Moderate sodium restriction. Do the benefits justify the hazards?

Moderate sodium restriction (70 to 100 mEq/day) leads to a fall in blood pressure for only a minority (approximately 25%) of patients with mild hypertension. At the same time, it may also be hazardous by 1) increasing blood pressure in some patients (perhaps 15%); 2) disturbing sleep; 3) reducing intake of other valuable nutrients; and 4) decreasing host resistance to such stressful events as diarrhea, hyperthermia, and bleeding. In view of the limited positive effect demonstrated in short term studies, the absence of proven reduction in cardiovascular disease occurrence, as well as both documented and theoretical hazards, a blanket recommendation that all hypertensives restrict sodium intake is unwarranted. Moderate sodium restriction is, like other strategies, one therapeutic modality that may be applied, with caution, in individual cases.