CEO and Country President of Novartis South Africa, Dr Thomas Kowallik, explains how unhealthy habits, such as excessive salt intake, are responsible for hypertension.

The old adage ‘take it with a pinch of salt’ is meant to be a positive one – implying that a pinch of salt is of little consequence. But for those with high blood pressure and chronic heart conditions, that pinch of salt could be enough to push your daily salt intake into dangerous territory.

Excessive salt intake is one of several factors increasing the risk of hypertension (high blood pressure). According to the International Society of Hypertension, hypertension is the major risk factor for cardiovascular disease and was named ‘the number one killer’ by the World Health Organisation (WHO) in The World Health Report in 2002. People with hypertension have a four times higher risk of stroke and twice the risk of myocardial infarction (a heart attack) of those with normal blood pressure, says the Society. Lifestyle factors, such as physical inactivity, a salt-rich diet with highly processed and fatty foods, and alcohol and tobacco use, are cited as reasons for the rapid increase in the number of people with hypertension worldwide.

South Africans have unacceptably high levels of hypertension, with up to 30% of adults known to be hypertensive. High salt consumption is a key driver of hypertension, and there is strong evidence to indicate that South Africans consume up to 2-3 times the recommended daily allowance of 5g.

Salt from processed food makes up as much as 75% of total salt intake in high-income countries. South Africans tend to follow international trends to include unhealthy processed foods in their diet, and on top of that, they season their meals with liberal sprinklings of salt. This is dangerous behavior, particularly among those with high blood pressure or heart disease. The Department of Health’s salt reduction targets for 2013-2019, along with increased awareness among consumers, could help reduce deaths and chronic illness caused by hypertension in South Africa.

According to World Action on Salt and Health (WASH), a high salt intake is associated with raised blood pressure, which is a major cause of cardiovascular disease, responsible for 62% of stroke and 49% of coronary heart disease.  

There is also considerable evidence that the onset of heart failure could be delayed or even prevented by modifying risk factors and controlling hypertension, and a reduction in sodium intake reduces blood pressure in people both with and without hypertension.

Studies have found a significant association between sodium intake and all stroke, fatal stroke, and fatal coronary heart disease events. Clearly, it is important to restrict salt intake to healthy levels to reduce the risk of cardiovascular disease, and for patients at risk of stroke or coronary heart disease to be particularly careful to follow their doctors’ guidelines on sodium intake. However, this does not mean one should eliminate all salt from one’s diet. Sodium is an essential nutrient, required for normal physiological function.

People with, or considered at risk, of stroke or heart disease should take extra care to ensure that they keep their salt intake well below the recommended maximum of 5g a day.

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