F. J. & MacGregor, G. A. Role of salt intake in prevention of cardiovascular disease: controversies and challenges. Nat. Rev. Cardiol. 15, 371–377 (2018).

    Article  PubMed  Google Scholar 

  3. de Wardener, H. E., He, F. J. & MacGregor, G. A. Plasma sodium and hypertension. Kidney Int. 66, 2454–2466 (2004).

    Article  PubMed  Google Scholar 

  4. He, F. J., Markandu, N. D., Sagnella, G. A., de Wardener, H. E. & MacGregor, G. A. Plasma sodium: ignored and underestimated. Hypertension 45, 98–102 (2005).

    Article  PubMed  CAS  Google Scholar 

  5. Suckling, R. J., He, F. J., Markandu, N. D. & MacGregor, G. A. Dietary salt influences postprandial plasma sodium concentration and systolic blood pressure. Kidney Int. 81, 407–411 (2012).

    Article  PubMed  CAS  Google Scholar 

  6. Shore, A. C. et al. Endocrine and renal response to water loading and water restriction in normal man. Clin. Sci. (Lond.) 75, 171–177 (1988).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK

    Feng J. He & Graham A. MacGregor

Authors
  1. Feng J. He
    View author publications

    Search author on:PubMed Google Scholar

  2. Graham A. MacGregor
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Feng J. He.

Ethics declarations

Competing interests

F.J.H. is a member of Consensus Action on Salt & Health (CASH) and World Action on Salt & Health (WASH). Both CASH and WASH are non-profit charitable organizations, and F.J.H. does not receive any financial support from CASH or WASH. G.A.M. is Chairman of Blood Pressure UK (BPUK), Chairman of CASH, and Chairman of WASH. BPUK, CASH, and WASH are non-profit charitable organizations, and G.A.M. does not receive any financial support from any of these organizations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

He, F.J., MacGregor, G.A. Reply to ‘Salt intake, cardiovascular disease, and physiology’. Nat Rev Cardiol 15, 497–498 (2018). https://doi.org/10.1038/s41569-018-0048-2

Download citation

  • Published:

  • Version of record:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41569-018-0048-2

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing